Healthcare Reimbursement in Iceland: Who Reimburses What Depending on Your Situation

CLEISS’s list of social security agreements mentions no bilateral convention between France and Iceland. The European coordination regulations apply in the 27 EU States and, in the European Economic Area, in Iceland, Liechtenstein and Norway: they lift residence conditions, add up periods of activity and organise posting. A French national is treated in Iceland under Icelandic rules, with forms issued by their French fund: EHIC, A1, S1.

The concepts of reimbursement base and out-of-pocket cost help compare contracts. How the system works is presented on the page on the healthcare system in Iceland.

The employee on a local contract comes in principle under the social security legislation of the country where they work (island.is). Icelandic health insurance requires six months of legal residence since registration with the national register (CLEISS); its application to a citizen of the European Economic Area who arrives to work should be confirmed with Sjúkratryggingar before leaving. The employee chooses a GP at a public health centre or with an approved practitioner. See the glossary entry on the local contract.

The posted employee sent by a French employer stays affiliated to the French scheme for up to 24 months with the A1 form, without registering with Icelandic insurance (europa.eu). If they live in Iceland, they can ask their French fund for an S1 form to be insured in their country of residence (island.is); their family members are covered without contributions if the local fund treats them as dependants (CLEISS). They can also ask their French fund to reimburse care on presentation of invoices with the S3125 form, at Icelandic or French rates. Sick leave certified in Iceland is declared within 48 hours to the French fund and the employer. See posted worker or expatriate and the glossary entry on the posted worker.

The self-employed person pays the overall contribution of 6.35% on their income and joins a pension fund; care falls under universal insurance after the residence period (CLEISS). The digital nomad who works for a foreign client without setting up comes first under the rule of the country of activity, to be confirmed with their home scheme.

The student on a temporary stay uses their EHIC at public health centres and hospitals; for a long course, international insurance or the CFE covers the period before local entitlement opens. Before the age of 30, the Caisse des Français de l’Étranger (CFE, the voluntary social security fund for French nationals abroad) offers its youth offer. See student insurance abroad.

The retiree who receives only a French pension and settles permanently in Iceland without working there requests the S1 form from their pension fund, preferably before leaving (CLEISS). The S1 confirms insurance in the former country of residence and, once requested, insures the person in the new country (island.is). No contribution to the local scheme is withheld; a contribution of 3.2% on the basic pension and 4.2% on the supplementary pension is levied on general scheme pensions when tax residence is outside France, and 7.1% for the self-employed. The retiree stays covered in France.

The spouse and children follow the holder’s status: dependants of the employee, individual S1 of the retiree, or their own insurance. Children benefit from a patient share capped at ISK 25,198 per month from age 2 to 18 and free care under 2 (island.is). See expat family insurance and the guide on retiree health insurance abroad.

The Caisse des Français de l’Étranger lets you keep the French scheme on top of the local scheme; the member pays both the country’s mandatory scheme and the CFE, which spares them waiting periods and the loss of pension quarters on returning (ameli.fr, the website of the French Assurance Maladie, the national health insurance). The CFE’s main offer covers GP consultations, medicines, tests, hospitalisation, maternity, dental care, emergency transport and vaccines, including stays of less than three months in France (CFE).

• Waiting period: immediate cover if you join before departure or within three months of settling in; beyond that, a three-month wait for under-45s and six months for over-45s (CFE, exact age to be confirmed with the fund).
• Maternity: the date of conception must be after joining or being attached as a dependant (CFE).
• Return to France: no waiting period for the member (CFE); they open their entitlement with the S1106 form (ameli.fr). See CFE reimbursements and the page on returning to France.

International health insurance with first-euro cover reimburses actual costs within its ceilings, after any deductible, waiting periods and exclusions. It usefully complements the Icelandic scheme during the six-month residence period, on dentistry, optical care and access to private providers, which the EHIC does not cover. Contracts are compared on the annual ceiling, the coverage area and the handling of pre-existing conditions.

The tourist uses their EHIC (Evrópska sjúkratryggingakortið) at public health centres and hospitals: the minimum is ISK 500 at a health centre, ISK 3,100 to 4,500 outside opening hours or for a home visit, and children under 18 are treated free of charge; private providers do not accept the card (CLEISS). Medicines are paid at the full price at the pharmacy, with partial or full reimbursement possible from Icelandic insurance on original invoices sent to Sjúkratryggingar. Without an EHIC, the S3125 form lets you request reimbursement on your return. See long-stay travel insurance.

• Consultation: GP at ISK 700 on weekdays in the daytime and ISK 3,100 in the evening according to CLEISS, free for under-18s and retirees; specialist with 90% of the cost at the patient’s expense; monthly cap of ISK 37,794 (island.is).
• Hospitalisation: free in public hospitals on referral from the GP outside emergencies; outpatient consultations with a patient share (CLEISS).
• Medicines: advance of costs and a sliding patient share from 100% to 15% then 7.5% over twelve months (CLEISS).
• Dental: covered, in full or in part, for under-18s, over-66s and retirees (CLEISS).
• Optical: not described by CLEISS; a supplementary contract is worth considering.
• Maternity: maternity care is free for a person meeting the six-month residence condition; leave comprises four months per parent and two shareable months, paid at 80% of average income subject to an activity condition (CLEISS). A CFE member must have conceived after joining.

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