Expat insurance and health insurance in the Comoros

The Comorian healthcare system relies on a limited network of public facilities — two district hospitals, two provincial hospitals and one regional hospital, backed by around fifty health posts — with the Centre Hospitalier National El-Maarouf in Moroni as the national reference. This facility, inaugurated in 1954 as the Georges Boussenot hospital, remains hampered by outdated infrastructure; new premises have been under construction since 2017. France Diplomatie states that “the weakness of the healthcare system across the three islands means that, in most medical cases requiring hospitalisation, medical repatriation to better-equipped hospitals is necessary, generally in Réunion and sometimes in Mayotte or mainland France.” No reliable source consulted documents a structured private sector comparable to that of Madagascar or Mauritius: in the absence of a confirmed reference private facility, medical evacuation remains the fallback solution for any serious health problem.

• A visa is mandatory for any stay, issued on arrival at Moroni airport (around €30); the application requires a return ticket and resources of around €30/day, with no specific health insurance formally required on the official pages consulted.
• France Diplomatie describes taking out an assistance contract covering hospitalisation, surgery and medical repatriation/evacuation as essential — costs cannot be covered by the French embassy.
• No specific vaccination requirement identified on France Diplomatie’s health page; vaccinations recommended depending on the traveller’s profile (hepatitis A/B, typhoid fever, rabies, chikungunya, dengue) and antimalarial prophylaxis advised.
• In the absence of a social security agreement, the French state points towards voluntary affiliation to the CFE or private insurance — no CFE rate zone specific to the Comoros could be confirmed by an official source to date.

The Comoros appear on no official CLEISS list: neither among the 45 countries and territories under agreements in force (which include several neighbours such as Madagascar, Mauritania or Senegal), nor among agreements signed but not yet in force (China, Moldova). CLEISS also publishes no dedicated country sheet for the Comoros, unlike Madagascar or Morocco — further evidence of the absence of a bilateral agreement.

In practice, no coordination of social security schemes links France and the Comoros, even partially: no temporary retention of rights, no cover for workplace accidents, no family benefits. A French national in the Comoros must rely entirely on private insurance or voluntary affiliation to the CFE.

• Before departure: check that the policy covers medical evacuation to Réunion — sometimes Mayotte or mainland France —, the most frequent recourse for any hospitalisation according to France Diplomatie, in addition to medical and hospitalisation costs.
• Before departure: medical consultation/vaccination centre visit to assess vaccination needs (hepatitis A/B, typhoid fever, rabies, chikungunya, dengue depending on profile) and antimalarial prophylaxis.
• Check visa arrangements on arrival (Moroni airport, around €30): return ticket and proof of resources (≈€30/day) required.
• Registration with the roll of French nationals living abroad at the French embassy in Moroni is recommended.
• Voluntary affiliation to the CFE or taking out private insurance is recommended in the absence of any social security agreement.