Expat insurance and health insurance in Kenya

The Kenyan health system is organised into six levels, from community units to national referral hospitals, with a mixed public, private and faith-based offering. Health financing underwent a deep reform in 2024: the National Hospital Insurance Fund (NHIF), the historic public scheme created in 1966 with modest contributions (160 to 320 KSh per month) and limited reimbursements (400 to 2,000 KSh per day of hospitalisation depending on facility level), was abolished and replaced by the Social Health Authority (SHA), created by the law of 22 November 2023. The SHA now runs the Social Health Insurance Fund (SHIF) as well as two other funds (primary care, emergencies and chronic/critical illness); the sources consulted place the effective transition between July and October 2024, with a gradual and contested rollout. About 80% of the population depends on the public sector, where resources remain unevenly distributed across regions. The private sector, concentrated in Nairobi, has facilities of a very good standard (Nairobi Hospital, Aga Khan University Hospital), funded by local private insurers (notably AAR, Jubilee, Britam, UAP) or by international cover.

• Entering the country: an electronic travel authorisation (eTA), to be obtained before boarding at etakenya.go.ke, is required of all travellers except specific exemptions. No proof of health insurance was identified among the documents required for the eTA in the sources consulted — check before departure, as this requirement may change.
• France Diplomatie describes taking out an assistance policy covering medical costs, surgery, hospitalisation and medical repatriation as essential, as costs are covered neither by the embassy nor by any automatic Kenyan scheme.
• Tourist visa: maximum duration of 3 months, extendable by a further 3 months with the Immigration Department (US$50), with no formalised insurance requirement identified.
• Stay of more than 6 months or professional activity: a residence permit is required (Work Permit, Dependant Pass); a Class N — Digital Nomad permit exists for remote workers employed by foreign companies, on presentation of a no-objection letter from the French embassy in Kenya.
• Yellow fever: vaccination strongly recommended by France Diplomatie (central and western Kenya are endemic areas) and required on entry from an at-risk transmission zone.
• Foreign residents: registration with the SHA is open to non-citizens holding a foreign resident certificate ("alien ID"), but this local affiliation does not exempt from taking out cover recognised in France, given the absence of any bilateral agreement.

No specific fine for lacking cover was identified, but Kenyan private facilities in practice require a payment guarantee before any admission outside a life-threatening emergency.

No bilateral social security agreement between France and Kenya has been identified. CLEISS does not list Kenya among the countries that have concluded such an agreement with France — unlike neighbouring countries such as Madagascar (1967 agreement) or some West African countries such as Senegal or Mali. With no agreement at all, no coordination exists for health, maternity, old age or family benefits between the two schemes.

• No form for maintaining French rights applies in Kenya.
• Affiliation with the CFE or taking out international private insurance are the only cover routes recognised by a French scheme, whatever the profile.
• Registering with the Kenyan SHA (open to foreign residents) gives access to the local system but is neither cover recognised in France nor a substitute for medical repatriation.

• Before departure, whatever the purpose: request the eTA at etakenya.go.ke and take out insurance or an assistance policy covering hospitalisation and repatriation, given the absence of any France-Kenya coordination.
• Before departure: a medical consultation/vaccination centre visit to assess the need for yellow fever, hepatitis A, typhoid fever, ACWY meningitis vaccination, and antimalarial prophylaxis (low risk in Nairobi, high risk near Lake Victoria and on the coast).
• For a stay of more than 6 months or professional activity: start the residence permit process (Work Permit, Dependant Pass, or Class N for remote work) well in advance.
• Resident: consider registering with the SHA (access to the local system) in addition to, not instead of, cover recognised in France.
• Voluntary affiliation with the CFE recommended given the lack of any health coordination.
• Within 6 months of arrival: register with the roll of French nationals living abroad, at the French embassy in Nairobi.