Expat insurance and health insurance in Saint Kitts and Nevis

Saint Kitts and Nevis is an independent state made up of two islands. Public care there is organised around the Joseph N. France (JNF) hospital in Basseterre, on the island of Saint Kitts, and the Alexandra hospital on the island of Nevis. The government's official website states that these two facilities are able to handle many types of treatment, but that serious cases lead to emergency evacuation, generally to the United States. It also mentions the existence of several private hospitals and clinics, without detailing them, and recommends having adequate health insurance as well as accessible funds for care abroad and repatriation.

On the French side, the "Useful contacts" page of France Diplomatie states that the equipment of local hospitals is very insufficient and recommends, in the event of a serious accident, evacuation to a hospital in Guadeloupe. The "Health" page specifies that it is essential to have an assistance policy or insurance covering medical costs and medical repatriation, that some hospitals require advance payment and that these costs can under no circumstances be covered by the French embassy.

The local social security scheme, run by the Social Security Board, has existed since 1978 and extends to all workers, with mandatory contributions. The government's website describes it as offering a wide range of cash benefits; it does not mention cover of medical care, and the official sources consulted do not describe a mandatory national health insurance or a schedule of fees for care for non-residents. These points are to be confirmed with the local Ministry of Health before any move.

The government launched the preparatory works for a new JNF general hospital, on the Camps site.

• Travel document: according to France Diplomatie, a valid passport is required; the national ID card is not sufficient and no exemption is provided for.
• Electronic travel authorisation (ETA): required since 26 May 2025 for travellers arriving by air or staying at least one night on the island; cruise passengers on a day stopover, with no overnight stay, are exempt. The application is made online on the official Saint Kitts and Nevis portal, at the earliest three months and at least 48 hours before arrival, with fees varying according to the type of authorisation.
• Length of stay: the ETA allows a stay of up to 90 days; an extension is requested from the local Ministry of Security.
• Longer stay or settling: residence conditions (permit, duration) do not appear on the France Diplomatie pages consulted; they are to be confirmed with the Saint Kitts and Nevis authorities or the French embassy in Saint Lucia before departure.
• Vaccinations: bring the vaccinations of the French schedule up to date; yellow fever is required for travellers coming from endemic areas, and other vaccines (hepatitis A and B, typhoid fever) depend on the length and conditions of the stay, according to France Diplomatie.
• Travel or expatriate insurance: an assistance policy or insurance covering medical costs and medical repatriation, considered essential by France Diplomatie; this requirement is a recommendation, no text consulted imposes health insurance on entry.
• Student: no EHIC (non-EU country); a student insurance or comprehensive insurance is essential, as no agreement opens any entitlements on the spot.
• Seconded employee : with no social security agreement, there is no certificate of continued affiliation to the French scheme provided for by an agreement; the situation depends on the law applicable to the employer and is to be checked with CLEISS. Affiliation with the Caisse des Français de l'Étranger (CFE) and an assistance policy remain worth considering.
• Retiree: no agreement-based procedure for local cover exists, as there is no agreement; private cover or that of the CFE is the usual route.

No individual fine linked to the lack of health insurance is mentioned in the sources consulted. The lack of an agreement with France and the embassy's inability to cover costs nonetheless make the financial risk high for anyone uninsured.

Saint Kitts and Nevis appears neither among the social security agreements in force nor among those signed but not yet in force in the list kept by CLEISS. As the country is not a member of the European Union, the EU coordination regulations do not apply either.

• Temporary stay: no European Health Insurance Card and no form for on-the-spot cover. According to ameli, outside the EU/EEA, Switzerland and the United Kingdom, only urgent and unforeseen care may possibly be covered on your return, after paying on the spot and keeping the supporting documents; the medical adviser assesses the urgency and reimbursement is made on the basis of French flat-rate tariffs, through the online request or form S 3125.
• Planned care: cover outside the EU is only accepted exceptionally, after approval by the national medical adviser (ameli).
• Expatriation or long-term move: with no agreement, no coordination of insurance periods between the two countries is provided for by an agreement. Cover options are therefore limited to local legislation, membership of the CFE or international private insurance.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds) and check the validity of your passport.
2. Take out an assistance policy or insurance covering medical costs, hospitalisation, evacuation and medical repatriation, checking for direct payment by hospitals that require advance payment.
3. Apply for the electronic travel authorisation (ETA) on the official Saint Kitts and Nevis portal, between three months and 48 hours before arrival.
4. Bring your vaccinations up to date (French schedule) and consult France Diplomatie's recommendations on mosquito-borne diseases.
5. For a stay beyond 90 days: enquire with the Saint Kitts and Nevis authorities about the conditions of stay, extensions being handled by the local Ministry of Security.
6. On site, keep prescriptions, paid invoices and proof of payment in order to apply for possible reimbursement of urgent care from the CPAM, through your ameli account or form S 3125.
7. Make yourself known to the French consular agency in Basseterre and register with the roll of French nationals living abroad (French embassy in Saint Lucia, which is responsible).