Healthcare Reimbursement in the Solomon Islands: Who Pays What Depending on Your Situation

The CLEISS, which centralises France’s social security agreements, lists the Solomon Islands neither among the agreements in force nor among those signed but not yet in force. As the country is not a member of the European Union, the European coordination regulations do not apply there. There is therefore no European card, no totalisation of periods and no cross-cover. For a stay abroad outside an agreement, the CLEISS reminds readers that care is at the traveller’s expense unless the fund has given prior agreement.

In the Solomon Islands, three players can step in depending on status: the maintained French scheme (secondment), the CFE and international health insurance. The local scheme provides no comparable benchmark: the official sources read describe no health insurance open to foreign residents, and the national provident fund is a savings account. France Diplomatie reminds readers that the French embassy in no case pays medical costs. The notions of reimbursement base and out-of-pocket cost help you compare offers. How the local system works is presented in the guide to the healthcare system in the Solomon Islands.

A posted employee sent by their French employer remains affiliated to the French scheme under domestic legislation (articles L. 761-2 and R. 761-1 to R. 761-6 of the Social Security Code), for three years renewable only once. After the maximum, a two-year gap is required before a new secondment to the same country for the same company; otherwise the employee becomes an expatriate and comes under the local system alone. Care is covered within what the employee would receive for the same care in France: they send their paid invoices, with form S 3125c, to their home fund, and the dependants who accompany them do the same. For a country where care is expensive, the employer may take out additional private insurance. Daily allowances are paid by the fund on the sick leave certificate sent within 48 hours. See the posted worker glossary entry.

An employee on a local contract leaves the French scheme: the CLEISS specifies that they will no longer be covered by French social security and must return their carte Vitale. Their employer contributes for them to the national provident fund, which does not reimburse care. Health cover therefore comes through a group policy from the employer, through the CFE (sickness, maternity, disability, work accidents and basic retirement) or through international insurance. See local contract and secondee or expatriate.

A self-employed person has no employer to cover them: according to the CLEISS, the CFE protects expatriate self-employed workers for sickness and maternity. International insurance including hospital care and repatriation remains the most complete solution for a stay of several years; see digital nomad insurance.

A student is treated by the CLEISS according to length of stay. For less than six months, only article R. 160-4 of the Social Security Code can open a reimbursement: the fund may pay a flat sum, without being obliged to, for unforeseen care (excluding pre-existing or chronic conditions) whose costs have been advanced, within French rates. Beyond six months, a student over 20 no longer comes under French health insurance and takes out voluntary insurance with a private insurer or the CFE; a student under 20 keeps the status of family member, with the limited mechanism of article R. 160-4. Before age 30, the CFE offers its youth offer. See insurance for students abroad.

The spouse and children of a posted employee are reimbursed like them, with the same form. The non-working spouse of an expatriate may continue voluntary insurance if they were compulsorily insured in France for at least six months and if they apply within six months of the end of that insurance; an alternative route exists with a dependent child under 20 and at least five years of cover, according to the CLEISS. See expat family insurance.

According to the Assurance Maladie (the French public health insurance), a retiree who settles outside the European Union no longer has their healthcare costs covered by French health insurance: they can join the CFE or take out private insurance. Form S1 is reserved for European countries covered by the coordination regulations. The CFE retirees’ offer is aimed at holders of a pension from the French basic scheme who no longer carry out any activity; the CFE asks for no health questionnaire.

For temporary stays in France, a general scheme retiree can register with the national centre for French retirees abroad: for a country with no agreement, reimbursement requires at least 15 years of contributions to French compulsory schemes. Their spouse is not covered during these stays in the absence of an agreement and must arrange insurance. See a retiree’s health insurance abroad and the page on retiring in the Solomon Islands.

The CFE is a voluntary social protection body. In France, it reimburses under the principles of the Assurance Maladie, with direct payment in public and private hospitals; abroad, it reimburses according to the country of care, through a rate or flat fee applied to the actual bill. As an example given by the CFE, a GP consultation billed at €25 is reimbursed €21 (70%). The scales specific to the Solomon Islands are read in the benefits table of the offer; the gap between the local price and the base used remains the member’s responsibility (see CFE reimbursements).

• Offers: main offer (age 30 and over) and youth offer (under 30), each with a contribution that depends on age and the plan chosen, according to the CFE home page, with no health questionnaire and no exclusion once a member.
• Waiting period: none if membership takes place before departure or within three months of settling abroad; otherwise three months for those under 44 and six months for those over 45 (see waiting period).
• Maternity: conception must come after joining or after being attached as a dependant; the option’s daily allowances require ten consecutive months of membership at the presumed date of delivery.

On returning to France, the CLEISS indicates that a person who takes up work again is covered for their healthcare costs from the first hour worked; without activity, they apply for the universal health protection (PUMa), with in principle a three-month waiting period. Periods of voluntary CFE membership may be taken into account, and the benefit of the expatriate scheme’s services may be kept for up to three months under conditions. See reducing the waiting period and returning to France insurance.

International health insurance from the first euro reimburses actual costs within its limits, after any deductible, waiting periods and exclusions of the policy. For the Solomon Islands, the criteria to read are validity in the territory, cover for surgery and hospitalisation, limits, handling of medical history and above all evacuation to Brisbane, which France Diplomatie recommends considering in the event of a serious problem. Direct payment avoids advancing costs, which answers the risk of refusal of care flagged by France Diplomatie.

A tourist stays up to 90 days with the visitor permit. The CLEISS indicates that, in a country with no agreement, no cover on the spot is possible, that an optional reimbursement of unforeseen care can be requested after returning to France, that the Assurance Maladie does not cover medical repatriation and that a travel contract matched to local costs is recommended. Bank card assistance can complement this arrangement, with limits to check. See long-stay travel insurance.

The official sources read publish no tariff for consultations, hospital stays or medicines in the Solomon Islands: the amounts are therefore not given here, and each item should be read in the chosen policy.

• Consultation: reimbursed on paid invoices under French rules for a posted worker; according to the scale of the country of care for the CFE; at actual cost within the limits for a first-euro policy.
• Hospital care: must be covered, as access may be refused without an assistance contract; a posted worker is reimbursed within French rates, the CFE according to its scale, international insurance according to its limits, with evacuation to Australia if the situation requires it.
• Medicines: to be taken in a personal first-aid kit with a prescription in international non-proprietary form; purchases on the spot are reimbursed on the same principle as consultations.
• Dental and optical: the CFE covers dental care according to its scales; optical comes mainly under international policies, with limits per period to be read in the benefits table.
• Maternity: for a person insured in France who goes to give birth in a country with no agreement, the CLEISS indicates that benefits are not paid; the CFE requires conception after joining, and international policies generally apply a waiting period.

The reimbursement guide and the page on expat health insurance give benchmarks; Expavy helps you weigh these options against your situation.