Expat insurance and health insurance in Iceland

Iceland is not an EU member state, but it belongs to the European Economic Area (EEA) alongside Norway and Liechtenstein, as well as the Schengen area. This agreement means it applies the same EU social security coordination regulations (883/2004 and 987/2009) as EU member states since 2012: the European Health Insurance Card (EHIC) and forms A1 and S1 therefore have the same effect there as in France or Norway. The healthcare system itself is a universal, tax-controlled and tax-funded scheme, whose health insurance is run by a single body, Sjúkratryggingar Íslands (national health insurance fund), which negotiates rates with public and private providers. The country is divided into seven healthcare regions (heilbrigðisumdæmi).

Every insured person freely chooses their family doctor (heilsugæsla), at a public medical centre or a contracted private practice, who acts as the entry point to specialist care while leaving free choice of specialist or facility. The national university hospital Landspítali, in Reykjavik, is the reference facility for specialist care, emergencies, teaching and research. Costs remain capped by a monthly co-payment mechanism (greiðsluþátttökukerfi): an insured person never pays more than 37,794 ISK in a given month, this cap dropping to 6,299 ISK for following months in case of ongoing care. Prescription medicines follow a tiered scale based on annual consumption (100% patient-paid at the first tier, then 15%, then 7.5% at following tiers); public hospital care and rehabilitation (physiotherapy, occupational therapy, speech therapy) are free for an insured person.

• EU/EEA citizen: no visa required for a stay under three months, free movement within the Schengen area of which Iceland is a member; a valid ID card or passport for the whole length of stay is enough.
• Registration with the national register (Þjóðskrá): mandatory once the stay exceeds three months, to obtain an ID number (kennitala) which is a condition for most administrative procedures, including health insurance.
• Affiliation with Sjúkratryggingar Íslands: opens six months after registration with the national register, unless the period is reduced for an EEA citizen proving prior insurance rights (form E104 or S1, depending on the case) requested from their French fund before departure.
• During the waiting period: care is charged at full rate without affiliation; only temporary private health insurance, or, for a stay still covered by the EHIC, limited one-off cover strictly within the scope of a temporary stay, can limit the financial risk.
• Student: the EHIC is enough for a temporary stay (Erasmus-type); beyond that, registration with the national register then, six months later, affiliation with Sjúkratryggingar Íslands become required, and a supplementary student insurance remains recommended during the transition.
• Seconded employee : via form A1, stays on the French scheme for the duration of the secondment, exempt from affiliation with Sjúkratryggingar Íslands.
• Retiree: form S1 from their French pension fund before departure, for cover by Sjúkratryggingar Íslands with no waiting period and no new contribution of their own.

No fine applies for lacking affiliation, but the risk remains purely financial during the six-month waiting period, with no help from the French embassy.

As Iceland is not an EU member state, no membership of EU institutions applies in theory — but in practice, social security coordination with France runs through the same EU regulations 883/2004 and 987/2009 as an EU member state, thanks to the European Economic Area (EEA) agreement, applicable to Iceland since 2012.

• Temporary stay: the EHIC gives the same cover as a local insured person in the public sector (consultation at a heilsugæsla centre charged at the reduced rate); it is however not accepted by non-contracted private practitioners.
• Secondment: form A1, staying on the French scheme for the duration of the secondment, exempt from affiliation with Sjúkratryggingar Íslands.
• Long-term move: registration with the national register (Þjóðskrá) then, six months later, affiliation with Sjúkratryggingar Íslands; an EEA citizen can have this period reduced by producing proof of prior insurance rights (form E104 or S1, depending on the case); form S1 for a retiree, covered with no waiting period and no new contribution of their own.
• The EHIC covers neither repatriation, nor planned care, nor a long-term move.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request form A1 from your French fund before departure.
3. Retiree: request form S1 from your pension fund before departure.
4. EEA citizen wanting to reduce the waiting period: request proof of prior insurance rights (form E104 or equivalent) from your CPAM before departure.
5. Before departure or on arrival: request the EHIC to cover the transition period.
6. On arrival, for a stay planned to exceed three months: register with the national register (Þjóðskrá) to obtain an ID number (kennitala).
7. Six months after this registration (or before, with proof of prior rights): check that rights are open with Sjúkratryggingar Íslands and register with a family doctor (heilsugæsla).
8. Register with the roll of French nationals living abroad (French Embassy in Reykjavik).