Expat insurance and health insurance in Venezuela

Venezuela formally has a mixed health system, combining a public sector managed by the Ministry of Health and the IVSS (Instituto Venezolano de los Seguros Sociales, the public social security body) and a private sector. In practice, France Diplomatie notes that "the prolonged crisis Venezuela is going through causes serious shortcomings in the health system, particularly outside Caracas", and that shortages affect "medicines [...] as well as medical equipment, both in pharmacies, public hospitals, and even private clinics". Human Rights Watch, citing the Venezuelan NGO Convite, noted that in March 2024, essential medicines were unavailable in 28.4% of the country's pharmacies, with a significant share of medicines still available also remaining financially out of reach for part of the population.

The IVSS in theory covers health-maternity, workplace accident, disability, old age, survivor and unemployment risks for affiliated formal workers. Its funding rests on an employer contribution of 9, 10 or 11% of salary depending on the company's risk classification, and an employee contribution of 4%, calculated on a base capped at five urban minimum wages. No source consulted documents an operational service level of the IVSS comparable to a Western social security system; the available sources mainly cover its legal framework rather than its actual day-to-day functioning.

Faced with these difficulties in the public sector, expats and part of the Venezuelan population in practice turn to the private sector, concentrated in Caracas. The French embassy in Venezuela's reputation list includes several private clinics in the capital used by French-speaking practitioners, including the Hospital de Clínicas Caracas, the Policlínica Metropolitana (Clínica Metropolitana) and the Clínica El Ávila. No source consulted documents official pricing or a public price list for these private facilities.

• Tourist stay (under 90 days): no visa or proof of health insurance legally required on entry for French passport holders, subject to a passport valid for at least 6 months after the entry date. France Diplomatie nonetheless describes insurance covering hospitalisation costs and medical repatriation as essential, due to health costs that are "sometimes very high" and the embassy's inability to cover them.
• Extending the tourist stay: authorisation from SAIME (the Venezuelan immigration service) allows an additional 90-day period; beyond 180 cumulative days, leaving the country is mandatory.
• Work, business, family, study, religious purposes: a visa is mandatory whatever the intended length of stay. No specific health insurance requirement tied to the issuance of these visas could be confirmed in the sources consulted; to check directly with the relevant Venezuelan consulate in France before any application.
• Seconded employees and residents on a local contract: IVSS affiliation in principle automatic from formal hiring, with an employee contribution of 4% and an employer contribution of 9 to 11% of salary depending on the company's risk classification.
• Yellow fever vaccination: certificate required if arriving from French Guiana.

No official fixed fine has been identified for simply lacking health cover outside visa requirements. The documented risk is being billed in full for care in the private sector and possible stock shortages of medicines and medical equipment, including in private clinics; it is strongly recommended to bring your own stock of medicines before departure for any specific treatment.

No social security agreement has been signed between France and Venezuela: Venezuela does not appear on the list of country sheets published by CLEISS, which only covers countries that have concluded a coordination agreement with France.

• With no bilateral agreement, no totalisation of insurance periods between the two countries is possible for building pension rights.
• No coordination mechanism allows even partial coverage of care received in Venezuela under French affiliation, nor the reverse for care received in France under IVSS affiliation.
• An employee affiliated to the IVSS through their Venezuelan employer benefits from local cover, but this does not replace any French social protection and is not recognised as such on return to France.

Absent an agreement, for any French national settling in Venezuela — IVSS-affiliated employee, self-employed or retired — voluntary membership of the Caisse des Français de l’étranger (CFE) or taking out international health insurance remain the only ways to get coverage recognised in France, alongside any local coverage — all the more recommended given the documented shortages and shortcomings of the health system outside Caracas.

• Before departure: take out insurance covering medical costs, hospitalisation and medical repatriation, whatever the intended length of stay — judged essential by France Diplomatie given hospitalisation costs that can sometimes be very high.
• Before departure, if undergoing ongoing medical treatment: build a sufficient stock of personal medicines, as shortages of medicines and medical equipment are documented in pharmacies, public hospitals and some private clinics.
• For a work, study or family stay: obtain a visa before departure with the Venezuelan consulate in France and check for any health insurance requirements specific to this visa.
• To extend a tourist stay beyond 90 days: apply for authorisation with SAIME before the initial deadline expires, within the limit of 180 cumulative days.
• Upon formal hiring in Venezuela: check IVSS affiliation with the employer.
• As soon as possible after arrival: register with the roll of French nationals living abroad at the French embassy in Caracas (free, valid 5 years, recommended).
• Absent a bilateral agreement: voluntary CFE membership or international health insurance upon settling.