Healthcare Reimbursement in the Falkland Islands (Malvinas): Who Reimburses What Depending on Your Situation

CLEISS does not cite the Falkland Islands among the countries and territories linked to France by a social security agreement in force; its pages on holidays and on the United Kingdom scheme do not mention them either. For a temporary stay, the category “other countries or situations not covered” applies: no cover is possible on site. There is therefore no European card, no totalisation of periods and no cross-border cover. The conditions of application to British overseas territories of the social security coordination protocol of the trade and cooperation agreement between the European Union and the United Kingdom were not read; they should be confirmed with CLEISS. On site, the territory’s fee notice exempts only people who would be entitled to free British National Health Service care, which does not cover a French national who is not resident in the United Kingdom.

Four players can intervene depending on status: the territory’s public service (the King Edward VII Memorial Hospital), the maintained French scheme (secondment), the CFE and international health insurance. The notions of reimbursement basis and out-of-pocket cost help compare plans. The conversions on this page are based on the ECB reference rate, the parity of the Falkland Islands pound with the pound sterling being suggested by the “GBP/FKP” wording of the departure tax. How care is organised is presented in the guide healthcare system in the Falkland Islands.

The local-contract employee holds a work permit. The fee notice in force exempts the ordinarily resident work permit holder from public care fees “where section 44(2)(e) of the Public Health Ordinance does not apply”: the text of that paragraph was not read, and the condition should be confirmed with the Department of Health. Where the permit is for nine months or less, the employee must also hold health insurance, with aeromedical evacuation of at least 2,000,000 US dollars, and present its details before care. They contribute to the territory’s pension scheme (£47.80 a week, or about €57, split equally with the employer), but this contribution does not reimburse care. See the glossary entry on the local contract.

The seconded employee remains affiliated to the French scheme during the assignment, for three years renewable once according to CLEISS. Their contributions are paid in France, but they may also have to pay those of the host country. They are covered up to what they would have received in France: they send their fund the paid invoices with form S 3125c, and top-up health insurance is advised if care is expensive, which is the case here. Children who accompany them give no entitlement to French family benefits when they no longer live in France. See seconded or expatriated and the seconded employee glossary.

The self-employed person has no employer to sponsor a permit: the pages read describe no self-employed permit, and the right to the fee exemption depends on the permit actually held. They can join the CFE voluntarily for sickness and maternity, and international insurance completes the arrangement for medical evacuation. See digital nomad insurance.

The student has no European card, and the immigration service’s permits page lists no student permit; they are therefore treated as a visitor, with insurance including aeromedical evacuation. Before the age of 30, the CFE offers a youth plan (with a contribution that depends on age and the plan chosen). See student insurance abroad.

The spouse and children of a work permit holder hold an accompanying dependant permit; they are exempt under the condition of paragraph 44(2)(f) of the Public Health Ordinance, the text of which was not read. The dependant permit of relatives of a permanent resident or of a holder of local status opens the exemption with no particular condition. Both the CFE and international insurers offer family contracts. See expat family insurance.

The retiree does not come under form S1, which is valid in the European Union. CLEISS indicates that they check with the local institutions to what extent the local scheme covers their care, and that they can join the CFE voluntarily or take out private insurance. No retiree residence permit is described on the government pages read; a retiree on a visitor stay must present insurance and pays for public care according to the fee notice. The CFE retirees’ plan has a contribution that depends on age and the plan chosen, with no health questionnaire, for people with no professional activity who receive a pension from a French basic scheme. See the guide health insurance for retirees abroad and the page retiring in the Falkland Islands.

The CFE is a voluntary social protection body. In France, it reimburses according to the principles of Assurance Maladie (French health insurance); abroad, reimbursement depends on the country of care and the type of care, with a rate or flat amount applied to actual expenses. The scale specific to the territory is read in the CFE’s table of benefits: the gap with the price charged remains the member’s responsibility, which matters here, as public fees are high. The guide CFE reimbursements details this mechanism.

• Plans: main plan, youth plan (under 30) and retirees’ plan, each with a contribution that depends on age and the plan chosen; the final price depends on the country, age and family composition. The main plan also covers stays of less than three months in France.
• Waiting period: cover starts immediately if membership takes place before departure or within three months of settling abroad; beyond that, the waiting period is three months before age 44 and six months from age 45.
• Evacuation: the plan pages consulted do not mention medical evacuation; the CFE table of benefits should be consulted before joining.

On return to France, service-public indicates that a CFE member can keep their expatriate benefits for three months under conditions. Without the CFE, someone who does not start work immediately must show three consecutive months of residence in France before submitting their application for universal health protection (form S1106); someone who goes back to work is covered from the first hour worked. See reducing the waiting period and the page return to France.

International health insurance with first-euro cover reimburses actual costs within the limits of its contract, after any deductible, waiting periods and exclusions. It answers the weak point of a public scheme that charges non-exempt people the full rate, evacuation included. Contracts are compared on the annual ceiling, the coverage zone, evacuation and the handling of pre-existing medical conditions.

The tourist is subject to an obligation: the visitor permit requires health insurance covering aeromedical evacuation for at least 2,000,000 US dollars, and the patient presents their contract or proof of ability to pay before care. CLEISS recommends travel insurance suited to the real cost of care. Reimbursement on return to France of unforeseen care is a possibility and not an obligation, and medical repatriation is not covered by health insurance. See long-stay travel insurance.

The amounts below are the public fees charged to a non-exempt patient, published in the fee notice in force of the Falkland Islands Gazette. An exempt resident does not pay them.

• Consultation: £147.25 (about €175) for a doctor, 15 minutes or less; £293.40 (about €349) beyond; £41.55 (about €49) for a nurse up to 15 minutes; emergency department visit or out-of-hours consultation: £522.70 (about €622).
• Hospital stay and imaging: £1,591.15 per 24 hours, £2,698.55 in intensive care (about €1,894 and €3,211); CT scan: £1,330.40 (about €1,583); X-ray: £158.85 (about €189); ultrasound: £270.10 (about €321).
• Medicines: free on prescription for residents of the territory and the United Kingdom; for a non-exempt patient, cost price plus 37.5% with a minimum of £30 (about €36).
• Dental: residents and people on long-term contracts receive routine care, visitors and short contracts are generally limited to emergencies (£163.00, or about €194). Laboratory work comes under part A of the notice, which covers all patients except residents under 19 in full-time education, aged 65 or over or recipients of social assistance: acrylic denture £148.90 (about €177), base metal crown or bridge £103.00 per unit (about €123).
• Optical: routine eye test £42.40 (about €50), free for eligible patients; lenses and frames at cost price. The FCDO specifies that there is no qualified resident optician.
• Maternity: pregnancy is followed by general practitioners, sonographers and midwives (£35.25 an hour, or about €42, for a midwife appointment). High-risk pregnancies are asked to continue their care in the United Kingdom by 35 weeks at the latest. For the CFE youth plan, conception must be after membership.

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