Expat insurance and health insurance in Antigua and Barbuda

The Ministry of Health, Wellness and the Environment oversees the public health system, which relies on community health centres, polyclinics, an emergency medical service and a reference facility in St. John's: the Sir Lester Bird Medical Centre, formerly Mount St. John's Medical Centre, presented on its website as the country's main referral hospital, with emergency care open 24 hours a day, imaging, surgery, a maternity unit and a dialysis service.

Alongside it, the Medical Benefits Scheme (MBS) is the local medical benefits scheme. It works on monthly contributions (employees, employers, self-employed workers, and unemployed people aged 16 to 69 who register voluntarily) and reimburses in particular tests, imaging examinations, procedures carried out in a doctor's office, hospitalisation and medicines; consultations are only reimbursed for a list of eleven illnesses. At least six months of contributions are required before benefits can be claimed. The spouse and children are not covered by the insured person's contributions: each beneficiary has their own card. The scheme also accepts claims for care received abroad.

France Diplomatie states that some hospitals ask for payment in advance, that the French embassy cannot pay medical costs, and that the country has only one decompression chamber, which means checking that your insurance covers diving if you practise it. MBS contribution amounts do not appear on the pages consulted: they have to be requested directly from the body.

• Stay of less than six months: no visa is required for a French national, according to France Diplomatie. Beyond six months, a residence permit application is necessary.
• Passport: it must be valid for at least six months from the date of entry; the national ID card is not sufficient.
• Supporting documents on entry: a return ticket is required and proof of sufficient funds may be requested.
• Health restriction: France Diplomatie reports a ban on entry for travellers who have stayed in Guinea, Liberia or Sierra Leone in the 21 days before arrival (Ebola virus). Covid-19 restrictions have been lifted.
• Health insurance: France Diplomatie requires cover for medical costs, hospitalisation and medical repatriation. No obligation to hold private insurance in order to enter the territory is mentioned in the sources consulted.
• Local affiliation: for a non-national, registration with the Medical Benefits Scheme requires twelve consecutive months of legal residence, a local social security card, then at least six months of contributions before any benefit is paid. A new arrival is therefore not covered locally for several months.
• Student: no European Health Insurance Card, as the country is outside the European Union; a student insurance or comprehensive travel insurance must be taken out before departure.
• Seconded employee : with no social security agreement, the applicable scheme and the conditions for continuing on the French scheme are to be checked with CLEISS and the French fund before departure. Affiliation with the Caisse des Français de l'Étranger (CFE) and an assistance policy remain worth considering.
• Retiree: no agreement procedure exists; health cover is arranged through private or voluntary insurance, taking into account the twelve-month legal residence period before any local registration.

No individual fine for lacking health insurance is mentioned in the sources consulted. The risk is financial: with no agreement, no immediate local affiliation and no help available from the French embassy, uncovered care remains payable by the person concerned.

As Antigua and Barbuda is not a member of the European Union, coordination does not run through EU regulations 883/2004 and 987/2009. Above all, CLEISS records no bilateral social security agreement between France and Antigua and Barbuda: the country appears neither in the list of agreements in force nor in that of agreements signed but not yet in force, and CLEISS does not publish a page on the local scheme.

• Temporary stay: no form allows direct on-the-spot cover. Costs advanced remain payable by the traveller; the conditions for any reimbursement on return should be requested from your health insurance fund before departure.
• Secondment or expatriation: with no agreement, the applicable legislation depends on French and local rules, to be confirmed with CLEISS and your fund before leaving.
• Retirement: no agreement-type certificate is provided for. The Medical Benefits Scheme only opens after twelve months of legal residence for a non-national.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Take out insurance covering medical costs, hospitalisation and medical repatriation, which France Diplomatie considers essential and which the embassy cannot replace; check that it covers diving if you practise it.
3. Check that your passport is valid for at least six months after the date of entry (the national ID card is not accepted) and plan for a return ticket.
4. See your doctor or a vaccination centre before departure: France Diplomatie mentions the presence of dengue, chikungunya and Zika, and a yellow fever vaccination required when arriving from an endemic area.
5. For a stay of more than six months: apply for a residence permit with the local immigration authorities.
6. Seconded employee or long-term move: ask CLEISS and your health insurance fund about the applicable scheme in the absence of an agreement.
7. After settling in: enquire with the Medical Benefits Scheme (registration after twelve months of legal residence, social security card, six months of contributions).
8. From June to the end of November (hurricane season): follow the instructions of the local authorities, as France Diplomatie reports possible disruption to essential services.
9. Register with the roll of French nationals living abroad; Antigua and Barbuda falls under the French embassy in Saint Lucia (Castries), and a consular agency exists in St. John's.