Expat insurance and health insurance in Honduras

Honduras’s healthcare system is organised by the Secretaría de Salud, which runs a public network that is in principle free to access. France Diplomatie states that public hospitals offer uneven quality of care, particularly outside the major cities. The two national reference facilities are the Hospital Escuela Universitario, in Tegucigalpa, and the Hospital Dr. Mario Catarino Rivas, in San Pedro Sula, the latter being described as the country’s largest general hospital and coordinating transfers of complex cases with the Hospital Escuela, the Hospital General San Felipe and the Instituto Nacional del Tórax in Tegucigalpa, as well as with the Hospital Leonardo Martínez Valenzuela in San Pedro Sula.

The Instituto Hondureño de Seguridad Social (IHSS) manages mandatory affiliation for any employee in formal employment. For the Enfermedad y Maternidad scheme (health cover), the employee contribution is 2.5% of ordinary salary and the employer contribution is 5%, both capped at a contribution salary of 11,290.18 HNL per month in 2026. The IHSS also runs a separate Invalidez, Vejez y Muerte scheme (pensions), whose rates and cap differ and whose reform, launched under the 2024 framework law on the social protection system, continues to change the employee share. Unlike Nicaragua’s INSS, which only contracts third-party facilities, the IHSS directly runs several hospital centres of its own, including at least two in the Tegucigalpa metropolitan area. No voluntary IHSS scheme open to self-employed workers or non-salaried foreign residents was identified in the sources consulted.

The private sector, considered of better quality by the specialised guides consulted, includes notably, in Tegucigalpa, the Hospital y Clínicas Viera and the Honduras Medical Center, and, in San Pedro Sula, the Hospital del Valle and the Centro Médico Sampedrano (CEMESA). France Diplomatie states that it is essential to have insurance covering medical expenses, hospitalisation and medical repatriation, since the embassy cannot cover medical costs that can be high in the private sector. Yellow fever vaccination is required for travellers coming from an endemic area, and hepatitis A and B, typhoid fever and rabies vaccinations are recommended depending on expected exposure. Dengue is endemic and the risk remains high year-round, notably in the central district (Tegucigalpa), in Choluteca, San Pedro Sula, Comayagua, Santa Bárbara and Tocoa; malaria mainly affects the departments of Olancho and Choluteca, and enhanced protection against chikungunya is also recommended by France Diplomatie.

• Tourist stay (up to 90 days for a French passport): no visa is legally required on entry, but the passport must remain valid for at least 6 months from the date of entry. An online customs declaration must be completed before arrival on the official Honduran customs portal, and a migration form must be filled in at border crossings. France Diplomatie presents insurance covering medical expenses, hospitalisation and medical repatriation as essential in practice, without it being a legal condition of entry.
• CA-4 free-movement area: Honduras, Guatemala, Nicaragua and El Salvador have created a movement area without systematic checks at shared land borders. France Diplomatie specifies that the total length of a continuous visa-free stay across all four countries cannot exceed 90 days, this count therefore being cumulative and not reset when moving from one CA-4 country to another.
• Overstaying 90 days: once the breach is identified, France Diplomatie states that a single 30-day extension can be obtained by paying a 20 USD fee to the Honduran migration authorities.
• Foreign student: temporary residency under the « Extranjeros Estudiantes » category of the Instituto Nacional de Migración (INM) can be requested for any enrolment at an institution recognised by the Secretaría de Educación or by the Universidad Nacional Autónoma de Honduras (UNAH), in principle within 90 days of entry (extendable by 30 days), on presentation of legalised and translated documents. No health insurance requirement specific to this status was identified in the sources consulted.
• Seconded employees and employees in formal local employment: an employment contract issued by the Honduran employer and a declaration from the employer covering the subsistence and departure of the foreign employee are required by the INM for the « Extranjeros Empleados por Contrato » category. IHSS affiliation is mandatory from the time of hiring, with a 2.5% employee contribution and a 5% employer contribution for the Enfermedad y Maternidad scheme.
• Rentista residency (permanent income of at least 2,500 USD per month, received via a Honduran bank or financial institution) and pensionado residency (permanent pension of at least 1,500 USD per month, plus 150 USD per dependant, paid from abroad): permanent residency is requested from the Secretaría de Gobernación y Justicia, on presentation of apostilled and translated proof of income (processing time of around 5 to 6 months according to Consortium Legal). No documented requirement to take out health insurance was identified in the sources consulted for either status. A 2025 ministerial agreement allows, as an exception, residency for applicants demonstrating at least half of the required income.
• Digital nomad visa: no specific status dedicated to remote work has been introduced in Honduras to date, despite announcements reported by some specialised guides; people wishing to settle there while working remotely must use the existing statuses (rentista, temporary residency, local employment contract).

Security, covered here only from the angle of access to care and assistance: France Diplomatie advises against travel except for essential reasons in several areas of the country, notably the peri-urban area and city centre of Tegucigalpa (Francisco Morazán department), San Pedro Sula and Puerto Cortés (Cortés department), La Ceiba (Atlántida department), the Bajo Aguán region (Colón department), the Juticalpa-Catacamas corridor and San Francisco (Olancho department), as well as certain areas of the departments of Yoro, Santa Bárbara and Ocotepeque, because of crime rates considered high. Heightened vigilance, compatible with tourist travel, applies instead to the Bay Islands (Roatán, Utila, Guanaja), the Valle department and Isla del Tigre, as well as the Copán department and its Maya archaeological site. This geographical breakdown affects in practice the access to the healthcare facilities listed in this guide, most of which are located in Tegucigalpa and San Pedro Sula.

No official fine amount has been identified for simply lacking health cover outside the statuses mentioned above; the documented risk remains full billing of care in the private sector.

No social security agreement has been signed between France and Honduras: the country does not appear on CLEISS’s list of country pages, which only covers countries that have concluded a coordination agreement with France.

• In the absence of a bilateral agreement, no totalisation of insurance periods between the two countries is possible for establishing pension entitlements.
• No coordination mechanism allows even partial cover for care received in Honduras under French affiliation, nor the reverse for care received in France under IHSS affiliation.
• IHSS affiliation, resulting from formal local employment, provides local cover but does not replace any French social protection and is not recognised as such upon return to France.

In the absence of an agreement, for any French national settling in Honduras — an employee affiliated with the IHSS, a rentista/pensionado resident, a student or a retiree — voluntary membership of the Caisse des Français de l’étranger (CFE) or taking out international health insurance remain the only solutions for maintaining cover recognised in France, in addition to any local cover.

• Before departure: take out insurance covering medical expenses, hospitalisation and medical repatriation, regardless of the planned length of stay.
• Before travelling: complete the online customs declaration on the official Honduran customs portal and check that the passport remains valid for at least 6 months from the date of entry.
• Before travelling outside Tegucigalpa or San Pedro Sula: check France Diplomatie's travel advisories, as certain areas of the country are advised against except for essential reasons.
• If planning a stay across several CA-4 countries (Honduras, Guatemala, Nicaragua, El Salvador): factor in the cumulative 90-day stay count before planning a sequence of countries.
• For a student residency application: gather the legalised and translated documents required by the INM and submit the application within 90 days of entry.
• For a rentista or pensionado residency application: gather apostilled and translated proof of income or pension, and arrange private health cover in the absence of a documented legal requirement.
• Once formally hired in Honduras: check with the employer on IHSS affiliation and the employment contract required by the INM for a foreign employee.
• In the months following arrival: register with the roll of French nationals living abroad at the relevant embassy or honorary consulate (free, valid for 5 years, recommended).
• In the absence of a bilateral agreement: voluntary CFE membership or taking out international health insurance as soon as you settle.