Expat insurance and health insurance in the Congo

The Congolese healthcare system falls under the Ministry of Health and Population and relies on a public hospital network supplemented by private and faith-based facilities, concentrated mainly in Brazzaville and Pointe-Noire. The Centre hospitalier universitaire de Brazzaville (CHU-B), created from the transformation of the former Brazzaville general hospital by law no. 008-87 of 7 February 1987, is the reference facility: around thirty specialties, an emergency department and a teaching link with Marien-Ngouabi University. Its reputation nonetheless remains mixed: several sources document recurring criticism of the quality of care and reception conditions, against a backdrop of work overload and limited resources, alongside ongoing modernisation projects (notably with the support of the French Development Agency). Brazzaville also has the Pierre Mobengo central army hospital, the Bacongo base hospital, the Djiri general hospital, the Talangaï hospital, and several private clinics (Clinique Pasteur, Clinique Médicale de Brazzaville, Clinique Cogemo, Les Rosiers, Oregon, Securex, Netcare). In Pointe-Noire, the economic capital, the main public facilities are the Adolphe Sicé general hospital, the Loandjili hospital and the Tié-Tié base hospital, supplemented by private clinics. If needed, a French resident can also turn to the medico-social centre of the French embassy in Brazzaville. Given the limits of local technical facilities for serious conditions (complex surgery, interventional cardiology, oncology), medical evacuation abroad remains common for severe cases.

• Mandatory visa before departure for every traveller, except holders of diplomatic passports; no visa is issued on arrival. The application must be submitted and paid exclusively online, with the Congolese embassy in Paris.
• Visa duration: between 15 and 91 days. Processing time of 7 days under standard procedure, 3 days under express procedure.
• Proof of accommodation (issued by a Congolese district town hall) or a paid hotel booking is mandatory to obtain the visa, documents to be presented on entry into the country.
• Yellow fever vaccination mandatory for adults and children over 9 months old, to be done at least 10 days before departure at an approved centre; the international vaccination booklet may be checked on entry into Congolese territory.
• No explicitly named legal health insurance requirement for entry or stay, but France Diplomatie describes cover for medical costs, surgery, hospitalisation and medical repatriation as “essential”, warning that access to care may otherwise be denied in a life-threatening emergency.

These costs can never be covered by the French embassy on site. Social assistance (monthly, annual, specific or exceptional) may be granted by the consular post to French residents depending on their situation and resources, independently of health cover.

The general France-Congo social security agreement, signed on 11 February 1987 and in force since 1 June 1988, applies to nationals of either state who carry out or have carried out salaried work, as well as their dependants (Art. 4). It therefore does not coordinate the situation of self-employed workers or residents without salaried work in either country.

• Health and death insurance: the agreement contains no coordination provision for these branches, so no reimbursement of care received in the Congo under French health insurance. Only Protocol No. 1 of 11 February 1987 allows benefits in kind and in cash under health insurance to be maintained for a period limited to 6 months when transferring residence.
• Maternity: totalling of insurance periods to establish entitlement, and compensated transfer of residence for a salaried woman who temporarily returns to her home country.
• Disability, old age-survivors, workplace accidents and occupational diseases: export of benefits, taking into account insurance periods completed in the other state if needed to establish entitlement.
• Family benefits: children of a worker residing in the other state receive family benefits from their state of residence.
• Unemployment insurance is explicitly excluded from the agreement's scope.

In practice, for a French resident in the Congo, this agreement does not replace effective health cover on the ground: only the Caisse des Français de l’Étranger (CFE) or private international health insurance allow real reimbursement of care received in the Congo.

1. Before departure, regardless of the purpose: take out health and repatriation insurance, since the France-Congo agreement does not coordinate health cover.
2. Get vaccinated against yellow fever at least 10 days before departure, at an approved centre, and keep the international vaccination booklet.
3. Apply for the visa online with the Congolese embassy in Paris, with proof of accommodation or a paid hotel booking.
4. Seconded employees covered by the agreement: check with the employer the terms for maintaining health benefits during the 6 months under Protocol No. 1.
5. In the months following settlement: register with the roll of French nationals living abroad at the French embassy in Brazzaville or the consulate general in Pointe-Noire, free of charge and recommended.