The Healthcare System in Mongolia: Compulsory Insurance, Primary Care, Hospitals and Health Risks

According to the World Health Organization, the Mongolian system has two levels, primary care and specialised care with referral, inherited from the Soviet model. The 2011 health law transformed family medicine groups and district hospitals into family and district health centres, more oriented towards public health than curative care. Family health centres are private structures that deliver public services funded by the State under contracts; essential primary care is free for citizens, funded by the public budget, and regional diagnostic and treatment centres complete the offer. A reform of social health insurance, supported by the WHO, began in 2018 and added day care, home care, rehabilitation and certain tests to the primary care package.

Social health insurance is compulsory. The International Labour Organization recalls that the country has a compulsory social health insurance scheme, a social insurance scheme open to herders on a voluntary basis and several support arrangements for vulnerable people. Health insurance coverage reaches nearly 90%. Since 2015, the insurer has funded discounts on medicines, and dialysis has been subsidised by the State since 2017. The country is the least densely populated in the world: about half of the population lives in Ulaanbaatar and 30 to 40% are herders in rural areas, which explains the unequal access.

The General Law on Social Insurance, revised in 2023 and in force since 1 January 2024, defines the insured person as a Mongolian citizen, a foreigner or a stateless person, and makes insurance compulsory for foreigners who work for an employer in Mongolia for pensions, benefits, unemployment and workplace accidents. The health insurance premium rate is set separately by the health insurance law, which the pages consulted do not reproduce: the employer and the insurer specify a foreign employee’s access to benefits.

Other profiles rely on the CFE (the French social security fund for expatriates) or international insurance: France Diplomatie declares it imperative to hold a contract covering the whole stay, illness, hospitalisation and repatriation, ideally with an administrative and medical correspondent in Mongolia. The page on healthcare reimbursement in Mongolia compares the solutions available.

France Diplomatie describes the medical infrastructure as rudimentary, particularly outside the capital, and notes that communication problems slow down care and transfers to Ulaanbaatar. It strongly recommends private hospitals, whose costs can be extremely high in the capital, and cites no establishment in its health sheet. The French embassy refers to its website for information on doctors and establishments, and its consular section can provide information.

• Police: 102; fire brigade: 101; emergency medical services: 103.
• French embassy in Ulaanbaatar: +976 11 32 45 19 (15 Peace Avenue, 1st Khoroo, Chingeltei district).
• Interpretation application: “Guide MON-FRA”, available on iOS and Android, useful outside the capital where foreign languages are rarely spoken.

For serious cases, a transfer abroad may be necessary: see the guide to the course of a medical repatriation.

France Diplomatie recommends taking only strictly necessary medicines, in their original packaging with their labels, accompanied by a prescription using the international nonproprietary name, and checking that they are authorised in Mongolia. No medicine should be bought in the street, because of the risk of counterfeits. If you have regular treatment, bring enough to cover the whole stay, as local equivalents are not always available or reliable. For flights with a connection via Moscow, keep your medicines in the cabin: checked baggage may arrive several days late.

France Diplomatie stresses that the vaccines recommended in France are also indispensable abroad, then cites, depending on the conditions and length of stay: hepatitis A, typhoid fever, hepatitis B (frequent or prolonged stays), tuberculosis (children under 15), rabies (young children, stays in rural areas) and tick-borne encephalitis depending on conditions. A consultation at an international vaccination centre, well before departure, leaves time for boosters.

• Plague: 17 of the 21 provinces are at risk of bubonic plague according to the National Centre for Communicable Diseases; infections are reported after handling or eating raw marmot. Avoid rodents, use flea products, and neither eat nor handle marmot meat.
• Ticks: tick-borne encephalitis, covered by vaccination for stays in rural or wooded areas, and Lyme disease; prevention through covering clothing, repellents and checking the body after a walk in the countryside.
• Rabies: almost always fatal once symptoms have appeared; immediate consultation after any risk exposure, even if vaccination is up to date.
• Typhoid and tuberculosis: water and food hygiene, vaccination and BCG vaccine.
• Cold and altitude: protect yourself from cold and altitude depending on the destination; winter lasts nearly eight months, with about -40 °C in Ulaanbaatar.

The geographical context weighs on access to care. Mongolia is the least densely populated country in the world, with 2.24 inhabitants per square kilometre, and France Diplomatie justifies classing the whole territory under heightened vigilance by the distances, the state of the roads and limited medical infrastructure. Roads outside the capital are often unpaved, with livestock and little signage; fuel and repairs are unreliable there, and both a GPS and a satellite phone are advised. In winter, outside Ulaanbaatar, it is recommended to travel with two vehicles.

• Cold: winter lasts nearly eight months and temperatures reach about -40 °C in Ulaanbaatar; bring cold survival gear, especially outside the capital.
• Air transport: winter frequently causes flight delays and cancellations; seven airports have paved runways, including Ulaanbaatar, Khovd and Oyu Tolgoi.
• Communications: outside Ulaanbaatar, people rarely speak a foreign language; the “Guide MON-FRA” application helps describe symptoms.
• Earthquakes: the west of the country has strong seismic activity and Ulaanbaatar has three active faults nearby; follow evacuation or assembly instructions.

These factors argue for an assistance contract that covers medically equipped transport from the provinces to the capital, and beyond to abroad when the patient’s condition requires it. Insurance for repatriating an immobilised vehicle is also recommended by France Diplomatie for car trips.

France Diplomatie insists on the protection of vulnerable people: children under 15 on frequent or prolonged stays are concerned by the tuberculosis vaccine, and young children in rural areas by the rabies vaccine. The elderly, pregnant women and people with chronic illnesses are the most exposed to the effects of air pollution, for which the French administration gives general protection advice. For regular treatment, the availability and reliability of local equivalents are not guaranteed: bring a sufficient supply for the length of the stay and keep the prescription under the international nonproprietary name.

As private hospital costs can be extremely high, direct billing by the insurer is valuable: see the guide to checking the contracted network.

A resident organises their cover before arrival: choice of contract, checking coverage of evacuation and direct billing in private hospitals, medical questionnaire. The guide to the medical questionnaire and medical history helps you anticipate exclusions, and the guide to budgeting for health abroad gives benchmarks for setting your budget. For life on the spot, also see the page on living in Mongolia.