Expat insurance and health insurance in the Solomon Islands

The health system rests on four levels of care, according to the role delineation policy drawn up by the Ministry of Health and Medical Services with the support of the World Health Organization (WHO): rural health clinics (basic primary care), area health centres (simple surgery), provincial hospitals and the National Referral Hospital in Honiara. The WHO described a country of around 620,000 inhabitants spread over more than 600 islands, where 126 of the 157 doctors practised in Honiara, and stated that nearly half of health spending came from donors. The World Bank gives fewer than one doctor per 1,000 inhabitants.

France Diplomatie describes the hospital infrastructure as precarious and recommends, in the event of a serious problem, considering a medical repatriation to Brisbane (Australia). It reminds that an assistance policy or insurance covering all medical costs (surgery, hospitalisation) and medical repatriation is essential: without it, access to care may be refused, even in a life-threatening emergency, and the French embassy in no case covers these costs.

The official sources consulted describe neither a mandatory health insurance fund nor a reimbursement schedule for a foreign resident: the details of financing and of the conditions of access to public care for a foreigner could not be established and must be confirmed with the Ministry of Health and Medical Services or CLEISS before settling.

• Stay of less than 90 days: on arrival, a 90-day visitor's permit is issued free of charge. The authorities may ask for proof of funds covering the length of the stay.
• Passport: valid for six months after the planned return date, with a return ticket, according to France Diplomatie.
• Extension: the permit can be extended free of charge for up to three months with the immigration services; beyond that, a further three-month period requires a specific application and a tax of 30 Solomon dollars per month. Processing times vary.
• Vaccinations: proof of measles vaccination is required to enter if you are coming from Australia, New Zealand, Fiji, Samoa, Tonga, the Philippines, Kiribati or Papua New Guinea; yellow fever is mandatory for travellers coming from endemic areas.
• Travel insurance: an assistance policy covering medical costs and medical repatriation is considered essential by France Diplomatie.
• Local affiliation: no individual health insurance obligation could be identified in the official sources consulted; to be checked before a long-term move or a local employment contract.
• Dual nationality: France Diplomatie states that it is not recognised in the Solomon Islands, which may complicate the consular assistance provided to dual nationals.
• Student: no EHIC, as the country is not a member of the European Union; a student insurance or comprehensive international health insurance is essential.
• Seconded employee : with no agreement, continuation on the French scheme falls under domestic legislation (articles L. 761-2 and R. 761-1 to R. 761-6 of the French Social Security Code, according to CLEISS), for a limited period to be confirmed with Urssaf or CLEISS. Affiliation with the Caisse des Français de l'Étranger (CFE) and an assistance policy remain recommended as a complement.
• Retiree: no agreement coordinates the schemes; any entitlements to cover must be checked with your pension fund and your health insurance fund before departure.

No individual fine for lacking health insurance is mentioned in the sources consulted. The risk is above all financial: France Diplomatie warns that care may be refused without an assistance policy and that the French embassy does not cover these costs.

No social security agreement is in force between France and the Solomon Islands. The country appears neither in the list of agreements in force nor in that of agreements signed but not yet in force published by CLEISS. As the country is not a member of the European Union, the EU coordination regulations do not apply either.

• Temporary stay: no form for on-the-spot cover exists, with no agreement; care is payable by the traveller, hence the central role of the assistance policy.
• Secondment: an employee sent by their French employer can remain on the French scheme under domestic legislation; CLEISS states a duration of three years, renewable once, with a two-year waiting period before a new secondment in the same country for the same company (information to be confirmed on the CLEISS website or with Urssaf, which receives the application). Dual affiliation is possible if the local scheme is mandatory.
• Expatriation under a local contract: the employee falls under local legislation; joining the CFE or international health insurance makes it possible to cover care.
• Retiree: with no agreement, no procedure for attachment to a local scheme is provided for by a bilateral text.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Take out an assistance policy or insurance covering all medical costs (surgery, hospitalisation) and medical repatriation, essential according to France Diplomatie.
3. See your GP or an international vaccination centre early enough: update of the vaccination schedule, measles, yellow fever depending on origin, prevention of malaria, dengue and chikungunya.
4. Check that your passport remains valid for six months after the planned return date and book a return ticket; bring proof of funds.
5. Obtain the 90-day visitor's permit on arrival; request an extension from the local immigration services if necessary.
6. Seconded employee: request continuation on the French scheme from Urssaf before departure.
7. Expatriation or long-term move: consider joining the CFE and international health insurance; confirm with the Ministry of Health and Medical Services the conditions of access to local care.
8. During the cyclone season (November to May), follow the instructions of the local authorities and plan for suitable insurance, as France Diplomatie recommends.
9. Registration with the roll of French nationals living abroad with the French embassy in Port Vila (Vanuatu), which is responsible for the Solomon Islands.