How does the state health insurance system work?

Technically, Venezuela has universal healthcare coverage and this has been the stated aim of successive governments. However, health authorities around the world report that public health facilities in Venezuela are poor, and that there are frequent shortages of medicines and funding.

Ambulance services in remote areas are unreliable and there is a lack of adequate medical supplies and equipment in local hospitals. Patients are reported to have died while waiting for surgery, and hospital patients may have to bring their own medicine and supplies. The infant mortality rate is increasing by 30%, in sharp contrast to other South American nations, in which infant mortality has been falling over past decades and non-communicable diseases such as diabetes and hypertension have replaced infectious diseases as the main causes of death. Maternal mortality rates have also risen by an alarming 65%.

The country has refused humanitarian aid, although some regional health authorities have been looking to public-private partnerships between companies and NGOs.

The Venezuelan Pharmaceutical Federation has reported that, as a result of the economic crisis in the country, there is a shortage of 80% of medical supplies. You should bring enough medication for your stay and include extra in case your return is subject to unexpected delays.

In urban areas, private clinics can cater for routine treatments but are experiencing shortages of medical supplies and medicines. More complex treatments may require medical evacuation.

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Who is eligible for state healthcare?

Expats in Venezuela must pay Venezuelan Social Security: this is compulsory and includes health insurance.

How do you apply to join the state health insurance system?

Your employer must register you. If you are self employed you will need to contact the Department of Social Security.

What is covered by the state health insurance system?

The state system covers primary care and hospitalisation, but the country is undergoing severe challenges. Some local governments have risen to this – El Hatillo, for instance, in Caracas, has partnered with private companies to provide primary care, in-home services and emergency care, including ambulances and paramedics. Under the circumstances, this is remarkable but by no means uniform.

Are retirees covered by state medical insurance?

As an expat retiree it is advisable to take out private cover.

Are students covered by state medical insurance?

As an international student in Venezuela you will need to take out private cover.

Will your family be covered by your insurance?

Yes, your dependents will be covered by your social security contributions.

Is dental treatment covered by state health insurance?

Some basic dental care is covered under state health schemes, for example free dental consultations at a regional level, but it is advisable for expats to take out a private dental plan and seek treatment in the private sector.

What are the contribution rates for state health insurance?

Your social security contribution is withheld from your monthly salary, based on a ceiling of five monthly minimum salaries, which currently vary several times a year. In general you will see deductions of 4% of monthly covered earnings for private sector workers and 2% for public sector workers. Your contributions are for social security overall, but include sickness and maternity benefits. As a self-employed person you will need to make contributions which amount to 13% of your declared earnings. At the time of writing, Venezuela is currently experiencing hyperinflation and this may significantly affect both your salary and your contributions.

Why buy private health insurance?

Although your registration with the national health scheme is compulsory, the state system in Venezuela is currently facing such significant challenges that your only real option is private insurance plus a medical evacuation clause.

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What is covered by private health insurance?

Primary and hospitalization costs, plus elective procedures such as cosmetic surgery and dental implants are covered.

Many expats opt for private cover, with a medical evacuation clause in case they need to be treated outside the country.

How much does private health insurance cost?

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.

Which companies offer private health insurance?

Many of the big international providers cover, including:

  • Allianz
  • AXA
  • Cigna
  • Pacific Prime

Always request quotes from as many insurance providers as possible.

Glossary of health insurance terms

Some medical personnel will be English-speaking but it will be helpful if you speak basic Spanish.

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