Expat insurance and health insurance in Ghana

The National Health Insurance Scheme (NHIS) was created by the National Health Insurance Act of 2003 (Act 650), one of the very first universal national health insurance schemes in sub-Saharan Africa, then reformed by the National Health Insurance Act of 2012 (Act 852), which created the National Health Insurance Authority (NHIA), the body that now manages it. Its funding combines a 2.5% levy on VAT (National Health Insurance Levy), a 2.5% contribution on the wages of members of the SSNIT pension scheme for the formal sector, and premiums for the informal sector; children, pregnant women, people over 70 and the destitute are exempt. According to the sources consulted, the scheme reportedly claims more than 16 million active members, which would make it one of the highest declared coverage rates in Africa — a figure reported by the scheme itself, to be treated with the usual caution for this type of statistic. For a foreign resident, access remains poorly documented: several guides mention possible registration with a valid residence permit, but the most recent registration procedures require presenting the Ghana Card (biometric national ID card), a document only obtainable as a non-Ghanaian with a particular status — a French expat's real access to the NHIS is therefore uncertain and should be checked case by case with the NHIA before relying on it. The private sector, concentrated in Accra, largely serves the business and expat community (Nyaho Medical Centre, The Bank Hospital), with a standard of care above the regional average, though not always offering the full technical capabilities of a Western facility. The leading public reference hospitals, Korle-Bu Teaching Hospital in Accra and Komfo Anokye Teaching Hospital in Kumasi, remain in high demand.

• Mandatory visa for any stay, regardless of purpose: according to France Diplomatie, the classic route is to apply at the consular section of the Ghanaian embassy in Paris before departure. An official e-visa portal (evisa.immigration.gov.gh), open to French citizens, also offers online application and payment, with processing announced at between 72 and 96 hours; both routes appear to coexist across the sources consulted — check which applies to your exact purpose of stay.
• The entry stamp allows a maximum stay of 60 days, regardless of visa type (single or multiple entry), extendable up to 3 months through the immigration services in Accra.
• Stay of more than 3 months: a residence permit is required from the Ghanaian authorities.
• Yellow fever: vaccination mandatory according to France Diplomatie (to be done at an approved centre), now valid for life.
• Malaria: high risk across the entire territory, including in upmarket accommodation in Accra; suitable chemoprophylaxis (atovaquone-proguanil or doxycycline depending on the source) is strongly recommended, in addition to vector protection.
• Non-resident visitor insurance (NNRVHIS): Ghana's Ministry of Health and the NHIA announced in February 2024 a mandatory health insurance policy for non-resident visitors staying less than 6 months, with a cost mentioned of between 45 and 270 USD depending on duration. Its mandatory nature was however disputed at the time by the Minister of Health himself, who described it as a mere NHIA proposal rather than settled government policy; its exact status at the time of departure (mandatory, recommended, or not enforced) could not be confirmed in the sources consulted and should be checked before travelling.
• France Diplomatie describes taking out an assistance contract covering medical expenses, surgery, hospitalisation and medical repatriation as essential, as costs are covered neither by the embassy nor by any automatic Ghanaian scheme.

Other health risks reported by France Diplomatie: recurrent cholera in the south of the country during the rainy season, epidemic meningitis in the north (November to June), Lassa fever, dengue, chikungunya. Medical infrastructure is described as generally insufficient outside Accra, and emergency ambulance services are considered unreliable outside contracted private cover.

No bilateral social security agreement between France and Ghana has been identified. CLEISS does not list Ghana among the countries that have concluded this type of agreement with France — unlike neighbouring or nearby countries such as Togo, Benin, Mali, Senegal or Mauritania. In the absence of any agreement, there is no coordination for sickness, maternity, old age or family benefits between the two schemes.

• No French rights-retention form applies to Ghana.
• Affiliation with CFE or taking out private international insurance are the only forms of cover recognised by a French scheme, whatever the profile.
• Possible registration with the Ghanaian NHIS, subject to obtaining a Ghana Card, would give partial access to the local system but would constitute neither cover recognised in France nor a substitute for medical repatriation.

• Before departure, regardless of purpose: apply for the visa (at the Ghanaian embassy in Paris or via the e-visa portal evisa.immigration.gov.gh), check the current status of the non-resident visitor insurance (NNRVHIS), and take out an assistance contract covering hospitalisation and repatriation, given the absence of any France-Ghana coordination.
• Before departure: medical consultation/vaccination centre for yellow fever (mandatory), hepatitis A, typhoid fever and, depending on the season and area, ACWY meningitis, as well as to determine suitable antimalarial chemoprophylaxis (high risk across the whole territory).
• For a stay of more than 3 months: start residence permit formalities with the Ghanaian immigration services well in advance.
• Resident: check directly with the NHIA on the conditions for registering with the NHIS (Ghana Card in particular), as a complement to, not a replacement for, cover recognised in France.
• Voluntary affiliation with CFE recommended given the absence of any health coordination.
• Within 6 months of arrival: register with the roll of French nationals living abroad, at the French embassy in Accra.