Expat insurance and health insurance in Bermuda

Bermuda's health system combines mainly insurance-based funding with a central public hospital. According to the national health accounts published by the Bermuda Health Council, total expenditure is 22.6% funded by the public sector (including 21.9% by the Ministry of Health), 61.5% by health insurance, 14.9% by households' out-of-pocket payments and 0.9% by donations. Spending on care abroad accounted for 12.6% of the total, and the Bermuda Hospitals Board (BHB), classed in the public sector, for 41.7%.

The Bermuda Health Council, created in 2006 by the 2004 Act, coordinates and regulates the system: it approves insurers, registers health professionals, regulates fees and publishes the standard premium rates each year. At the heart of the arrangement is the Standard Health Benefit (SHB), a basic package that every policy must include, whose content and premium (Standard Premium Rate) are set each year by the Minister of Health. It comprises ten categories of benefits, with no co-payment or extra billing for these services, and the government covers 100% of the SHB hospital services for people under 19.

The Health Insurance Department runs two public plans, the Health Insurance Plan (HIP, ages 18 and over) and FutureCare (ages 65 and over), open to all residents. Hospital care is provided by the BHB, which includes the King Edward VII Memorial Hospital (KEMH), the Mid-Atlantic Wellness Institute and the Lamb Foggo urgent care centre. A statement from the Ministry of Health and the BHB specifies that the KEMH is the only emergency department in the territory. As no France Diplomatie health advice page was found for Bermuda, an assistance contract with medical evacuation remains to be considered: the public plans exclude air ambulance transport for care abroad.

• Tourist stay: the government states that travel authorisations have no longer been required since 14 November 2022 and that all arriving non-residents must complete the Bermuda Arrival Card, which is digital, free of charge and involves no approval procedure; cruise passengers are exempt. French nationals are not among the nationalities listed in the Prohibition of Entry Order (No. 2) of 17 July 2025; the version in force should be checked on gov.bm before departure.
• Length of stay: the Department of Immigration stated a maximum tourist stay of 180 days since 1 August 2020 and a passport valid for 45 days after the planned departure date for extensions. These rules should be reconfirmed with the Department before a long stay.
• Work: any non-Bermudian (other than the spouse of a Bermudian and holders of a permanent resident's certificate) must hold a work permit applied for online by the employer, before starting any activity; the standard permit lasts from 1 to 5 years.
• Employee health insurance: the employer must insure any employee who works more than 15 hours a week for more than two months a year, as well as their non-working spouse, with an approved local insurer, from the first day of employment. The Bermuda Health Council specifies that basic cover must come from an approved local insurer and that providers do not accept foreign insurance for this cover. The official labour guide provides for the employer to pay at least 50% of the premium.
• Resident without a job: the HIP is open to all residents aged 18 and over; the Health Insurance Department serves residents who are not civil servants, as government employees come under a separate scheme.
• Student: the European Health Insurance Card does not exist for this territory, which is not in the European Union; a student insurance or the HIP, which offers basic cover, should be compared depending on the length of stay.
• Seconded employee : stays on the French scheme, according to CLEISS, for three years renewable once, with reimbursement up to what the French scheme provides on paid invoices (form S 3125c). Membership of the Caisse des Français de l'Étranger (CFE) remains an optional top-up.
• Retiree: CLEISS points to local institutions, voluntary membership of the CFE or private insurance; no S1 form exists, as this territory is not in the European Union.
• Hurricanes: the hurricane season runs from 1 June to 30 November; the government broadcasts its instructions on the emergency station 100.1 FM and recommends checking your home insurance.

No individual fine is mentioned in the sources consulted for a resident's failure to have health insurance; the legal obligation rests on the employer, who is liable for medical expenses incurred during a period without cover (Bermuda Health Council).

Bermuda is not in the European Union, and CLEISS lists it neither among the States linked to France by a social security agreement nor among the territories covered by the European regulations: for a temporary stay, it falls under the category “other countries or situations not covered”. The CLEISS page on the United Kingdom scheme does not mention Bermuda. Without an agreement, no cover is arranged between the funds.

• Temporary stay: CLEISS states that reimbursement on return to France of unforeseen care is a possibility and not an entitlement, that medical repatriation is not covered by health insurance, and that it is prudent to take out travel insurance suited to the real cost of care.
• Secondment: the employee remains affiliated to the French scheme, three years renewable once; contributions are paid in France as if they worked there, but they may also have to pay those of the host country. Care is covered up to what they would have received in France (form S 3125c with paid invoices).
• Expatriation: the employee comes under the local scheme and leaves the French scheme; they can join the CFE voluntarily for sickness cover. Without an agreement, France does not take local periods into account when calculating the French pension.
• Retiree: CLEISS recommends checking local cover, choosing the CFE or private insurance, and points out that a retiree who is not tax resident in France pays neither CSG, nor CRDS, nor Casa.
• Taxation: the BOFiP list of tax treaties in force does not include Bermuda. An agreement in the form of an exchange of letters on the exchange of tax information, signed in Paris on 2 October 2009 and in Hamilton on 8 October 2009, has been in force since 28 October 2010 (decree no. 2010-1467): it does not allocate taxing rights between the two States. Tax residence remains defined by article 4 B of the French General Tax Code (home or main place of stay, professional activity, centre of economic interests).

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds) and choose your cover according to your status.
2. Check the entry rules on gov.bm (prohibition of entry order, arrival card, length of stay).
3. Employee: have the employer submit the work permit application before arrival and obtain the written contract (statement of employment), which details the health insurance.
4. Seconded employee: request attachment to the French scheme from your employer and your fund; keep paid invoices for form S 3125c.
5. Resident without an employer: contact the Health Insurance Department (HIP) or consider the CFE and international insurance.
6. Retiree: prepare health cover and the residence procedure with the Department of Immigration before departure.
7. Family: arrange insurance for your spouse and children (the HIP has a rate for young people up to 18, or 21 for a full-time student at a local institution).
8. Register on the roll of French nationals living abroad via service-public, with the Consulate General of France in New York.
9. Hurricanes: prepare a family plan and an emergency kit before 1 June.