Expat insurance and health insurance in Burundi

France Diplomatie generally describes Burundi’s medical and hospital infrastructure as failing. The country nonetheless has a national health insurance scheme, the Health Insurance Card (CAM), created as early as 1984 for informal-sector populations and later made mandatory by a joint inter-ministerial order (Interior/Security, Finance/Budget, Public Health) of 7 February 2025, for every household and every adult not already covered by another scheme (civil service mutual fund, community mutual fund). Its base cost is 3,000 BIF, with an announced coverage of 80% of routine care costs (consultations, hospitalisation, generic medicines), the remaining 20% staying at the patient’s expense as a co-payment, and certain procedures such as surgery still billed at 100%. The rollout of this requirement has been the subject of local press reports of a number of cards available falling short of demand in certain provinces. The civil service mutual fund also covers state and semi-public sector employees, around 10% of the population according to available estimates. This scheme, designed for Burundi’s resident population, in no way constitutes cover recognised in France nor a substitute for medical repatriation for a French national.

In Bujumbura, Prince Regent Charles Hospital, a public facility opened in 1949, is the country’s largest hospital with more than 600 beds and national reference hospital status. CHUK (the Kamenge University Hospital Centre), also known as King Khaled Hospital, is the capital’s second reference university hospital. The private sector remains limited: Kira Hospital, opened in 2015 with Swiss funding, a local insurance company and private investors, offers specialised services previously unavailable in the country. None of these facilities is presented by France Diplomatie as meeting European standards of care quality and diagnosis.

• Mandatory visa: online application (e-visa) with Burundian authorities (migration.gov.bi) before departure, or issued on arrival at Bujumbura airport for a payment of USD 90. France Diplomatie strongly recommends keeping a printed copy of the certificate generated and emailed after validation.
• Duration: one month maximum, with the possibility of extension locally with the local authorities.
• Mandatory yellow fever vaccination, to be carried out at an approved centre, with an international certificate to be presented on entry.
• Vaccinations recommended depending on profile and length of stay, according to France Diplomatie: hepatitis A and B, typhoid fever, meningitis ACWY, rabies, tuberculosis for children under 15, and Mpox depending on exposure.
• Malaria transmission is present year-round, with a resurgence from December to May: chemoprophylaxis to be determined with a travel doctor before departure.
• No specifically named legal health insurance requirement for entry, but France Diplomatie describes as essential taking out a contract covering medical costs, hospitalisation and medical evacuation, as the embassy does not cover any costs.
• CFE recommended, as no Franco-Burundian agreement coordinates the health branch.

Context, covered here solely from the angle of access to care and travel: France Diplomatie formally advises against the entire border with the Democratic Republic of Congo (the road to Gatumba and the associated border post, open during daytime only), as well as certain areas near the Rwandan border and the northern part of Kibira National Park. Other areas, notably the centre of the Kibira forest and the areas near the Congolese border, are classified as advised against except for essential travel. The rest of the territory, including Bujumbura, is placed under heightened vigilance, with night-time travel restrictions recommended in both the capital and the provinces. The land border between Burundi and Rwanda has been closed since 11 January 2024 (air links are not affected). The French embassy in Bujumbura operates normally, by appointment.

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

• No form for maintaining French rights applies in Burundi.
• No aggregation of insurance periods, no exporting of rights.
• Registering with the CFE or taking out private international insurance are the only routes to cover recognised by a French system, whatever the profile.
• The Health Insurance Card (CAM) is a scheme designed for Burundi’s resident population; even where a foreign resident can be locally affiliated to it, it constitutes neither cover recognised in France nor a substitute for medical repatriation.

• Before departure: apply for an e-visa online (migration.gov.bi) or prepare payment of USD 90 for a visa on arrival, and keep a printed copy of the certificate received by email.
• Before departure: take out insurance or an assistance contract covering hospitalisation and medical evacuation, given the lack of any Franco-Burundian coordination and the local infrastructure described as failing.
• Before departure: medical consultation / vaccination centre for yellow fever (mandatory), hepatitis A and B, typhoid fever, meningitis ACWY, and malaria prophylaxis.
• Before any trip: check France Diplomatie’s regularly updated travel advice, as certain border areas are formally advised against or advised against except for essential travel.
• Voluntary CFE registration recommended in the absence of any health coordination.
• In the months following arrival: register with the roll of French nationals living abroad, at the French embassy in Bujumbura (open by appointment).