Bermuda – Health Service

What is the standard of healthcare in Bermuda?

The healthcare system in Bermuda is generally regarded to be of good quality, although as it is such a small place with a population of around 65,000, facilities are relatively limited. Despite this, the island’s medical infrastructure is modern and well-equipped for its size, and outcomes reflect a reasonably healthy population.

Life expectancy at birth in 2024 was 82.5 years, higher than the average for the Region of the Americas and 4.2 years higher than in 2000. Between 2000 and 2022, infant mortality in Bermuda fluctuated but ended the period at zero deaths per 1,000 live births. These figures compare favourably with many developed nations.

King Edward VII Memorial Hospital, Mid-Atlantic Wellness Institute, and Lamb Foggo Urgent Care Centre are fully accredited by Accreditation Canada. Evaluating against accreditation standards enables the hospital to meet the highest standards of patient care. This international accreditation — similar to the system used by Canadian hospitals — gives confidence that clinical processes are independently assessed and verified.

According to the US Consulate General in Bermuda, “All physicians in the yellow pages of the Bermuda telephone directory are licensed by the Bermuda Government and are considered acceptable. Local doctors and dentists are competent and most are trained in the U.S., Canada or the United Kingdom.”

Key achievements include specialised advancements, such as the creation of a comprehensive stroke centre in collaboration with Johns Hopkins Medicine International, enhancing acute neurological treatment capabilities. However, it is important to note that Bermuda’s medical facilities are good for a 21-square-mile island but are not equipped for very serious conditions, such as heart, stroke, and other complex conditions. If you require extensive and/or intensive treatment, you will likely be air-lifted elsewhere, usually to hospitals in the USA, possibly Lahey in Boston or Johns Hopkins in Baltimore, at your expense.

The Bermuda Health Strategy 2022–2027 highlights the high cost of healthcare as the major challenge to equitable access to quality care among the population. Bermuda’s health outcomes do not fully reflect the amount currently spent on health, as about 35% of the population are unable to access quality healthcare without financial hardship, including those who are uninsured (12%) and people who are unable to afford health insurance or are underinsured (23%).

How is healthcare paid for in Bermuda?

Bermuda’s healthcare system is largely private, and most residents and expats, including retirees, are responsible for covering the costs of their own healthcare. Unlike systems such as those in France or Germany — where a mandatory social insurance contribution funds broad public coverage — Bermuda does not operate a centralised, tax-funded scheme that covers all residents automatically.

The Health Insurance Department offers two public insurance plans: the Health Insurance Plan (HIP) and FutureCare. Bermuda employers are legally obligated to offer health insurance to their employees (and their non-employed spouses) who work 15 hours or more per week for at least two months a year. The HIP is intended for individuals 18 years or older, with the HIP Youth plan covering individuals younger than 18. The FutureCare plan was designed for individuals who are 65 or older.

The Government Employee Health Insurance (GEHI) covers all government pensioners, employees, and their dependants. These public plans provide a baseline of coverage, but they do not cover the full spectrum of healthcare costs that many people may encounter.

According to the Health Insurance Act, employers must provide health insurance coverage for all employees working more than 15 hours per week and beyond two months out of the year. Employers must provide the same coverage to an employee’s non-employed spouse. Employers may deduct no more than half of the monthly premium from an employee’s salary or wages towards the health insurance policy.

Hospital fees in Bermuda are structured around a diagnosis-related group (DRG) system, where charges are based on the specific medical conditions and treatments provided. Bermuda spends 11.6% of GDP on health, representing the third highest proportion in the Organisation for Economic Co-operation and Development. This makes healthcare in Bermuda among the most expensive anywhere in the world.

Is private health insurance necessary in Bermuda?

Private insurance is highly recommended for expats and travellers in Bermuda, as healthcare is extremely expensive, especially if medical evacuation is required for specialised treatment. Private health insurance is highly recommended for any expat who wants access to high-quality, reasonably priced treatment in Bermuda.

For those moving to Bermuda for work, employers are legally required to provide health insurance plans to their employees, whether they are Bermudian citizens or foreigners. The extent of that health insurance coverage can vary from one employer to another, which means that taking out a private health insurance plan can help fill in any gaps.

The Health Insurance Plan only covers relatively basic dental services, and even then will only cover 75% of the payment. If you are likely to need more extensive or regular dental care while in Bermuda, you should look to take out private medical cover that includes dental care as required.

Having private medical insurance in place in Bermuda means you can benefit from shorter waiting times, access to more healthcare facilities, and faster specialist appointments. Private health insurance gives you access to more comfortable facilities and a more dedicated approach to care. Dental cover through private insurance ensures treatment bills do not become unaffordable, and prescription cover may help take care of regular medication costs.

With the country’s closeness to the USA, it is also advisable to obtain a plan that covers medical treatment in the USA and Canada. Any serious medical injuries or illnesses may require medical treatment on the island, so medical evacuation coverage is essential. Check the official Government of Bermuda Health Insurance Department website for current plan details and premium figures.

What services do Bermuda’s hospitals provide?

The Bermuda Hospitals Board (BHB) comprises King Edward VII Memorial Hospital (KEMH), Mid-Atlantic Wellness Institute (MWI), and the Lamb Foggo Urgent Care Centre. BHB offers comprehensive diagnostic, treatment, and rehabilitative services in response to Bermuda’s full spectrum of medical and mental health needs.

KEMH functions as Bermuda’s sole full-service hospital, delivering emergency, acute inpatient, outpatient, surgical, diagnostic, and rehabilitative care to a population exceeding 60,000 residents and visitors. Specialty services include cardiology, oncology, orthopaedics, psychiatry, surgery, and much more.

The Emergency Department at KEMH operates 24 hours a day, 365 days a year, from the Ground Floor of the Acute Care Wing, serving as Bermuda’s sole provider of round-the-clock emergency healthcare. It handles acutely and critically ill patients across all ages and diagnoses, delivering complex assessments, high-intensity interventions, trauma care, critical care management, and urgent care using advanced technology, with board-certified emergency medicine physicians and dedicated specialists available continuously.

The hospital facility has undergone substantial expansion by way of a Public Private Partnership, with the addition of a new Acute Care wing comprising a Single Nursing Unit with a 90-bed capacity, a Renal and Oncology Care Unit, Operating Theatres, and an Emergency and Walk-in Facility.

There is also the Mid-Atlantic Wellness Institute that covers mental health, the Lamb Foggo Urgent Care Centre that looks after less severe illnesses and injuries, and four government-run community health centres. The Lamb Foggo Centre is located in St. George’s parish on the east end of the island, making it a practical option for those in that area rather than travelling to Hamilton.

Additionally, there are several private healthcare facilities around Bermuda, which offer faster access to care and a more dedicated approach to treatment for those with the appropriate private cover in place.

Locally, problems such as cardiovascular disease, asthma, renal dialysis, orthopaedic surgery, childbirth, and paediatrics are all covered in the same fashion as a district general hospital. However, for highly complex or rare conditions, patients may be advised or choose to travel overseas for specialist care.

Are patients’ families expected to provide care in hospital?

BHB is strongly committed to delivering exceptional patient care in an environment where quality, respect, caring, and compassion are at the centre of all they do. Bermuda’s hospitals are staffed by professional medical teams and do not rely on families to provide basic nursing or personal care — this differs significantly from practices in some lower-income countries where family members may be expected to assist with feeding, bathing, or medication.

Almost 1,800 staff members from around the world work at BHB in a broad range of healthcare and support roles. This professional workforce means that the full burden of patient care rests with clinical and support staff rather than relatives.

KEMH actively encourages visiting, as it plays an important role in care and recovery. BHB welcomes student and adult volunteers in areas throughout its hospitals. Its sister charities, the Hospitals Auxiliary of Bermuda and Friends of Hospice, also coordinate volunteers to benefit BHB’s patients and their families. Visitors are, therefore, warmly welcomed as a positive contributor to recovery rather than as a substitute for professional nursing care.

KEMH inpatients have access to interactive health education content and entertainment from their bed. Patients can access TV shows, movies, games, internet, and music, as well as relaxation content to ease relaxation, reduce noise interruption, and help manage pain. These patient engagement systems help people feel supported and informed during their stay, even when family visits are not possible.

How is follow-up care provided after hospital treatment?

BHB provides convenient, high-quality care to patients who need access to hospital-based technologies and expert staff without inpatient hospitalisation. This outpatient and day-care provision forms a key part of post-discharge follow-up for many patients recovering from surgery or managing ongoing conditions.

After leaving hospital, patients are typically referred to their primary care physician (GP) or a specialist practitioner for follow-up appointments. All medical doctors in Bermuda must be licensed locally before they qualify and — except for those in the public sector working at a hospital — all are in private practice. This means follow-up visits to GPs and specialists will generally attract a fee, which underlines the importance of maintaining adequate health insurance throughout your time in Bermuda.

Bermuda has implemented Integrated Care Pathways (ICPs) for breast cancer, prostate cancer, end-of-life care, the first 1,000 days of life, chronic kidney disease, and acute adult mental health. Plans include expanding these pathways to encompass diabetes, metabolic diseases, respiratory illnesses, post-acute care, and cardiovascular diseases. These care pathways are designed to ensure structured, coordinated follow-up after initial diagnosis or hospital treatment, rather than leaving individuals to navigate the system independently.

Phase II of the National Digital Health Strategy will entail setting up an appropriate governance structure and developing an implementation plan to begin to integrate data across the health sector into a centralised system, make patient-level health data more available, and enable better reporting across the health system. This should ultimately improve the overall quality of care and health outcomes of patients.

For conditions requiring a level of specialist intervention not available on the island, it has been known for some patients who require more advanced and extensive care to head overseas, principally to the United States. Ensuring your health insurance policy includes overseas treatment and medical evacuation cover is therefore strongly advisable for anyone living in Bermuda long-term.

Locally, problems such as cardiovascular disease, asthma, renal dialysis, orthopaedic surgery, childbirth, and paediatrics are all managed, and patients have an element of choice afforded through their insurance — for example, some patients choose to have a knee replacement on the island while others travel to Boston for the same procedure. This flexibility means that follow-up care may sometimes continue abroad, depending on where initial treatment took place.

What are the rules for medical treatment of foreign visitors?

Foreign visitors to Bermuda are entitled to receive medical treatment at KEMH and other facilities, but they should expect substantially higher costs than residents. Non-residents must pay an extra 100% charge for all services (as of 2024). This surcharge applies on top of already high base costs, making uninsured medical treatment exceptionally expensive for tourists and short-term visitors.

There is no legal requirement to take out travel insurance for Bermuda. However, it is strongly encouraged because the cost of healthcare in Bermuda can be high, and taking out travel insurance will mitigate some or all of the risk of covering those costs personally if medical attention is needed during a stay.

The Emergency Department at KEMH operates 24 hours a day, 365 days a year and will treat all patients arriving with emergency medical needs regardless of insurance status. However, patients will be liable for the full cost of care — plus the non-resident surcharge — if they do not have valid travel or medical insurance in place. The main emergency number for Bermuda is 911, which can be used to call for an ambulance, or to contact the police or the fire brigade.

Every week, visitors suffer emergencies, and many say they do not make any contingency or emergency plans. Some claim they have no money and no health or travel insurance for unexpected problems. Planning ahead with comprehensive travel insurance before arriving in Bermuda is therefore strongly advised.

International health insurance guarantees care worldwide, even if a patient is medically evacuated to another country. For visitors planning an extended stay — or those with pre-existing health conditions — a policy that explicitly covers both in-Bermuda treatment and potential medical evacuation to the United States is the most prudent option.

Visitors should be aware that some pharmaceuticals available without prescription elsewhere require prescriptions in Bermuda from registered local medical doctors. It is worth carrying sufficient supplies of any regular prescription medication and a letter from your doctor at home to avoid disruptions to treatment during your visit. For the most current entry and medical requirements, consult the Government of Bermuda official website before travelling.

Frequently asked questions

Does Bermuda have a public healthcare system like the NHS?

No. Unlike the NHS, which is free at the point of use for residents, Bermuda operates an insurance-based model. There is no universal coverage — individuals access care through employer-provided insurance, government-run plans such as HIP or FutureCare, or private insurance policies. Most medical services carry a direct cost to the patient or their insurer.

Are employers in Bermuda required to provide health insurance?

Bermuda employers are legally obligated to offer health insurance to their employees (and their non-employed spouses) who work 15 hours or more per week for at least two months a year. However, the level of coverage varies between employers, so it is worth reviewing your policy carefully and considering supplementary private cover.

What is the FutureCare plan and who is it for?

The FutureCare plan was designed for individuals who are 65 or older. It is one of the government-administered plans offered through the Health Insurance Department and is intended to provide older residents with access to a baseline of healthcare coverage. Eligibility rules apply, so check the official Government of Bermuda Health Insurance Department website for current criteria.

Is mental health treatment available in Bermuda?

The Mid-Atlantic Wellness Institute handles mental health and learning disabilities. It is part of the Bermuda Hospitals Board network and provides inpatient and community mental health services. Psychiatric care is generally covered by health insurance policies, though the extent of coverage varies by plan.

What happens if I need treatment that is not available in Bermuda?

If you require extensive and/or intensive treatment, you will likely be air-lifted elsewhere, usually to good hospitals in the USA, possibly Lahey in Boston or Johns Hopkins in Baltimore or New York or Philadelphia, at your expense. Medical evacuation insurance is therefore an important component of any health policy held by someone living in or visiting Bermuda.

Will I be treated in an emergency if I have no insurance?

The Emergency Department at KEMH will treat patients in genuine emergencies regardless of their insurance status. However, you will be billed for the full cost of treatment, and as a non-resident you will face a 100% surcharge on top of the standard rate (as of 2024). Bills can be very substantial, so travel insurance is always strongly recommended.

Are there private clinics in Bermuda as an alternative to the hospital?

There are several private healthcare facilities around Bermuda, which offer faster access to care and a more dedicated approach to treatment for those with the appropriate private cover in place. These clinics can be a useful option for routine consultations, specialist appointments, and diagnostic services without going through the main hospital system.

Does Bermuda have a plan to improve healthcare access in the future?

The vision of universal health coverage is to ensure all Bermuda residents have equitable access to quality care, without suffering financial hardship when paying for these services and critical medicines. The Government of Bermuda is working towards a phased implementation of a Core Care Benefits Package for all residents, though full universal coverage has not yet been achieved. Check the Bermuda Health Strategy website for the latest updates.