Curaçao's Healthcare System: Basic Insurance, General Practitioner, Hospital and Emergencies

Curaçao has been an autonomous country of the Kingdom of the Netherlands since 2010 and defines its own health organisation (CBS Curaçao). The national law on care facilities provides that hospitals are designated by decree. The decree of 19 June 2019 designates four hospital facilities: the Curaçao Medical Center, the Dr David Ricardo Capriles psychiatric hospital, a general hospital and the Sint Elisabeth hospital, whose designation is to end on a date set later, because the Curaçao Medical Center replaces it as the island’s central hospital.

The Sociale Verzekeringsbank (SVB), the island’s social protection body, carries out the BVZ for the right to care. The official sources consulted do not detail the split between public and private facilities beyond these designations; the general practitioner, specialists and facilities are chosen within the framework of affiliation with the SVB.

The basisverzekering ziektekosten covers all residents: the law provides that a person who is ingezetene, that is a resident, is insured. A French national settled in Curaçao with a valid residence permit therefore falls under the BVZ. The SVB lists among the uninsured people those who are not authorised to stay on the island (without a temporary or permanent residence permit), people exempt from contributions by international obligations, those who work outside Curaçao for an entity of the Kingdom while proving their cover, and certain people already covered in 2013 by private or foreign insurance of at least equivalent level. The pages consulted describe no registration procedure for a new arrival: the employee approaches their employer, which withholds the employee share of premiums, and the SVB (telephone (599-9) 434-4000).

The SVB table sets the BVZ premium at 13.6% of income for an employee (9.3% paid by the employer and 4.3% by the employee), 6.5% for a retiree and 13.6% for a self-employed person, with an income ceiling of Cg 150,000. Social protection also includes the AVBZ (2%), which funds long-term care, often for life, for people with chronic illnesses or disabilities; it came into force on 1 January 1997. Supplementary benefits managed by the SVB are reserved for civil servants and similar. For others, private supplementary insurance or the Caisse des Français de l’Étranger (CFE, the French overseas nationals’ health fund) extends the BVZ.

Each insured person is linked to a single general practitioner (huisarts), who can be changed once a year in September. The general practitioner covers consultations, visits, prescriptions, minor surgery and laboratory tests. They issue the referral letter, valid for six months, needed to see a specialist, to be admitted to hospital or for care such as dialysis or rehabilitation. The first outpatient consultation at the Curaçao Medical Center also requires a referral letter, and the appointment is made by calling the clinic concerned.

The BVZ covers the first-line psychologist (intake interview, treatment plan and five sessions, extension possible on request), physiotherapy (first four sessions, then prior approval), and speech therapy and occupational therapy on prescription. Dental care is covered subject to income (less than NAf 12,000 a year for adults over 18), with no condition for minors, low-income people and retirees; it includes annual prevention, scaling, fluoride, fillings, dentures and extractions. Glasses are reimbursed every two years, with a frame up to NAf 90 and lenses on prescription. The detail by item appears in the page healthcare reimbursement in Curaçao.

The Curaçao Medical Center (CMC), in Otrobanda (Willemstad), was commissioned in 2019 to replace the Sint Elisabeth hospital as Curaçao’s central hospital. It presents itself as the island’s main provider of specialised and high-level clinical care, with clinics in cardiology, oncology and haematology, radiotherapy, nephrology and dialysis, neurology, paediatrics, obstetrics and gynaecology, orthopaedics, surgery and intensive care, among others, as well as a hyperbaric chamber and alliances with Dutch university hospital centres.

The emergency department is open 24 hours a day all year round. You first present at reception; an emergency nurse carries out triage, then the patient is treated by teams trained in emergency care. The department has 7 treatment rooms and 2 large trauma and resuscitation rooms, and a stay of more than four hours in principle leads to admission to an acute care unit. You should bring an identity document (sédula or passport), the SVB or insurer registration certificate, any letter from the general practitioner and a list of medicines. In case of life-threatening danger, the CMC asks you to dial 910; 912 is the number of the ambulance service, presented as free. The hospital’s general number is +599 9 745 0000.

Under the BVZ, prescribed medicines are covered outside the negative list, with a co-payment of 1 florin per prescription line. The maximum dispensing periods vary with the treatment: one year for the contraceptive pill, three months for chronic diseases, 15 days for antibiotics and one month in other cases. Some contraceptives are excluded, with exceptions, and medicines that can be replaced by a cheaper equivalent are not reimbursed. Diabetes supplies, oxygen or CPAP devices fall under aids and prostheses, subject to prior approval.

When a treatment is impossible in Curaçao or vital, the BVZ can fund care abroad, on the advice of a local specialist and with the agreement of the medical referrals board: medical costs, tickets, daily allowances, transport and accommodation are then included. This scheme does not replace an assistance policy: repatriation to France, at the traveller’s or their family’s initiative, is prepared with an assistance policy.

France Diplomatie recommends, depending on the conditions and length of stay in the Dutch islands, vaccines against hepatitis A and typhoid fever, and advises hepatitis B for frequent or prolonged stays. Dengue, a mosquito-borne disease, is reported in the overseas territories; it has no curative treatment, a doctor should be seen immediately in case of symptoms and anti-inflammatory drugs avoided. Chikungunya, also mosquito-borne, receives symptomatic treatment, and prevention rests on vaccination and protection against bites. Aruba, Bonaire, Curaçao and Sint Maarten were affected by Zika in 2015 and 2016. A yellow fever vaccination certificate may be required depending on the route: France Diplomatie publishes an annex on the countries concerned, to be consulted before departure.

On the environment, the Curaçao Meteorological Service describes a semi-arid climate, with a dry season from February to May and a rainy season from October to January; the hurricane season runs from 1 June to 30 November. An assistance policy covering medical costs and repatriation remains essential according to France Diplomatie, including for a short stay.