Belize has only recently instigated a public health insurance system: most health insurance has up until now been covered by the private sector. However, this is changing, since in line with many other countries, Belize is developing a system of national health insurance.

The public sector has become progressively more independent. Regional Management Teams with increasing autonomy are now in place in northern, central, western and southern regions. A ‘Bridging Strategy’ has been outlined to further empower these regional teams. These offer primary and secondary healthcare, but at present, only the central region offers tertiary care.

Public healthcare is most advanced in Belize City, with the Karl Heusner Memorial Hospital being the main public provider in the country alongside seven regional hospitals and 60 public health clinics. The Belize government currently subsidizes some medications and treatments such as vaccinations and emergency surgeries.

However, it must be said that although state healthcare is either free at the point of delivery or low cost, the current standard of public healthcare in Belize is not high, and will not be what you are accustomed to in a Western nation. The system is overcrowded and overstretched, with limited medical facilities and equipment, although medical personnel are usually well trained and qualified.

You will be eligible to pay contributions into the social security system if you have a work permit for Belize or are a resident or a citizen. Public healthcare is government funded and as an expat, you are most likely to need to access this in an emergency. Most expats in Belize take out private health insurance with a medical evacuation clause. The region is prone to natural disasters such as hurricanes, and it is important that your insurance reflects this.

Your employer will need to register you with social security, but this has limited application to actual public healthcare.

If you are self employed in Belize, it is advisable to arrange your own private health insurance.

The state health insurance system covers:

• primary care
• secondary care
• tertiary care in the central region
• mental health treatment
• basic dental care
• neurology
• ENT
• physiotherapy
• orthopedic surgery
• paediatrics
• OB-GYN

The public healthcare system is not extensive: there is no level one trauma centre in the country, for instance.

The Karl Heusner hospital, which is public, offers private rooms at around US$250 per day (a room in a private hospital will cost around US$500). Seeing a doctor will cost in the region of US$10-25 per appointment. A dental extraction will cost around US$25.

The Western Regional Hospital in Belmopan and the Southern Regional Hospital in Dangriga are held to be the best quality providers after the Karl Heusner itself, but some, such as the Northern Regional Hospital in Orange Walk and the Corozal Hospital, are not recommended by expats resident in the country.

There is a small public small cancer clinic in Dangriga, run on a not-for-profit basis, offering basic chemotherapy, but oncological care in Belize is very basic and there is no provision for radiotherapy in the country. Most patients travel to Guatemala for cancer treatment if they can afford it.

Many locals still seek treatment with traditional medical practitioners, in response to the limited provision of Western medicine.

Most retired expats in the country choose to take out private cover, usually with a clause for medical evacuation.

If you are an international student in Belize you will need to take out private insurance to cover the duration of your education in the country. Check with your educational provider to see if they have an in-house private policy or any local recommendations, or approach one of the international providers.

You will need to take out private health insurance to cover your dependents.

Basic dental treatment is covered by the state health insurance system.

You will need to make contributions into social security itself (the Social Security Board or SSB) and these will be calculated according to your monthly earnings: contributions range from 1- 3.91% of your monthly salary. Your employer must also pay around 5-7%. However, note that this is for social security in its entirety and has limited application to health insurance: most public healthcare is still funded by the government. Your contributions will cover some disability, accident and sickness benefits.

The private health sector in Belize is not regulated and can be expensive, but is significantly better than the public sector which is underfunded and under strain. Many expats choose to go north to Mexico (for cheaper treatment than the US and better facilities than Belize) or to the USA itself to access treatment.

Chetumal (Mexico) and Melchor-Flores (Guatemala) are popular destinations and the ADO bus service between Belize and Mexico is known as the ‘hospital run’ on some routes, with daily runs between Belize, Cancun, Playa Del Carmen and Merida in the Yucatan, a tier one medical centre.

Belize Medical Associates is the most popular private provider.

Private health insurance will cover all primary and hospital care, plus dental treatment and any chronic illness cover. It will also cover elective treatments such as cosmetic surgery, dental implants, corrective optical treatment or operations such as hip replacements. Most medical tourism into Belize is related to dental care.

Medical tourism has not been a major industry in Belize, but this has been gradually changing since the establishment of the Belize Medical Tourism Association. Its aim is to limit the number of residents of Belize seeking treatment abroad, by providing adequate treatment in-country, and developing private clinics for various forms of care.

It faces something of a struggle, due to the reputation of the country in places such as the US (the drug trade and violent crime levels have caused the country to be placed on various US blacklists), and at present the country is not a major player in the medical tourism market of the region. However, development organization BELTRAIDE is currently seeking foreign investors and it is expected that this sector will continue to develop.

Check that your chosen private provider accepts your insurance – you may also need to contact your insurer for pre-approval of some treatments. You should also ask your chosen hospital or clinic how they would prefer to be paid. Expect to have to make some payments upfront.

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 for Belize, including:

• Cigna
• Expat Financial
• Foyer Global Health
• Pacific Prime

Belize is a former British colony so you should have few difficulties with communication if you speak English.