Healthcare Reimbursement in Greenland: Who Reimburses What, Depending on Your Situation

Greenland is a self-governing territory of the Kingdom of Denmark, outside the European Union. On the CLEISS page that lists countries for holidays, Greenland appears neither among the 30 states where the European regulations apply (including Denmark), nor among the 23 other states or territories; the Danish scheme described by CLEISS does not mention it. No bilateral France-Greenland social security agreement is therefore listed, and there is no automatic coordination between schemes: no carte Vitale abroad, no aggregation of periods listed.

Four players can step in depending on status: the Greenlandic public system for registered residents, the French scheme maintained under secondment, the CFE and international health insurance. The notions of reimbursement basis and out-of-pocket cost help to compare offers. How care works is presented in the guide healthcare system in Greenland.

The local-contract employee, holding a residence and work permit, who declares their move to the municipality and registers in the population register, falls under the public system: according to Sullissivik, medical consultation, hospitalisation and treatment are free for people registered in the population register and living in Greenland, certain services remaining wholly or partly at their expense (non-prescription medicines outside special cases, vaccines outside the programme, certificates, copy of the file). Dental care is free for inhabitants, with no guarantee for very damaged teeth on arrival. During the delay before registration, transitional insurance avoids having to advance costs. See the glossary entry on the local contract.

The seconded employee sent by a French employer falls under secondment to a country with no social security agreement: CLEISS indicates a duration of 3 years, renewable once, continuation of the French scheme with no exemption from the contributions and levies due in the host country, and cover within the limit of what the same benefit would give in France, on paid invoices sent to the fund with form S 3125c. CLEISS suggests private supplementary insurance when care is expensive. As Greenland has no dedicated CLEISS page, the conditions should be confirmed with CLEISS and Urssaf (the French social security contributions collection body) before departure. See seconded or expatriate and the glossary entry on the seconded employee.

The self-employed person or digital nomad has no Greenlandic employer to affiliate them; the SIRI agency pages consulted describe no permit specific to self-employed activity, and the route to the public system should be confirmed with SIRI and the municipality. In the meantime, the CFE or international insurance covers hospitalisation, outpatient care and repatriation; see digital nomad insurance.

The student needs a study residence permit issued by SIRI. Sullissivik specifies that a person following training in a district other than that of their home can see a dentist free of charge in the district of their studies. Before age 30, the CFE offers its youth plan. See student insurance abroad.

The retiree does not fall under the S1 form, valid in the EU: according to Assurance retraite (the French pension insurance body) and CLEISS, coverage of care abroad by France requires an EU country or a country linked to France by an agreement, and Greenland is on neither of these lists. A retiree holding a French basic scheme pension can join the CFE retirees’ plan, with no health questionnaire, for care received abroad. See the guide retiree health insurance abroad and the page retiring in Greenland.

The spouse and children of a work permit holder apply for an accompanying family permit, which allows work but excludes public benefits, according to SIRI: the impact of this rule on access to the health system should be confirmed with the municipality. The CFE and international insurers both offer family contracts. See expat family insurance.

The CFE is a voluntary social protection body. Abroad, reimbursement depends on the country of care and the type of treatment: a rate or a flat amount is applied to actual expenses. As an example, the CFE cites a French GP consultation set at €25, reimbursed at 70%, i.e. €21. When the local price exceeds the basis used, the difference remains at the member’s expense: the guide CFE reimbursements details this mechanism. The CFE simulator asks for the country of residence, to be filled in to obtain the scale applicable to Greenland.

• Plans: the main plan (30 and over), the youth plan (under 30) and the retirees’ plan, each with a contribution that depends on age and the plan chosen, as shown on the CFE home page.
• Medical questionnaire: none, whatever the age; members cannot be excluded.
• Waiting period: immediate cover if membership takes place before departure or within three months of settling abroad; beyond that, three months’ wait before age 44 and six months after 45 (the page does not specify the case of 44- to 45-year-olds).
• Maternity: conception must be after membership or after joining as a dependant.

On return to France, according to service-public.gouv.fr, a former CFE member can benefit from its benefits for 3 months, under conditions; with immediate resumption of work, affiliation to Assurance Maladie is acquired from the first day worked; otherwise, 3 consecutive months of residence in France open universal health protection (Puma). See the guide reducing the waiting period and the page return to France.

International health insurance at the first euro reimburses actual costs within its ceilings, after any deductible, waiting periods and exclusions in the contract. It answers the Greenlandic health system’s recommendation: insurance covering acute illness, treatment, hospitalisation, medicines, repatriation, civil liability and luggage, as well as public care, private dental care and transport from places with no year-round habitation. Contracts are compared on the annual ceiling, the coverage zone, medical evacuation and the handling of pre-existing conditions.

The visitor staying less than 6 months can, according to a document from the Greenlandic Department of Health, obtain necessary care free of charge (doctor, hospital, prescribed medicines, prescribed transport from a year-round inhabited locality to the district hospital and to Nuuk, emergency dental care) by presenting proof of health entitlement in their country, for example the EHIC. Repatriation and transport from places with no year-round habitation are excluded; without proof, payment is in full. This document still cites the former regulation 1408/71: confirmation with the CPAM, like taking out travel insurance, remains recommended. France Diplomatie reminds us that the embassy can under no circumstances cover these costs.

• Consultation: free for a registered resident; free for a visitor staying less than 6 months with proof, for necessary care; reimbursed by the CFE on its country scale; actual costs within the ceilings of a first-euro contract.
• Hospitalisation: free for a registered resident; French scheme for the seconded employee within the limits of French tariffs; CFE depending on the country; international contract with direct payment where provided.
• Medicines: prescribed, free for those entitled under the public system; non-prescription medicines at the patient’s expense, except chronic illness, under 18 and retirees; reimbursed according to CFE scales or the ceilings of an international contract.
• Dental: free for inhabitants, with priority up to 21; care is not covered abroad; travel insurance must cover visitors’ private dental care.
• Optical: glasses are not mentioned on the benefits page consulted; they mainly fall under international contracts, subject to a ceiling per period.
• Maternity: the CFE requires conception after membership; international contracts generally apply a waiting period; the public system’s arrangements should be confirmed with the municipality and Peqqik.

The reimbursement guide and the page expat health insurance give benchmarks; Expavy helps you weigh these options against your situation.