Expat insurance and health insurance in Egypt

Since 2018, Egypt has been pursuing a fundamental reform with law no. 2/2018 on universal health insurance (Universal Health Insurance, UHI), which is meant to eventually replace the old public HIO scheme (Health Insurance Organization, historically reserved for affiliated employees and their dependants). The rollout proceeds governorate by governorate on a schedule planned through 2032: Port Said (pilot, 2019), Luxor (2021), Ismailia (2022), South Sinai (2024), before extending to the Greater Cairo and Alexandria governorates. This scheme targets the Egyptian population and local contributors; it does not automatically open rights to an unaffiliated foreign resident. In practice, the public sector (university hospitals, Ministry of Health hospitals) remains uneven in equipment and waiting times, while the private sector, concentrated in Cairo and Alexandria, accounts for most of what foreign residents use, with facilities of international standard but rates borne by the patient in the absence of insurance.

• Short tourist stay: visa required (about one month, obtained at the Egyptian consulate in France or on arrival), no health insurance is legally required to obtain it. France Diplomatie nonetheless strongly recommends an assistance policy covering medical expenses, surgery, hospitalisation and repatriation, as costs can under no circumstances be covered by the embassy.
• Long-term move: beyond the validity of the tourist visa, a residence permit must be obtained from the Egyptian authorities; no Egyptian legal requirement for minimum health insurance has been identified for this type of permit at this stage of research — to be confirmed case by case with the consulate or the host employer/school.
• Locally hired employee: affiliation through the employer possible depending on the scheme in force in the governorate (the historical HIO or UHI depending on the rollout phase).
• Seconded employee: no France-Egypt social security agreement, so no form for staying on the French scheme equivalent to those existing with Morocco or Tunisia — cover relies entirely on private insurance or the CFE.
• Lack of cover: no specific fine identified on entry, but private clinics generally require a payment guarantee or a deposit before a planned hospitalisation.

No bilateral social security agreement exists between France and Egypt — confirmed by the absence of Egypt from the list of agreements in force or signed published by CLEISS. Unlike Morocco or Tunisia, there is therefore neither a scheme coordination mechanism, nor a form for staying on the French scheme for a seconded employee, nor any possibility for a retiree to activate local cover on the basis of a French pension.

• A French national staying, on assignment or settled in Egypt remains, for any local medical care, dependent on private insurance or the Caisse des Français de l’étranger (CFE), which alone does not reimburse at the level of rates charged by Egyptian private providers and generally needs to be supplemented with health insurance.
• Unforeseen emergency care can, on presentation of supporting documents, be the subject of a retroactive reimbursement claim with the original French fund (CPAM), based on the rates and caps applied in France — never at the level of the cost actually billed locally.
• The absence of an agreement makes private insurance particularly necessary as soon as you settle, including for profiles that would benefit from exemptions in other countries in the region (Morocco, Tunisia).

• Before departure: take out private insurance or check your CFE cover, as no Franco-Egyptian agreement can substitute for it.
• Before departure: update your vaccination record (standard French vaccines, hepatitis A/B, typhoid, meningitis ACWY depending on the stay profile).
• On arrival for a short stay: visa obtained at the consulate or on arrival, valid for about one month, extendable locally.
• For a long-term move: start residence permit procedures with the competent Egyptian authorities; check with the French consulate for up-to-date requirements.
• Within 6 months of arrival: register with the roll of French nationals living abroad (consulates in Cairo and Alexandria), free, recommended for any later consular procedure.