Very similar to the French system, Tunisian public health insurance covers foreign residents working in the country in the same way as nationals and their families. However, there are strong disparities in the supply of healthcare between the city and the countryside, and between the public and private systems. Therefore, expats may consider taking out complementary international health insurance.
Health insurance for expats in Tunisia
The health insurance system in Tunisia
The Tunisian National Health Insurance Fund (CNAM) operates on the French model for both Tunisian employees and expatriates. The self-employed have a specific plan that they can join separately. Tourists, on the other hand, do not have access to Tunisian health coverage.
The Tunisian health system provides comprehensive coverage for the whole family: healthcare and medication, work accidents, maternity leave, etc. Insured persons have to choose between three plans to cover their outpatient care (care provided in private practice or in hospital, but without hospitalisation):
Known as the "public sector" plan (or "blue card"), which provides full coverage in the public and parapublic system, subject to the payment of moderate co-payments (which, when added up throughout the year, cannot exceed 1.5 months' salary).
The "private sector" plan ("yellow card"), which provides reimbursement in the form of third-party payments for care provided in the public and private sectors under an agreement, according to a specific scale (excluding extra fees) and if referred by a GP. On the other hand, there is a cap on reimbursements for outpatient care (200 TND per year and per insured person, i.e., €60).
The "reimbursement of expenses" plan ("green card"), which allows access to all types of care facilities, public or private, with or without prior referral by the general practitioner. Reimbursements, again limited by a specific scale and capped over the year, are made a posteriori and therefore imply that the care recipient pays all costs in full first.
As for hospital costs, they are covered in the same way regardless of the chosen plan:
In the form of third-party payments in the public sector, with a maximum co-payment (80 TND maximum).
Only for certain surgical treatments in the private sector, and with prior authorisation in order to benefit from third-party payment, excluding extra fees.
How to choose health insurance in Tunisia: local or international?
Healthcare is therefore partially covered by the Tunisian Health Insurance system, especially if it is provided in the private health sector.
To benefit from a wider range of care and/or obtain more comfortable levels of reimbursements, policyholders generally take out complementary health insurance, either local or international. International health insurance offers more flexibility, allowing insured persons to seek treatment more easily in the country's major cities, or abroad in case of a specific need.