Expat insurance and health insurance in Botswana

The Botswana National Health Service (BNHS) runs almost all of the country’s health facilities — the government reportedly manages around 98% of medical facilities according to specialised sources — and provides near-free public care to Botswana citizens, largely funded by revenue from the diamond industry: a nominal fee, in the range of 5 to 70 BWP depending on the type of procedure, generally applies, with sexual and reproductive health services and antiretroviral treatments remaining free. Foreigners, including expatriate residents, have access to the same public network but pay a higher subsidised fee, around 70 USD per consultation according to brokers specialising in expat health insurance — a figure to be checked case by case, as no official fee schedule was identified. Princess Marina Hospital, in Gaborone, the country’s leading public teaching hospital, affiliated with the University of Botswana’s faculty of medicine, is the largest hospital in the country with around 530 beds; the Sir Ketumile Masire Teaching Hospital, the capital’s second public university hospital, opened in 2014 (around 450 beds), rounds out the national referral offering. There is no compulsory national health insurance scheme comparable to Zambia’s NHIMA: formally employed residents most often turn to a private medical aid fund, generally taken out through their employer — Bomaid and Pula Medical Aid Fund are among the most widely used in the private sector, with the Botswana Public Officers Medical Aid Scheme (BPOMAS) reserved for civil servants. These funds give access to the private sector, more developed in Gaborone: Life Gaborone Private Hospital (132 beds, 4 operating theatres, a neonatal unit and an oncology unit, part of the South African Life Healthcare group) and Bokamoso Private Hospital (235 beds, in Mmopane, around 15 km west of Gaborone, part of the Lenmed group, the country’s first COHSASA-accredited private hospital) are the two main facilities.

France Diplomatie describes taking out insurance or an assistance contract covering medical costs, surgery, hospitalisation and medical repatriation as essential, and notes that “repatriations are most often carried out to hospital facilities in Johannesburg”, in South Africa, with the embassy covering no costs. The site flags an endemic malaria risk in the northern districts (Ngamiland, Okavango, Chobe, Boteti, Tutume), an intermediate risk in the centre and east, and a very low risk in the south, around Gaborone; other vector-borne diseases also circulate (dengue, chikungunya, zika, yellow fever), along with typhoid fever, hepatitis A, poliomyelitis, rabies and tuberculosis. The public healthcare system also went through a medicine shortage in summer 2025 (treatments for hypertension, diabetes, cancer, tuberculosis, dressings and sutures) serious enough for President Duma Boko to declare a health emergency on 25 August 2025, a situation the press attributed to falling diamond revenue funding the healthcare system and to reduced US health aid — an episode that strengthens the case for international private cover rather than exclusive reliance on the local public sector.

• No visa is required for French nationals for a tourist stay: a free entry stamp is issued at the border (international airports and land border posts), generally granting up to 3 months’ stay, with the exact length left to the discretion of the immigration officer according to France Diplomatie.
• A passport valid for at least 6 months after the date of entry into the country is required.
• Stay of more than 3 months: a residence permit is mandatory, its issuance conditional on presenting an employment contract (one’s own or a spouse’s); no visa or permit dedicated to remote workers (“digital nomads”) has been identified to date.
• France Diplomatie describes taking out insurance or an assistance contract covering medical costs, surgery, hospitalisation and medical repatriation as essential, as repatriations are most often carried out to Johannesburg and the embassy covers no costs.
• Minors: a full, certified copy of the child’s birth certificate (or a multilingual birth certificate) is required in addition to the passport; when travelling with a single parent, a travel authorisation signed by the absent parent is required.
• Malaria: endemic risk in the northern districts (Ngamiland, Okavango, Chobe, Boteti, Tutume), intermediate risk in the centre and east; suitable antimalarial prophylaxis is recommended before a stay in these areas.
• No yellow fever vaccination requirement has been identified on the official France Diplomatie pages devoted to Botswana; to be checked case by case depending on the country of origin or transit, as the disease is otherwise among the vector-borne risks flagged in the country.

No bilateral social security agreement between France and Botswana has been identified. CLEISS lists only 16 African countries and territories that have signed such an agreement with France (Algeria, Benin, Cameroon, Cape Verde, Congo, Côte d’Ivoire, Gabon, Madagascar, Mali, Morocco, Mauritania, Mayotte, Niger, Senegal, Togo, Tunisia) — Botswana is not among them. In the absence of any agreement, there is no coordination for sickness, maternity, old age or family benefits between the two schemes.

• No French rights-continuation form applies in Botswana.
• Affiliation with the CFE or taking out international private insurance are the only routes to cover recognised by a French scheme, whatever the profile.
• Access to the BNHS public network on payment of the subsidised fee applicable to foreigners, or possible membership of a private medical aid fund (Bomaid, Pula Medical Aid Fund) through a Botswanan employer, gives access to the local care network but is neither cover recognised in France nor a substitute for medical repatriation.
• The French embassy in Gaborone has had no consular section since 1 June 2016: the administrative procedures of French residents in Botswana fall to the Consulate General of France in Johannesburg (South Africa), with consular outreach sessions organised roughly every three months and an honorary consul based in Maun.

• Before departure, whatever the purpose of the trip: take out an insurance or assistance contract covering hospitalisation and medical repatriation, given the absence of any Franco-Botswanan coordination; entry itself requires no visa procedure for a tourist stay of less than 3 months.
• For any minor travelling with a single parent: prepare the certified birth certificate and the travel authorisation signed by the absent parent.
• Before departure: a medical consultation/vaccination centre visit to assess the need for yellow fever vaccination (depending on origin and transit), hepatitis A and B, typhoid fever, rabies, and antimalarial prophylaxis for a stay in the northern districts (Ngamiland, Okavango, Chobe, Boteti, Tutume).
• For a stay of more than 3 months or a professional activity: start the residence permit procedure backed by an employment contract, well in advance, with the relevant Botswanan authorities.
• Formally employed staff: check with your employer whether you are enrolled in a private medical aid fund (Bomaid, Pula Medical Aid Fund, or BPOMAS for civil servants), as a complement — never a replacement — to cover recognised in France.
• Voluntary affiliation with the CFE recommended given the absence of any health coordination.
• Within 6 months of arrival: register with the roll of French nationals living abroad; as the French embassy in Gaborone has had no consular section since 2016, procedures fall to the Consulate General of France in Johannesburg, with consular outreach sessions organised roughly every three months and an honorary consul based in Maun.