Expat insurance and health insurance in Sri Lanka

Sri Lanka has an extensive and long-established public healthcare system, built around teaching hospitals in major cities (Colombo, Kandy, Galle, Anuradhapura, Jaffna) and around 555 public hospitals across the country. The public sector accounts for the large majority of healthcare provision (more than 90% of admissions and consultations) and the country shows, according to several specialised sources, health indicators (life expectancy, maternal and infant mortality) above the regional average despite relatively low health spending. Several specialised guides for expatriates state that public hospitals are in principle accessible free of charge to foreigners, including tourists, for routine care; however, this could not be confirmed with certainty from an official Sri Lankan source, and waiting times as well as the level of comfort are commonly described as well below the standards expected by a Western resident. The National Hospital of Sri Lanka, in Colombo, founded in 1864 and affiliated with the Faculty of Medicine of the University of Colombo, is the national reference facility, with around 3,400 beds.

The private sector, significantly more expensive but better equipped, is concentrated in Colombo and caters primarily to expatriates, international patients and the wealthiest Sri Lankans: the main groups are Asiri Health (Asiri Central, Asiri Surgical, Asiri Medical), Nawaloka Hospital, Durdans Hospital and Lanka Hospitals. The French embassy in Sri Lanka states that it keeps an up-to-date list on its website of known doctors and facilities considered reliable, and recommends informing it — or informing your insurer — before any planned hospitalisation, so as to be directed to a reliable facility. For the most serious procedures, a transfer to India or Singapore is sometimes still necessary, due to a lack of local availability for certain advanced specialties.

• ETA (Electronic Travel Authorization) mandatory for any stay, to be requested before departure on the official portal eta.gov.lk. Since 25 May 2026, it has been free for French nationals on a 30-day tourist stay with a double-entry option (down from 50 to 60 USD previously); beyond 30 days, a visa extension is required, subject to applicable fees.
• Passport valid for at least 6 months after the planned entry date; a return ticket and proof of funds may be requested at the border.
• No specific fine linked to a lack of health insurance has been identified for entry into the country, but France Diplomatie stresses that medical costs abroad can be very high and that these costs can under no circumstances be covered by the French embassy, which recommends taking out an assistance contract covering medical costs, surgery, hospitalisation and medical repatriation.
• Digital Nomad Visa, implemented by the Department of Immigration and Emigration since 19 February 2026: reserved for adults whose activity and income (around 2,000 USD per month depending on the application) come exclusively from abroad, subject to an application fee of around 500 USD, for a renewable one-year stay. Proof of international health insurance valid in Sri Lanka is among the documents requested according to several specialised guides consulted, though this could not be confirmed on a first-tier official Sri Lankan source.
• Dengue: France Diplomatie reports a significant increase in cases, particularly in the Colombo district; no curative treatment exists (symptomatic management only, anti-inflammatories to be avoided) — mosquito protection is the only prevention.
• Malaria: Sri Lanka is considered a country where transmission has been interrupted since 2016 (WHO certification), with rare imported cases reported occasionally.
• Vaccinations to consider depending on profile and length of stay, in addition to universal vaccines: hepatitis A and B, typhoid fever, rabies (particularly for young children in rural areas), Japanese encephalitis and chikungunya depending on season and length of stay, and tuberculosis for children under 15 on an extended stay.

No bilateral social security agreement between France and Sri Lanka has been identified. CLEISS lists only eight Asian countries and territories that have concluded an agreement of this kind with France (China, South Korea, India, Israel, Japan, the Philippines, Taiwan, Turkey) — Sri Lanka is not among them. A France-Sri Lanka agreement does exist, signed in 2022, relating to the authorisation for family members of official mission staff to carry out salaried professional activity: its Articles 8 and 9 refer those concerned solely to the host state’s legislation on tax and social security, without establishing any coordination of rights between the two systems. In the absence of any coordination agreement, no portability exists for health, maternity, old age or family benefits between France and Sri Lanka.

• No form for maintaining French rights applies in Sri Lanka.
• Affiliation to CFE or taking out private international insurance are the only forms of coverage recognised by a French scheme, regardless of profile.
• Access, even free access, to the Sri Lankan public system is neither coverage recognised in France, nor a substitute for repatriation or medical evacuation.

• Before departure, whatever the purpose: apply for the ETA on eta.gov.lk (free for French nationals on a 30-day tourist stay since 25 May 2026) and take out insurance or an assistance contract covering hospitalisation and medical evacuation/repatriation, in the absence of any France-Sri Lanka coordination.
• Check passport validity (6 months after the entry date) and prepare proof of a return ticket and of funds before finalising the ETA application.
• Before departure: medical consultation/vaccination centre to assess the need for hepatitis A and B, typhoid fever, rabies, Japanese encephalitis and chikungunya vaccinations depending on season and length of stay, and to protect against dengue, which is significantly increasing according to France Diplomatie, particularly in the Colombo district.
• For a stay of more than 30 days: apply for a visa extension or an appropriate status (resident, work, digital nomad) before the ETA expires.
• For digital nomad status: put together the "Digital Nomad Visa" application with the Department of Immigration and Emigration (proof of foreign income, application fee of around 500 USD, international health insurance) before submission.
• Before any planned hospitalisation: contact the French embassy in Colombo or your insurer to be directed to a reliable facility.
• Voluntary affiliation to CFE recommended in the absence of any health coordination.
• Within 6 months of arrival: register with the roll of French nationals living abroad, at the French embassy in Colombo.