Expat insurance and health insurance in Montserrat

Montserrat's health system rests on public care under the authority of the Ministry of Health and Social Services. Primary care is delivered in four district health centres (St John's, Cudjoe Head, St Peter's and Salem), open Monday to Friday from 8 a.m. to 4 p.m., and hospital care at Glendon Hospital in St John's. The United Kingdom's travel advice describes "a small hospital and four district health centres". The ministry's workforce report lists, in the public sector, about ten doctors (8 of them non-local, on contracts of one to three years), about thirty nurses, 8 midwives, 2 dentists and 2 pharmacists, and notes that the supply of specialists is limited.

No compulsory public health insurance scheme was identified in the sources read. Public care is charged according to the scale in the Public Hospital Regulations (Cap. 14.01), amended by a text published on 23 January 2026: the scale applies to Montserratians, people who are not Montserratian pay double, except citizens of the Caribbean Community and of the Dominican Republic who have lived there for at least three years and UK residents holding a British health service medical card; children receive care free of charge. The amounts in the scale were not read. The ministry's social services department grants medical assistance to Montserratians and permanent residents, subject to means testing. The Montserrat Social Security Fund pays cash benefits (sickness, maternity, disability, retirement) without reimbursing care.

For cases beyond the island's means, the report indicates that patients are referred to other Caribbean territories or to the British health service, and the British advice specifies that medical evacuations are possible only in daylight. A new national hospital project is led by the Ministry of Health. The World Bank does not publish the share of health spending in GDP for Montserrat: this figure is therefore not given here. The cost and organisation of an evacuation fall under an assistance contract (see repatriation and assistance).

• Tourist stay: Montserrat's immigration service places France among the countries whose nationals do not need a visa (list of 159 countries). The United Kingdom's travel advice, written for holders of a British passport, asks for a passport valid throughout the stay and an online immigration and customs form, available 72 hours before departure. The length of stay authorised for a French national was not read on the immigration pages, which only specify that an electronic visa, for the nationalities that are subject to one, is valid for one year and does not allow work. Access is via Antigua or Sint Maarten.
• Work: a person who is not Montserratian must hold a work permit for any employment or self-employed activity (Labour Code of 2012, article 125). The employer files the application with the Department of Labour, with in particular a certificate of good conduct, a medical certificate, proof that the post was advertised in Montserrat and the arrangements for the employee's return. Exempt from a permit, among others, are holders of a permanent residence permit or an economic residence permit, spouses of Montserratians and citizens of the states of the Organisation of Eastern Caribbean States.
• Local social security: anyone working in Montserrat from the age of 16 must register with the Montserrat Social Security Fund and contribute until pension age, including non-nationals, who present their work permit; registration takes place within four days of the start of employment.
• Resident's health insurance: no legal obligation to take out health insurance was read on the pages consulted. The British advice recommends travel health insurance covering care and repatriation, as payment up front may be required.
• Student: the European Health Insurance Card does not exist for this territory, which lies outside the European Union; a student insurance or the CFE youth plan are to be compared.
• Seconded employee: continuation of the French scheme, according to CLEISS, for three years renewable once, with reimbursement up to what the French scheme provides on paid invoices (form S 3125c). Membership of the Caisse des Français de l'Étranger (CFE) remains an additional option.
• Retiree: CLEISS points to local institutions, voluntary membership of the CFE or private insurance; there is no S1 form, as the territory is not in the European Union.
• Long-term residence: a non-national who owns property in Montserrat can apply online for a resident's permit (50 US dollars, family included). According to the administration's leaflet, the permanent residence permit requires eight years of habitual residence if it began in 2003 or later; the economic residence permit requires net assets of more than EC$400,000 and a contribution of the same amount. The texts have been amended several times: the conditions in force should be confirmed with the Consular Division.
• Volcano and cyclones: zone V (which includes Plymouth) is accessible only with authorisation, and the maritime exclusion zones may not be entered without permission; the cyclone season runs from 1 June to 30 November.

No law requiring a resident to hold private insurance was read on the pages consulted; the obligation identified is registration with the Montserrat Social Security Fund. The dollar amounts in this page are those of the official texts, whose currency is not always specified; the territory's currency is the Eastern Caribbean dollar (EC$). Conversions are based on the ECB reference rate.

The territory is not in the European Union. CLEISS cites it neither in the list of social security agreements in force with France, nor in its list of foreign schemes: the page on the British scheme does not mention Montserrat either. For a temporary stay, it falls into the category “other countries or situations not covered”: on site, CLEISS indicates that no cover is possible unless an agreement applies. Without an agreement, no cover is organised between the funds.

• Temporary stay: reimbursement on return to France of unforeseen care only is a possibility and not an obligation, medical repatriation is not covered, and travel insurance suited to the real cost of care is advised.
• Secondment: the employee remains affiliated to the French scheme, for three years renewable once; their contributions are paid in France, but they may also have to pay those of the host country, so here those of the Montserrat Social Security Fund. Care is covered up to what they would have received in France (form S 3125c with the paid invoices).
• Expatriation: the employee comes under the local scheme and is no longer socially insured in France; they can join the CFE voluntarily. Without an agreement, local insurance periods are not taken into account in calculating the French pension.
• Retiree: CLEISS recommends checking local cover, choosing the CFE or private insurance, and points out that a retiree who is no longer a French tax resident pays neither CSG, nor CRDS, nor Casa.
• Taxation: the BOFiP list of tax treaties in force does not include Montserrat; the entry for the United Kingdom mentions no territorial extension. The BOFiP list of tax information exchange agreements cites Anguilla and the British Virgin Islands, but not Montserrat. Tax residence remains defined by article 4 B of the French General Tax Code (CGI) (home or main place of stay, professional activity, centre of economic interests); a single criterion is enough.
• Institutional framework: the Government of Montserrat manages immigration, labour, health and social security; the administration's pages mention the Governor's Office, and the United Kingdom indicates that there is no British embassy on site.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds) and choose your cover according to your status.
2. Prepare entry: a passport valid for the stay, checking your nationality on the immigration service's list of countries exempt from a visa, then the online immigration and customs form before departure; plan the stopover via Antigua or Sint Maarten.
3. Employee: have the employer file the work permit application with the Department of Labour before starting the activity; the post must have been advertised in Montserrat.
4. Register with the Montserrat Social Security Fund (E. Karney Osborne Building, Little Bay; tel. 664 491 2567) within four days of the start of employment, with the work permit; obtain the social security and Inland Revenue Department certificates required for permit renewals.
5. Take out health insurance with evacuation before arrival, as no public reimbursement scheme was identified; compare the CFE and private insurance.
6. Seconded employee: request continuation of the French scheme from your employer and your fund; keep the paid invoices for form S 3125c.
7. Retiree: arrange health cover before departure (CFE or private insurance) and find out about long-term stay options from the immigration service (visa@gov.ms) or the Consular Division (consular@gov.ms).
8. Register on the roll of French nationals living abroad via service-public, with the French embassy in Saint Lucia; it is strongly recommended beyond six months of settlement.
9. Volcano and cyclones: identify the exclusion zones published by the observatory, follow announcements from the local radio and the observatory, identify your shelter and prepare a family plan before the start of the cyclone season.