Expat insurance and health insurance in Nepal

Nepal’s healthcare system falls under the Ministry of Health and Population (MoHP). Despite current health expenditure that is relatively higher than in some neighbouring countries (6.16% of GDP in 2023, World Bank), the household out-of-pocket share is rising and reached 59.39% of current health expenditure in 2023. The public network is built around major university and general hospitals in Kathmandu: Tribhuvan University Teaching Hospital (TUTH), founded in 1982 and affiliated with Tribhuvan University’s Institute of Medicine, has around 700 beds and provides both general care and specialised training; the Bir Hospital, the country’s oldest hospital (founded in 1889), has a stated capacity of around 960 beds under the Ministry of Health. These facilities remain primarily sized for the local population, with no identified arrangement for foreign patients, and specialised sources note that equipment is sometimes outdated and hygiene standards vary between facilities.

The private sector and structures specialised in international patients are concentrated in Kathmandu. The CIWEC Clinic (now CIWEC Hospital), Nepal’s first travel medicine centre, opened in 1982, is the go-to reference for trekkers and expats, particularly for acute mountain sickness and travel-related illness; it accepts credit cards and handles insurance claims on site. The Norvic International Hospital, a private facility founded in 1993 (around 200 beds, Thapathali district), has a NABL-accredited laboratory and modular operating theatres built to JCI standards; other facilities such as HAMS Hospital or Grande International Hospital are also cited by specialised guides aimed at expats. France Diplomatie nonetheless describes insurance covering medical expenses (including surgery and hospitalisation) and medical repatriation as essential: serious cases most often require evacuation out of the country, for lack of sufficient infrastructure locally.

• Mandatory visa for all French nationals, regardless of the purpose of the stay: to be obtained on arrival at Kathmandu’s Tribhuvan International Airport or at a land border crossing, or before departure from the Nepalese embassy in Paris. Two passport photos and a passport valid for at least 6 months beyond the length of stay are required.
• Official visa-on-arrival fees (Department of Immigration of Nepal): 30 US$ for 15 days, 50 US$ for 30 days, 125 US$ for 90 days, preferably paid in cash (notes in good condition); the visa allows multiple entries. An extension on site is possible up to 150 cumulative days per calendar year, at a rate of 3 US$ per day.
• Customs declaration mandatory for any cash sum exceeding the equivalent of 2,000 US$ on entering the country.
• Trekking and mountain hiking: since 31 March 2023, using a licensed guide and obtaining a TIMS card (Trekking Information Management System) are mandatory for almost all trekking routes. Proof of trekking insurance is also required to obtain permits for restricted areas.
• Health/repatriation insurance described as essential by France Diplomatie, which recommends an assistance contract covering all medical expenses (including surgery and hospitalisation) and medical repatriation; for any high-altitude hike, search and mountain evacuation insurance is presented as mandatory, since Nepalese helicopter companies only intervene once financial cover is guaranteed.
• Since 2026, hotels, travel agencies and trekking companies must register their foreign clients in a government database.
• Seconded employee : in the absence of an agreement, staying on the French scheme is governed solely by French law (unilateral secondment), for a period of 3 years renewable once, with no exemption from any contributions owed in Nepal.

France Diplomatie places the entire country under a heightened vigilance zone and notes the frequency of earthquakes (including those of April and May 2015, magnitudes 7.9 and 7.3), as well as monsoon-related flooding and landslides, from June to October. The local police emergency number is 100; the Kathmandu tourist police can be reached at +977 01 5347041.

France and Nepal have no bilateral social security agreement: Nepal does not appear on the list of agreement countries published by CLEISS, which lists only a limited number of Asian countries and territories with such an agreement with France (including China, South Korea, India, Israel, Japan, the Philippines, Taiwan and Turkey). There is therefore no applicable European health insurance card, no A1 or S1 form enforceable with the Nepalese authorities, and no direct reimbursement mechanism between the two systems.

• Temporary stay: no European or bilateral coordination applies; only health/travel insurance taken out before departure covers costs on site, described as essential by France Diplomatie, with a search-and-mountain-evacuation component for any trek.
• Secondment from France: in the absence of an 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 is not exempt from any contributions owed in Nepal. Care received on site is reimbursed after the fact by the French fund, within the limits of French rates, on presentation of receipts and form S3125.
• Long-term move: no local social security scheme accessible to foreigners has been identified for routine healthcare; a voluntary enrolment with CFE remains the recommended route to stay covered by a system recognised in France, alongside international private insurance covering medical evacuation.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Before applying for a visa: take out health/travel insurance covering medical expenses (including surgery and hospitalisation) and medical repatriation, described as essential by France Diplomatie.
3. For any trekking or high-altitude hiking: check that the contract specifically covers search and helicopter evacuation in the mountains, and obtain an insurance certificate before applying for the restricted-area permit.
4. Obtain the visa on arrival at Kathmandu airport or a land border crossing, or request it before departure from the Nepalese embassy in Paris; bring cash in US dollars and two passport photos.
5. For any trek: book a licensed guide and obtain the TIMS card (Trekking Information Management System) from an authorised agency.
6. Seconded employee: arrange the unilateral secondment with the employer through the French fund before departure (maximum duration 3 years renewable once).
7. Update vaccinations (hepatitis A and B, typhoid, Japanese encephalitis in the Terai region during the monsoon, rabies) and follow gradual altitude ascent rules (no more than 400 m of elevation gain between two consecutive nights above 2,500 m).
8. Keep receipts for care and form S3125 for any after-the-fact reimbursement request from the French fund (secondment case).
9. Register with the roll of French nationals living abroad (French Embassy in Kathmandu).