Expat insurance and health insurance in Kazakhstan

Since 2020, Kazakhstan has undertaken a transition toward a mandatory social health insurance system, OSMS (in Russian: Обязательное социальное медицинское страхование, literally "mandatory social medical insurance"), which is gradually replacing the pure budget funding inherited from the Soviet system. OSMS is funded by contributions from employers, employees and self-employed workers, supplemented by state funding for children, the unemployed, pregnant women, retirees and other vulnerable categories. The scheme distinguishes a basic care basket guaranteed by the state, accessible to all (emergencies, primary care, HIV and tuberculosis treatment in particular), and a supplementary basket reserved for people affiliated with OSMS (diagnostic care, chronic disease management, some dental care and broader access to medicines). According to available sources, over 84% of the population was covered by OSMS in early 2024.

A new OSMS reform, enacted 14 July 2025 and in force since 1 January 2026, revises the contribution calculation caps (up to 40 minimum wages for the employer share, up to 20 minimum wages for the employee share) without changing the scheme's general principle.

Foreigners' access to OSMS remains limited in practice: according to the sources consulted, only foreigners permanently residing in Kazakhstan and holding a permanent residence permit (ВНЖ) can in principle be affiliated, while foreigners on a temporary stay (work visa, assignment, tourism) generally have no access and must resort to private health insurance. People on a temporary stay, including asylum seekers, nonetheless retain a right of access to free emergency care for conditions posing a danger to others (contagious diseases in particular), funded outside OSMS by the state budget.

The private sector, concentrated in Almaty and Astana, has developed to meet demand from expatriates and part of the local population, with clinics and medical centres at international standards, some accredited by international bodies, at the expense of the patient or their international health insurance.

• No visa required for a tourist or business stay not exceeding 30 calendar days per visit, since 1 January 2022, within a cumulative limit of 90 days over any 180-day period, on presentation of a passport valid for the length of stay.
• Mandatory arrival declaration: the host, employer or hotel must report the foreign traveller's arrival to the migration authorities within 3 working days, including for a visa-free stay; any change of address must also be reported.
• Electronic travel authorisation (ETA) being rolled out: a law enacted 24 June 2026 establishes a legal framework for an electronic authorisation applicable to nationals of visa-exempt countries, including France; it comes into force on 25 August 2026, with a gradual rollout announced between August and December 2026 (recommended during the pilot phase before becoming mandatory) — check France Diplomatie before any departure, as the terms may still change.
• No health insurance legally required on entering the territory for a visa-free stay, but cover for medical costs, hospitalisation and medical repatriation is strongly recommended by France Diplomatie, as these costs are not covered by the French embassy.
• No European health insurance card: as Kazakhstan is a member of neither the European Union nor the European Economic Area, the EHIC does not apply there, whatever the length of stay.
• OSMS affiliation: in practice reserved for Kazakh citizens and foreigners holding a permanent residence permit; a foreign employee on a local contract or a long-term assignment should check their affiliation status with their employer or the local authorities, as the precise terms are not uniformly detailed publicly.
• Seconded employee : with no France-Kazakhstan agreement, continuation of the French scheme falls solely under French law (unilateral secondment), for a duration of 3 years renewable once, with no exemption from any contributions owed in Kazakhstan.

Outside OSMS cover and outside private insurance, care is billed at full rate by the facility, public or private, rate varying by facility and not uniformly published publicly; the risk remains primarily financial, with no help from the French embassy for medical costs.

France and Kazakhstan are bound by no bilateral social security agreement: CLEISS classifies Kazakhstan among the countries appearing neither on the list of states where EU regulations apply, nor on the list of states with a bilateral agreement with France. There is therefore no European health insurance card, no A1 or S1 form enforceable with the Kazakh authorities, and no direct reimbursement mechanism between the two systems.

• Temporary stay: no European or bilateral coordination applies; only health/repatriation insurance taken out before departure covers costs on site, with CLEISS recommending requesting reimbursement of unplanned care from your French fund on return, within the limit of French rates.
• Secondment from France: with no agreement, French law provides for unilateral secondment of 3 years renewable once. The employee remains affiliated with the French scheme, with contributions paid in France, but with no exemption from any contributions owed in Kazakhstan under OSMS. Care received on site is reimbursed retroactively by the French fund, within the limit of French rates, on presentation of supporting documents and form S3125.
• Long-term move: OSMS affiliation depends on residency status in Kazakhstan (permanent residence permit); no transfer of rights from France is provided for, retirees included.
• Retiree: no coordination mechanism allows rights acquired in France to be claimed; international health insurance remains necessary, as access to OSMS is in practice conditional on obtaining a permanent residence permit.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Before departure: take out health/repatriation insurance covering medical costs and hospitalisation, valid in Kazakhstan — not required for visa-free entry, but essential in practice.
3. Check before departure, on France Diplomatie, the rollout status of the electronic travel authorisation (ETA) planned from 25 August 2026.
4. On arrival: make sure the host, employer or hotel completes the arrival declaration with the migration authorities within 3 working days.
5. Seconded employee: arrange the unilateral secondment with your employer through your French fund before departure (maximum duration 3 years renewable once).
6. Employee on a local contract or long-term resident: check with the employer or local authorities the conditions for obtaining a permanent residence permit and OSMS affiliation.
7. Keep proof of care and form S3125 for any retroactive reimbursement request to the French fund (secondment case).
8. Register with the roll of French nationals living abroad (French embassy in Astana).