Expat insurance and health insurance in Haiti

Haiti’s healthcare system is run by the Ministère de la Santé Publique et de la Population (MSPP, Ministry of Public Health and Population) and historically rested on three pillars: a public hospital network, a private sector concentrated in Port-au-Prince, and a mandatory social insurance scheme for formal-sector employees, OFATMA (Office d’Assurance Accidents du Travail, Maladie et Maternité, the Occupational Accidents, Sickness and Maternity Insurance Office), funded by a 6% contribution on base salary (3% employer, 3% employee) and covering, according to its own figures, more than 400,000 insured members and dependents through a network of around 150 contracted facilities. This system, already fragile before the current crisis, has weakened considerably since 2024.

France Diplomatie explicitly states that public hospitals are few in number and poorly equipped and that most doctors are based in Port-au-Prince. This impact on the supply of care is documented by several organisations on the ground: the Hôpital de l’Université d’État d’Haïti (HUEH), the capital’s main public hospital, has been closed since it was occupied by armed groups in February 2024; Zanmi Lasante/Partners In Health announced the closure of its flagship facility, the Hôpital Universitaire de Mirebalais, following armed attacks in 2025; and Médecins Sans Frontières reports recurrent saturation at its trauma hospital in Tabarre, Port-au-Prince, faced with an influx of wounded patients.

In this context, the facilities still accessible to a foreign resident are mostly run by non-profit organisations: the Zanmi Lasante network, the country’s largest care provider outside the public sector, with around fifteen clinics and hospitals serving more than 3.3 million people in the Central Plateau and lower Artibonite; and Médecins Sans Frontières, present notably in Tabarre for trauma and severe burns care. The private clinics still operating, mainly in Port-au-Prince, generally require a deposit or proof of insurance before any treatment, including for urgent care.

• Tourist stay (up to 90 days): no visa is required for a French passport, with a 90-day entry visa issued free of charge at the border; a 10 USD/EUR tourist tax is due on arrival. The passport must remain valid for six months after the planned return date. No health insurance is legally required for entry, but France Diplomatie strongly recommends cover for medical expenses, hospitalisation and medical repatriation, since the French State can under no circumstances cover these costs.
• « Départ/Sòti » exit card: a green card is issued on entry by the Haitian authorities; it is mandatory to leave the country and must be kept with the passport.
• Extension beyond 90 days: the entry visa can be renewed once for a further 90-day period; beyond that, the stay must be regularised with the Direction de l’Immigration et de l’Émigration (DIE), in Port-au-Prince.
• Seconded employees or those in formal local employment: mandatory OFATMA affiliation by the employer (6% contribution on base salary); private supplementary cover remains essential for direct access to international facilities and for medical evacuation.
• No working-holiday programme (PVT) agreement links France and Haiti: the country is not among the fifteen partner destinations listed by France Diplomatie.
• Security advisory: France Diplomatie formally advises against all travel to the entire territory of Haiti because of the presence of armed gangs. This advisory is not in itself a legal insurance requirement, but it strongly affects the real-world availability of care and the conditions for medical evacuation.

No official fine amount has been identified for simply lacking health cover; the documented risk is operational and financial: significantly reduced access to care facilities, private clinics requiring payment or a guarantee before treatment, with no possible assistance from the French consulate.

No social security agreement links France and Haiti: CLEISS does not publish a dedicated country page for Haiti among the roughly one hundred country pages it maintains, unlike neighbouring Mexico, Brazil, Chile or Colombia, for which a page exists.

• No coordination between schemes: no carry-over of entitlements, no totalisation of contribution periods between the two countries.
• No secondment form (A1, SE, etc.) applies: an employee sent to Haiti falls, absent a specific contractual arrangement, under the Haitian scheme (OFATMA) as soon as they work there formally.
• Voluntary affiliation to the Caisse des Français de l’étranger (CFE) or an international private insurance policy explicitly covering medical evacuation are the only options for maintaining cover recognised in France in parallel.

For lower-income households, the French Consulate General’s social service can, under the same arrangements as in other posts, point toward means-tested assistance with CFE contributions; given the security context, checking directly with the consulate on access arrangements is recommended before any travel.

• Before any departure: check the latest France Diplomatie advisories for Haiti, as the territory is formally advised against.
• Before departure, regardless of the length of stay: take out insurance covering medical expenses, hospitalisation and, above all, medical evacuation and repatriation, given the absence of any France-Haiti agreement.
• On arrival: keep the green « Départ/Sòti » card issued by the authorities safe, as it is required to leave the country; pay the 10 USD/EUR tourist tax.
• For a stay of more than 90 days: apply to regularise status with the Direction de l’Immigration et de l’Émigration (DIE) in Port-au-Prince before the initial visa expires.
• Once in formal local employment: check OFATMA affiliation with the employer and the actual scope of cover provided.
• On arrival: register with the roll of French nationals living abroad at the French Embassy in Haiti (free), and contact the embassy to learn the current security guidance.
• In the absence of a social security agreement: voluntary CFE membership or an international private insurance policy explicitly including medical evacuation; means-tested assisted category possible via the consulate’s social service.