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

CLEISS publishes sheets for the countries bound to France by a social security agreement: Honduras does not appear among them. The two countries therefore do not coordinate their schemes: no card giving access to care in both countries, no totalisation of insurance periods, no cross-coverage. ameli.fr (the Assurance Maladie website) reminds readers that a worker expatriated outside the European Union necessarily comes under the scheme of the country of work, which reimburses their medical costs, and that a specific contract, with repatriation insurance, can be useful.

Four players can come into play: the Honduran scheme (IHSS for employees), the French scheme kept in place (secondment outside an agreement), the CFE and international health insurance. The notions of reimbursement base and out-of-pocket cost help you compare; the local organisation is described on the page on the healthcare system in Honduras.

In practice, France Diplomatie specifies that foreigners pay their own costs, notably for a day of emergency hospitalisation, and that private clinics are of acceptable quality. Reimbursement therefore most often takes place after the costs have been advanced, on paid invoices: keep the medical reports, prescriptions and detailed receipts that the CFE or the insurer asks for in order to reimburse.

Employee on a local contract. The employer affiliates them to the IHSS, which runs the sickness-maternity insurance of formal-sector employees; the rates, ceiling and conditions for opening rights are confirmed with the institute. As French schemes are not recognised, supplementary insurance covering private clinics and repatriation is useful. See the notion of a local contract.

Seconded employee. In a country without an agreement, the seconded employee remains affiliated to the French scheme for three years, renewable once. They are covered up to the benefits they would have received for the same care in France: they send their fund the paid invoices with form S 3125c, their dependants who accompany them follow the same procedure and those who stayed in France turn to the affiliation fund. A sick-leave certificate must be declared within 48 hours. See seconded worker.

Self-employed. They take out the CFE, which covers sickness-maternity for a self-employed person, or international insurance; the page does not describe a voluntary IHSS scheme open to non-salaried foreigners.

Retiree. The S1 form, reserved for residents of the European Union, the EEA, Switzerland and the United Kingdom, does not apply. The retiree chooses between the CFE and international insurance. During a temporary stay in France, they are reimbursed for their care if they draw a pension from a basic scheme based on at least 15 years of insurance and have no activity; the spouse who accompanies them is not covered (CLEISS).

Student. In the absence of an agreement, CLEISS indicates that, for a stay of under six months, the French fund may reimburse unforeseen care on a flat-rate basis, on an optional basis and after the costs have been advanced. Beyond six months, a student over 20 is no longer covered by French health insurance and takes out cover locally, with the CFE or a private insurer. See student insurance abroad.

Spouse and children. They are dependants of the local scheme depending on the holder’s status, remain under the French scheme if they accompany a seconded worker, or have their own contract. See expat family insurance.

Tourist (90 days across the C4 area). France Diplomatie considers a contract covering care, hospitalisation and repatriation obligatory in practice; the French embassy covers none of these costs.

The CFE offers its main offer (aged 30 and over), its youth offer (under 30) and a retiree offer, each with a contribution that depends on age and the plan chosen, with no health questionnaire. Cover is immediate if you join before departure or within three months of settling; otherwise the waiting period is three months before age 44 and six months beyond age 45. Abroad, reimbursement depends on the country of care and the procedure, with a rate or a flat amount applied to the actual expense; maternity requires conception after joining. See CFE contributions.

First-euro insurance reimburses actual costs within the contract’s ceilings, with direct payment to the establishment possible, which avoids advancing high costs; excesses, waiting periods and exclusions determine the out-of-pocket cost. See first euro.

Return to France. A CFE member with no activity in France keeps their rights for up to three months after returning and affiliates to the CPAM of their place of residence with form S1106; an employee taking up a contract in France has rights from the start. With no agreement with Honduras, the lifting of the waiting period does not rely on an agreement and is confirmed with the CPAM. See return-to-France insurance.

• Consultation: covered by the IHSS for a member, according to its arrangements; payable by the patient in the private sector unless covered by a contract; according to the CFE’s country scale.
• Hospitalisation: IHSS network for a member; French scheme for the seconded worker within the limit of French benefits; for the others, an international contract with direct payment, because emergency costs are high and payable by the foreigner.
• Medicines: according to the list and availability of the local scheme; reimbursed according to the CFE’s scales or the ceilings of an international contract; never buy medicines in the street.
• Dental: the extent of IHSS cover is checked with the institute; the CFE and international contracts apply their own ceilings.
• Optical: mainly a matter for international contracts, with ceilings per period to be read in the benefits table.
• Maternity: covered by the IHSS sickness-maternity scheme for female members; the CFE requires conception after joining; international contracts generally apply a waiting period.

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