Expat insurance and health insurance in Chile

The Chilean healthcare system relies on a mandatory contribution of 7% of salary, which every formally employed worker must pay either to FONASA (Fondo Nacional de Salud, the public insurer) or to an ISAPRE (Institución de Salud Previsional, one of the competing private insurers). FONASA now covers around 85% of the population and splits its members into four income tiers (A to D), with tier A (people with no income) getting free access to the public network. ISAPREs sell individual plans with medical underwriting at entry: they cover a steadily shrinking population (around 2.5 million members at the end of 2025, against nearly a third more five years earlier), in exchange for faster access to private clinics.

A foreign resident can join FONASA or an ISAPRE under the same conditions as a Chilean national, provided they have an identification number (RUT). An employee under contract has their 7% contribution automatically deducted by their employer as soon as they obtain a residence permit, or even while their residence application is being processed: a provisional RUT and FONASA affiliation remain accessible at this stage, including for someone without formal employment declared as having no income. Outside this framework, healthcare access for a foreigner without resident status depends on individual facilities and is not guaranteed by any scheme equivalent to the French Sécurité sociale.

Santiago’s private clinics (Clínica Alemana, Clínica Las Condes, Clínica Santa María, Clínica Indisa) offer facilities and a standard of care comparable to European standards, but at high prices, with a payment guarantee systematically required on admission — whether insured or not. Chilean law, however, requires emergency facilities to treat every patient regardless of insurance status, with billing taking place after treatment.

• Tourist stay (under 90 days): no health insurance is legally required to enter the country; France Diplomatie nonetheless describes it as essential in practice, since the embassy cannot cover costs in the event of hospitalisation.
• Working Holiday Programme (PVT) : bilateral France-Chile agreement signed in Paris on 8 June 2015, in force since 1 November 2015, open to those aged 18 to 30 (the age condition varies across the sources consulted and should be reconfirmed before applying), annual quota of 400 places (never reached to date), 12-month stay once the visa is activated. Mandatory insurance covering the entire stay is required in the application; no minimum guarantee amount is set by the texts consulted, but an incomplete insurance file is a frequent cause of refusal. A minimum savings amount of €2,500 is also required in the application.
• Temporary or permanent residence: the Servicio Nacional de Migraciones (SERMIG) does not systematically require proof of health insurance for every category of temporary residence; however, filing a permit application opens access to a RUT (provisional, then permanent) and to FONASA affiliation, even before the permit itself is granted.
• Seconded employees and other temporary residents: as soon as formal employment is declared, the 7% contribution is automatically deducted and allocated to FONASA by default, unless the employee explicitly chooses an ISAPRE.

No official fixed fine has been identified for simply lacking coverage outside the PVT; the documented risk is full billing for non-urgent care in the private sector, with a payment guarantee required upon admission.

A general social security agreement between France and Chile was signed in Santiago on 25 June 1999 and entered into force on 1 September 2001, supplemented by an administrative arrangement dated 22 October 1999. CLEISS handles liaison on the French side.

• Scope covered: old age, disability and survivors (totalisation of insurance periods in both countries), as well as healthcare, but this last part only benefits pension or annuity holders residing in the other State. Workplace accidents and unemployment insurance are not coordinated by this agreement.
• For a working expatriate in Chile, CLEISS is explicit: « the Franco-Chilean agreement makes no provision for coordination on health and maternity insurance ». An employee therefore falls entirely under Chilean law (FONASA or ISAPRE affiliation) for themselves, with no coordinated coverage for family remaining in France and no cover for a stay or a birth in France on account of their Chilean employment.
• An employee seconded strictly under the terms of the agreement may remain subject to the French scheme for a limited period, but this does not remove the need to check actual access to care on the ground, since the agreement does not coordinate this aspect for working people.

CLEISS does not issue an explicit fallback recommendation for Chile as it does for other countries; in practice, in the absence of health coordination for working people, voluntary membership of the Caisse des Français de l’étranger (CFE) or international private insurance remain the most commonly cited solutions to fill this gap, before or alongside local affiliation with FONASA or an ISAPRE.

• Before departure: take out insurance covering medical expenses, hospitalisation and medical repatriation, whatever the length of stay planned.
• For a PVT: put together the application with insurance valid for the entire stay and proof of a minimum of €2,500 in savings, before filing the application.
• For a stay of more than 90 days: start the temporary residence process with the Servicio Nacional de Migraciones (tramites.extranjeria.gob.cl) before the visa-free period expires.
• As soon as the residence application is filed: request a RUT (provisional then permanent) and FONASA affiliation, or direct the 7% contribution to an ISAPRE if that choice is made.
• Within 6 months of arrival: register with the roll of French nationals living abroad at the general consulate in Santiago (free, valid for 5 years, recommended).
• For a retiree: check directly with CLEISS and your French pension fund on how the “healthcare” section of the agreement applies, before leaving.