Expat insurance and health insurance in Peru

Peru’s healthcare system rests on three distinct pillars. EsSalud (Seguro Social de Salud) is the public social insurance scheme: it is funded by a mandatory employer contribution of 9% of the employee’s total pay, borne entirely by the employer, and covers formal-sector workers in the public and private sectors along with their dependants, about 30% of the population according to available data. An employee can, together with their employer, redirect up to 25% of this contribution to an EPS (Entidad Prestadora de Salud), a private supplementary insurance giving access to a network of clinics.

SIS (Seguro Integral de Salud), run by the Ministry of Health (MINSA), is free public insurance originally designed for people in extreme poverty. The 2009 universal health insurance law turned it into a near-automatic safety net for anyone without other cover, to the point that 99% of Peruvians nominally had health cover in 2023 according to the sources consulted. This high coverage on paper nonetheless masks major disparities in real access to care, particularly outside Lima.

The private sector, concentrated in Lima, offers well-equipped clinics (Clínica Anglo Americana, Clínica Internacional, the Auna network, among others) with a standard of care rated good by France Diplomatie, but at high rates and with payment generally required in advance, a bank card being requested on admission. UK authorities note that medical care is markedly harder to access outside Lima, which alone is thought to concentrate close to a quarter of the country’s hospitals; the gap between the capital and the regions remains marked, for example in the rate of births assisted by qualified staff. No source consulted explicitly guarantees free or automatic emergency care for a foreigner without cover, unlike some neighbouring countries.

• Tourist stay (under 90 days within 183 days): no health insurance legally required for entry; France Diplomatie nonetheless describes it as essential in practice, since the embassy cannot cover medical costs, and private clinics generally require a guarantee of payment on admission.
• PVT (working holiday programme) : bilateral France-Peru agreement, open from age 18 to 30, annual quota of 300 places, stay of up to one year. Mandatory insurance covering illness, hospitalisation, disability, maternity and repatriation for the whole stay; minimum savings of €2,500 and a clean criminal record required in the application, along with a medical certificate of good health.
• Students and temporary residents: the portal of the Superintendencia Nacional de Migraciones, which manages Peruvian visas and residence permits, could not be accessed at the time of verification (technical access blocked); no uniform health insurance requirement for temporary residence could therefore be confirmed in the available sources. To be checked directly with the Peruvian consulate in France or the host institution before taking any steps.
• Seconded employees and other temporary residents : once formally hired by a Peruvian employer, EsSalud affiliation is automatic, with the 9% contribution paid entirely by the employer, with no deduction from the worker’s pay.

No official set fine has been identified for simply lacking cover outside the PVT scheme; the documented risk is being billed in full for care in the private sector, with a guarantee of payment required on admission, including for urgent care.

No social security agreement has been signed between France and Peru: Peru does not appear in CLEISS’s list of country factsheets, which only covers countries that have signed a coordination agreement with France, and PwC’s overview of Peru’s tax and social treaties likewise does not mention France among its partners.

• In the absence of a bilateral agreement, no totalisation of insurance periods between the two countries is possible for building up pension rights.
• No coordination mechanism allows for even partial cover of care received in Peru under a French affiliation, nor the reverse for care received in France under a Peruvian affiliation.
• An employee affiliated to EsSalud through their Peruvian employer benefits from local cover, but this does not substitute for any French social protection and is not recognised as such on return to France.

In the absence of an agreement, for any French national moving to Peru — an employee affiliated to EsSalud, a self-employed person or a retiree — voluntary enrolment with the Caisse des Français de l’étranger (CFE) or taking out international health insurance remain the only options for cover recognised in France, alongside any local cover.

• Before departure: take out insurance covering medical costs, hospitalisation and medical repatriation, regardless of the planned length of stay.
• For a PVT: put together the application with insurance valid for the whole stay (illness, hospitalisation, disability, maternity, repatriation) and proof of minimum savings of €2,500, before submitting the request.
• For a stay of more than 90 days: check directly with the Superintendencia Nacional de Migraciones or the Peruvian consulate in France on the applicable visa or residence procedure (official portal inaccessible at the time this page was verified — to be reconfirmed before taking any steps).
• Once formally hired in Peru: check EsSalud affiliation with the employer, and consider a supplementary EPS plan if desired.
• Within 6 months of arrival: register with the roll of French nationals living abroad at the Consulate General in Lima (free, valid for 5 years, recommended).
• In the absence of a bilateral agreement: voluntary enrolment with the CFE or taking out international health insurance from the time of moving.