Expat insurance and health insurance in Cuba

Cuba organises its healthcare system around a public national service, free for Cuban citizens, structured around local primary care (family doctor and nurse) then polyclinics and general hospitals. This system, widely documented internationally for its organisation, is in practice not the route to care for a foreign resident or a tourist: the sources consulted do not document registration open to foreigners outside formal local employment.

Foreign residents and tourists are directed to dedicated facilities. The reference, in Havana, is the Clínica Internacional Cira García, a pioneer in caring for international patients in Cuba, with a multilingual team and emergency care open 24/7, seeing patients of around a hundred different nationalities each year. France Diplomatie also notes that international sections exist in Cuban hospitals in most provincial towns, intended for the care of foreign residents and tourists outside the capital.

France Diplomatie notes that Cuban pharmacies are often out of stock and recommends every traveller bring a sufficient supply of their regular medicines for the length of their stay. This operational point comes on top of one with no equivalent in most other destinations: the Cuban authorities do not allow a traveller to leave the country if they have unpaid medical bills, which must be settled by international bank card before departure.

• Mandatory travel/medical insurance: France Diplomatie states it explicitly, insurance covering medical expenses is required by the Cuban authorities for every traveller going to Cuba. The proof usually accepted is a certificate of insurance tied to a bank card; without presentable proof, the traveller must take out cover on the spot, generally from ASISTUR (Asistencia al Turista S.A.), the Cuban tourist assistance agency present at every airport in the country, with no guarantee of a level of cover suited to their situation.
• Tourist stay (e-Visa, up to 90 days): since the paper tourist card (tarjeta de turista) was withdrawn, entry is via an e-Visa for tourism purposes requested online on the official evisacuba.cu portal (fee of around 22 EUR, to be checked when applying, as fees can change), valid for a 90-day stay and renewable once locally for a further 90 days. The passport must remain valid for at least 6 months after the arrival date and an onward/exit ticket is required.
• D’viajeros form: to be completed online within the 72 hours before travel, with the generated document to be presented on both departure and arrival.
• Exit from the country conditional on medical bills: the Cuban authorities do not allow a traveller to leave the country if they have unpaid medical bills; settling them, by international bank card, is required before departure.
• Long-term stays or residency: the exact procedures (study visa, family reunification, investment) are not publicly detailed in the sources consulted for this case; direct verification with the Cuban embassy in Paris remains essential before any plan to settle.
• No working holiday scheme links France and Cuba: the country is not among the fifteen partner destinations listed by France Diplomatie.

Before departure, it is also recommended to check with your bank whether your card can be used in Cuba: several French banks refuse transfers to Cuba and cash machines there frequently run short of cash, according to France Diplomatie.

No social security agreement links France and Cuba. CLEISS publishes no dedicated country factsheet for Cuba among the roughly one hundred country factsheets it maintains, and Cuba does not appear on the list of states and territories linked to France by a bilateral social security agreement.

• No coordination of schemes: no carry-over of rights, no totalisation of contribution periods between the two countries.
• No secondment form (A1, SE…) applies to Cuba.
• Voluntary affiliation with the Caisse des Français de l’étranger (CFE) or private international insurance are the only options for keeping cover recognised in France alongside a stay in Cuba.

For lower-income households, the social services of the French embassy in Havana direct, as at other posts, towards means-tested assistance (aided category) for CFE contributions.

• Before departure, regardless of the length of stay: take out travel/medical insurance covering medical expenses and medical repatriation, the only way to avoid buying cover on the spot from ASISTUR with no guarantee of the level of cover.
• Before departure: keep a printable certificate of this insurance (for example the certificate tied to a bank card), which may be requested on entry.
• Before departure: request the tourist e-Visa online on the official evisacuba.cu portal, check that the passport remains valid for at least 6 months, and have an onward/exit ticket.
• Within the 72 hours before travel: complete the D'viajeros form online and print the generated document.
• Before departure: check with your bank whether your card can be used in Cuba, as some French banks refuse transfers to Cuba.
• During the stay: settle any medical bill by international bank card before leaving the country, as the Cuban authorities do not allow departure with an unpaid medical bill.
• Within 6 months of settling: register with the roll of French nationals living abroad at the French embassy in Havana (free, valid 5 years).
• In the absence of a social security agreement: voluntary affiliation with the CFE (aided category possible subject to means) or private international insurance.