The Ministry of Health regulates a number of Regional Health Authorities, which provide primary care centres and hospitals, which are free at the point of delivery for the local population. There are currently five RHAs providing public healthcare services to Trinidad and Tobago:

• North West Regional Health Authority or the NWRHA
• Tobago Regional Health Authority or the TRHA
• North Central Regional Health Authority or the NCRHA
• Eastern Regional Health Authority or the ERHA
• South West Regional Health Authority or the SWRHA

As an expat, you will be eligible for public healthcare, but be aware that the system is very basic and under strain: it is overcrowded and underfunded, and with equipment and facilities that will probably be substantially below the standard that you are accustomed to in your home country.

Ambulance transport, for example, is very limited and you may find yourself facing medical evacuation: some expats choose to be treated in the USA in locations such as Miami. Recent reports show that there are four main challenges faced by the public health system: long waiting times, inadequate health financing, poor maintenance, and social inequality.

The region is subject to a number of infectious diseases, which include dengue fever and malaria, typhoid and yellow fever, and there is a high rate of HIV in the islands. The government has also released a National Strategic Plan covering non-communicable diseases, such as diabetes and hypertension.

Every resident in the country is eligible for state healthcare, regardless of nationality and origin.

You will need to register with the state health insurance system via your employer: make sure that they have signed you up with the NI. Your monthly contributions will be made for social security generally, but you will need to pay a health surcharge each month.

Primary healthcare services for the prevention and treatment of common illnesses are freely provided to everyone in Trinidad and Tobago. This includes antenatal healthcare, malaria and HIV testing, and treatment for these conditions. Secondary or specialized healthcare, such as chemotherapy, is free for children but is not free for adults.

In addition, you will be entitled to access the Chronic Disease Assistance Programme (CDAP), which provides citizens with free prescription drugs and other pharmaceutical items to combat the following health conditions:

• diabetes
• asthma
• cardiac diseases
• arthritis
• glaucoma
• depression
• high blood pressure
• benign prostatic hyperplasia (enlarged prostate)
• epilepsy
• hypercholesterolemia
• parkinson’s disease
• thyroid diseases

If you suffer from one of the chronic illnesses listed above, you will need:

You will be able to access the public system but it advisable not to rely on public healthcare provision. Most expats take out private health insurance and a medical evacuation clause.

If you are studying in Trinidad and Tobago, you will need to take out private international health insurance to cover you during your stay in the country.

Everyone in the country is eligible to access public healthcare, regardless of nationality.

The Dental Services Division covers some very basic treatment. Dental services currently provided for children aged 2-12 years are fillings, cleaning, fluoride treatment and dental health education. For adults, only tooth extraction is provided under the public healthcare system. Dental services are provided at specified health centres throughout Trinidad and Tobago.

Most expats take out a dental plan and many choose to be treated off the islands.

National Insurance is deducted at source at varying rates. The maximum rate is TTD 414.30 (US$61) per week for a monthly income over TTD 13,600 (US$2010), which is payable at a rate of TTD 276.20 (US$40) by the employer and TTD 138.10 (US$20) by the employee. 70% of such contributions are deductible by a resident individual in arriving at taxable income.

A health surcharge is payable by all individual taxpayers and is deducted at source by employers. The maximum rate is TTD 8.25 (US$1.22) per week for a monthly income over TTD 470 (US$69).

Most expats prefer to deal with the private sector in Trinidad and Tobago, due to the limitations of the public healthcare system.

Primary care costs and hospitalization costs, plus elective procedures such as cosmetic surgery and dental implants, are covered. Non-emergency surgical procedures and specialized treatments like dialysis and chemotherapy will also need to be covered by the private sector. Private hospitals, such as the St Augustine Private Hospital, offer accident & emergency services, ambulance transport, medical laboratory services, radiology, and ultrasound services.

Many expats opt for private cover with a medical evacuation clause in case they prefer to be treated outside the country. Some health insurers note that even some private provision in Trinidad and Tobago may not be of the standards of private sector care in the West.

Check with your chosen provider that they accept your insurance and ask them about their preferred method of payment. You may also need to check with your provider with reference to pre-approval for some procedures.

The country has a plan for increasing the medical tourism sector. The Ministry of Health reports that the private sector has capacity and the country’s investment promotion agency, InvesTT, has commissioned a draft strategy for medical tourism. You may want to check prices and outcomes at local clinics, for instance, for dental treatment.

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.

Many of the big international providers cover Trinidad and Tobago, including:

• Allianz
• AXA
• BUPA
• Cigna
• Foyer Global Health
• Pacific Prime

Always request quotes from as many insurance providers as possible.

The official language of Trinidad and Tobago is English, so you should experience few linguistic difficulties.