Barbados has an excellent healthcare system in comparison with the rest of the Caribbean, and is a popular choice of residence among expats. However, it only has universal health insurance coverage for citizens and you will need to take out private coverage if you are going to be moving to the island, or visiting it. Although healthcare is of a generally high quality, it can be expensive.

The Queen Elizabeth Hospital, which is the main public hospital on the island, has 600 beds offering secondary and specialized care. In addition there are eight government polyclinics providing free medical treatment for minor ailments, five geriatric hospitals for care of the elderly, and a network of child care centres.

Healthcare is free in the public sector. The country has been moving towards universal coverage, with a number of papers having been produced in recent years to evolve a health insurance strategy, but Barbados is not there yet. In this respect, the island is in line with its Caribbean neighbours: the region overall is intending to implement universal health coverage by the 2030s.

Like other Caribbean islands, Barbados faces the challenge of a small risk pool and a shallow tax base, and is looking at different ways of addressing this, such as implementing high premiums or limiting entitlement to expensive treatments. These strategies, however, undermine the central point of UHC, which is to provide coverage to the poorest citizens, so it is a genuine concern.

The WHO reports that a draft National Strategic Plan for Health (NSPH) for the period 2017-2022 is currently awaiting finalization. This has been developed in collaboration with private and public sectors, civil society and community partners. The NSPH has four main goals:

• promotion and protection of the health of the population
• provision of safe and quality centred services
• improvement of the performance of the health system
• engagement and mobilization of partners in health

Strategic plans have been completed for non-communicable diseases (NCDs), which are a main cause of death in Barbados, mental health and child obesity.

Bajan citizens are eligible for state healthcare. You can apply for citizenship if you are a current Commonwealth or Irish citizen and are planning to make the island your permanent home. This is subject to the discretion of the government. You will need to:

• have lived in Barbados for 5 of the 7 years immediately before applying
• have lived in Barbados for the entire 12 months immediately before applying
• have the intention to live in Barbados thereafter
• swear allegiance to the Queen of Barbados

You will only be eligible for free state healthcare if you are a citizen, but as an expat you may be able to access public healthcare if you are prepared to pay upfront – this is likely to be in cash – or if your private insurance is accepted by a public sector hospital or polyclinic.

You will need to take out private cover or pay out of pocket, unless you have citizenship.

If you are working in Barbados, check with your employer whether you have private group coverage as part of your employment package.

The Queen Elizabeth hospital and the clinics cover most forms of primary and secondary healthcare, although some conditions may need specialist treatment off the islands. The state system can cover most eventualities, however. Queen Elizabeth is also a teaching hospital.

The Barbados Psychiatric Hospital offers both in-patient and out-patient services including:

• physical and psychiatric medical care
• day programs
• specialized professional services (social work, psychology, psychotherapy, occupational therapy)
• rehabilitative services
• community outreach services

You will need to take out private insurance to cover your stay in Barbados.

You will need to take out private cover during the course of your education in Barbados. Contact your educational institution to see if they have in-house cover or can recommend an affiliated insurer.

You will need to take out cover for your dependents, unless they are Barbadian citizens or unless you are prepared to pay out of pocket for any hospital costs.

You will need to take out a dental plan or pay out of pocket, although basic dental treatment is offered to those who are eligible at government-run polyclinics.

Since the system is currently being revised, this information may change and will not apply to most expats. At present, social security contributions are set at 6.75% of covered earnings (6.2% for permanent government employees; 5.93% for foreign service help; 8.3% for the voluntarily insured) plus 0.1% for the catastrophe fund (this is to cover, for example, rebuilding after a hurricane).

The minimum weekly earnings used to calculate contributions are B$21 (US$10.50); the minimum monthly earnings are B$91 (US$45.50).

The maximum weekly earnings used to calculate contributions are B$1,073 (US$536.50); the maximum monthly earnings are B$4,650 (US$2325).

If you are self employed, you will need to make contributions of 13.5% of quarterly covered earnings plus 0.1% for the catastrophe fund.

Your employer must also contribute 6.75% into social security.

Contributions also finance sickness and maternity benefits.

Barbados has a number of private medical institutions. Bayview is the island’s main private hospital: smaller than the Queen Elizabeth but with excellent facilities. There are also the medical centres of Sandy Crest (a 24-hour facility) and FMH Emergency Medical Clinic.

Expats have little choice at present other than to take out private health cover. You will however have access to some top class facilities and highly qualified medical personnel.

Bayview offers a full range of treatment, including

• ENT surgery
• neurology
• cosmetic and reconstructive surgery
• obstetrics and gynaecology

Sandy Crest offers a range of services, including:

• emergency care
• family medicine
• corporate healthcare
• radiology
• lab work

This will depend on factors such as your age and any pre-existing conditions, and the kind of package you opt for (obviously, a more expensive insurance package will give you more a extensive range of treatment and facilities). As so many variables have an effect on the cost of international private medical insurance it becomes very difficult to give accurate estimates without knowing the full details of the coverage required.

However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

Some of the main international providers cover health insurance in Barbados, including:

• Cigna
• Foyer Global Health
• Globalsurance
• Pacific Prime

You will have no difficulty in finding English-speaking medical personnel on the island.