Healthcare Reimbursement in Seychelles: Who Reimburses What Depending on Your Situation

France Diplomatie describes as essential an assistance contract or insurance covering all medical costs, surgery, hospitalisation and repatriation, and specifies that the French embassy cannot pay for them. CLEISS lists no social security agreement with Seychelles: no coordination between schemes, no totalisation of periods, no cross-border payment of care (see the bilateral agreement).

Four players therefore come into play: the local scheme (public network of the Ministry of Health and Seychelles social security), the French scheme kept in place (secondment), the CFE and an international health insurance. The notions of reimbursement base and out-of-pocket cost help you compare. How the network is organised is presented in the page on the Seychelles healthcare system.

The locally employed worker holding a gainful occupation permit (GOP) is registered by their employer; affiliation to Seychelles social security, benefits and access to the public network are confirmed with the employer and the ministry before signing the contract. Private sector costs and evacuation remain to be covered by supplementary insurance. See the local contract.

The seconded employee in principle remains attached to French social security during the assignment. With no agreement with Seychelles, this retention falls under French law on secondments outside an agreement: duration, conditions and contributions should be checked with Urssaf (the French social security contributions collector) and CLEISS before departure. Costs are reimbursed under French rules, on paid invoices, whatever price is charged locally; employers often add an international group contract. See seconded or expatriate and the glossary entry on the seconded employee.

The self-employed person or digital nomad has no employer to affiliate them: they combine the CFE and international insurance, the visitor or residence permit giving no right to free care. Cover that opens up the private sector and evacuation remains the most complete. See digital nomad insurance.

The student must check their residence permit with the immigration service and the cover required by their institution; before age 30, the CFE offers its youth offer. See student insurance abroad. The spouse and children appear on the residence permit (separate fees per person) and come under CFE family contracts or international ones, with maternity and paediatrics depending on the contract. See expat family insurance.

The S1 form is valid only in the European Union and equivalent States: a retiree settled in Seychelles does not keep automatic French cover, and their residence permit gives no right to free care. They choose between the CFE (retirees’ offer, with a contribution that depends on age and the plan chosen according to cfe.fr) and international insurance. See the guide to health insurance for retirees abroad and the page on retiring in Seychelles.

The CFE is a voluntary social protection body. In France, it reimburses according to the principles of social security, with direct payment (third-party payment) in public and private hospitals, for stays of less than three months; abroad, the amounts depend on the country of care and the procedure, in the form of rates or flat amounts applied to actual expenses. Example from cfe.fr: a GP consultation billed €25 in France is reimbursed €21 by social security, and the CFE reimburses at most €21 abroad. When local prices or the cost of an evacuation exceed the base used, the difference remains payable by the member (see CFE reimbursements).

• Offers: the main offer (age 30 and over), the youth offer (under 30) and the retirees’ offer, each with a contribution that depends on age and the plan chosen, and an offer for care in France only.
• Waiting period: immediate cover if enrolment takes place before departure or within three months of settling; otherwise three months, or six months from age 45 (see waiting period).
• Maternity: conception must come after enrolment or after attachment as a dependant.

On returning to France, a CFE member with no activity benefits free of charge from a retention of rights of three months (Assurance Maladie, the French national health insurance), then joins the CPAM (the local health insurance office) under PUMa; without activity, three months of uninterrupted residence are required, a condition from which the holder of a French old-age pension is exempt. See reducing the waiting period and returning to France.

International health insurance with first-euro cover reimburses actual costs within its ceilings, after any deductible, waiting periods and exclusions. It finances the evacuation abroad or to Réunion that France Diplomatie mentions for specialist care, and direct payment when the facility is a partner. Compare the annual ceiling, the zone of cover, evacuation and the treatment of pre-existing medical conditions.

The tourist stays on a three-month visitor permit, with a paid travel authorisation. France Diplomatie recommends checking your cover before leaving; the assistance included with a bank card can supplement it, with ceilings to be checked. See long-stay travel insurance.

• Consultation: public network under the ministry’s conditions; private sector paid by the patient unless covered by a contract; reimbursed by the CFE according to its country scale; actual costs under a first-euro contract.
• Hospitalisation: French scheme for the seconded employee; CFE with third-party payment in France; international contract with direct payment and evacuation.
• Medicines: local supply sometimes irregular (France Diplomatie); reimbursed according to CFE scales or within the ceilings of a contract.
• Dental: the Ministry of Health offers public dental services; included in the CFE according to its scales and in most international contracts with an annual ceiling.
• Optical: mainly a matter for international contracts, with ceilings per period.
• Maternity: the ministry describes maternal health programmes; the CFE requires conception after enrolment; international contracts generally apply a waiting period.

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