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Health Service

Peru - Health Service


The ministry of health in Peru has a national health service, EsSalud, which allows residents to access health care services for free. The service will only treat national citizens who are registered. Employers contribute to a health care insurance fund, whilst those without work can access services without paying contributions.

The waiting times for treatment can be long, and some of the facilities are fairly basic. Quality all depends on the location within this vast and sometimes physically challenging country.

Private healthcare is faster and of a generally better quality than that available within the public sector. Many expats will not be eligible to access state services and must use the private medical industry. Charges for medical and dental treatment are low compared to the UK and US. However, outside of Lima and Cusco, it will become increasingly hard to access complex medical treatment the further away you go.

Private health insurance is a good investment for anyone moving to Peru for work or adventure. If you have a serious accident or need an operation, the number of procedures you need over a length of time means all charges will mount up into a large bill. Hospitals usually require a cash deposit on arrival and full payment before departure. Insurance takes the worry away, as it limits how much you will be expected to pay at a time when you will be too sick to actively earn an income. Make sure you choose an insurance provider who will pay for your treatment in Peru and has confirmed this in writing.

A lot of hospitals and clinics employ doctors who speak English. If they don’t, a translator can usually be found.

If you see a doctor as an outpatient, you will often be given a prescription to take to a pharmacist, or asked to take samples to the nearest laboratory for testing.

The natural environment in Peru can be harmful to health, both in terms of the native animals and disease carrying insects, and the ever present threat from criminals. In cities and the wild, you should never travel alone. Be wary of who and what is around you, and avoid remote areas unless accompanied by knowledgeable and trustworthy local people.

A number of poisonous snakes and spiders can give bites that cause serious injury and even death. Sometimes people are not aware they have been bitten before their limbs swell or they suffer other symptoms. In the national park, jaguars and pumas will attack if threatened. The blood-sucking sandfly and mosquitos are carriers of a whole myriad of diseases.

Peru has wild and remote areas covering significant amounts of the terrain, including the mountain peaks of the Andes and the dense tropical rainforest in the Amazon basin. If you are in a remote area, there will be few medical facilities available, and any services that are available will be basic. Your phone and internet signals may be intermittent or absent. You cannot expect helicopters and rescue teams to appear promptly, or even at all in some locations. Hiking and climbing accidents occur frequently, and it can take many hours to be reached if you need to be rescued, even once the alarm has been raised. Make sure you leave written detailed instructions about your travelling plans with friends and relatives who can be relied upon to take action if you do not return.

If you are visiting the Andes, you may be affected by altitude sickness. Even healthy people can be affected, but if you have an existing medical condition, make sure you know the risks and symptoms. The consequences of altitude sickness can become serious within a short amount of time. Many people like to acclimatize near the coast for a week before venturing to the high altitudes of the Andes.

The powerful hallucinogen ayahuasca is offered on some tours in Peru. You may find articles praising the drug for its spiritual and medical benefits whilst ignoring its many risks. The drug is not regulated, and some tourists who have taken it have suffered physical side effects, psychological harm, robbery and sexual assault.

When travelling to Peru, comply with all local laws and customs. The police services and prisons do not meet the guidelines expected in the US and UK. Ask for the police or prison officials to notify your country’s embassy if you are arrested or detained.

Some of the laws and customs you should be aware of include:

• Carry a copy of your passport at all times (keep the original in a safe)
• LGBTQIA+ activity is legal, but society in Peru is generally conservative, so take care if you are an LGBTQIA+-identifying person
• Sexual activity with anyone under the age of 14 is strictly prohibited
• Don’t use or smuggle drugs
• Don’t be fooled into carrying items or bags which contain hidden drugs
• Don’t take cocoa leaves or cocoa tea out of the country
• Do not take any photographs of a military or security nature
• Official permission must be obtained before exporting historic artefacts
• Do not buy souvenirs of animal parts
• Do not buy condor wings, which are sold illegally

If you have a disability, Peru may be a challenging place to live. Under the law in Peru, no one is allowed to discriminate against people with physical or mental disabilities, and public spaces should be accessible to wheelchair users. In reality, there has not been much expenditure in either physical adaptation to the environment nor in training to change the attitudes of local people towards those with disabilities. Many public buildings and areas are still inaccessible to wheelchair users; private buildings, pavements and public transport even more so.

A number of life-threatening and serious diseases can be contracted in Peru. For the benefit of your health, as well as to avoid significant financial consequences for yourself and your family, you should always receive your vaccinations at least two months in advance of arriving in the country. The following vaccinations are recommended or necessary:

• Polio
• Tetanus
• Typhoid
• Yellow fever
• Rabies
• Hepatitis A
• Malaria

Cholera is also prevalent in Peru, especially in large towns and cities.

Whilst malaria is not contracted within the coastal and Andean regions, it is a very real risk everywhere else in Peru. In addition to correctly taking the course of anti-malarial tablets, you should sleep under a close-meshed mosquito net and cover yourself in insect repellant as soon as dusk appears.

Zika can also be transmitted by mosquitos, or by exposure to the bodily fluids of a zika sufferer. The World Health Organisation (WHO) declared the zika virus as a global public health emergency in 2016. A number of South American countries, including Peru, identified zika sufferers for the first time.

Occasionally there are small outbreaks of bubonic and pneumonic plague in Peru. The fleas on rats bite humans, and if the illness is not quickly treated with antibiotics then it can mutate in the victim’s lungs. At that point the disease becomes airborne. The government moves in quickly to implement measures that will halt the spread of the disease as soon as an outbreak is identified.

If you need access to medicines, you will find them on sale cheaply in local pharmacies. These are known as farmacias or boticas. Even drugs such as antibiotics can be purchased without any restrictions, and you may find simple conditions can be treated by the pharmacist without recourse to a doctor. However, check the expiration dates carefully and bear in mind regulation standards of medicines will not reflect the stringent rules of the US and UK.

You will be at risk of developing diarrhea when in Peru. Clean water is not available except for bottled water, and in some areas refrigerators are rare. Expensive hotels will make great efforts to keep their guests safe and well, but food hygiene standards will not be as high elsewhere. Avoid uncooked foods including salads and fruit; even fruit juice drinks and ice cubes will probably contain unclean water. If you do suffer an upset stomach, the pharmacist will have a stock of electrolytic drinks to prevent dehydration. Should the condition not clear up within a week, the pharmacist will provide antibiotics.

The sun can cause damage to your eyes and skin no matter where you are, and the risk is increased in Peru because it is near to the equator. Don’t be fooled by the cold air and fog. Always wear high factor sun cream and good quality sunglasses. A wide brimmed hat also protects your head and eyes. Keep a bottle of clean water with you at all times.

Water services can be erratic in Peru, especially if you are staying somewhere cheap and basic. Shower water is sometimes heated by solar energy, which may limit the warmth and availability of hot showers. Meanwhile electric showers may have visible wires, so avoid fiddling about with the area around the shower head.

Along with the lack of clean drinking water, Peru suffers from poor sanitation facilities. Toilets may be primitive and dirty, although modern hotels and restaurants serving Western tourists will ensure their facilities meet customer expectations. Toilet paper in Peru is rougher and thinner than that available in the US and UK, and you may be charged for it when visiting restrooms. You may wish to carry a small pack of tissues around with you. You must not put toilet paper or wipes down the toilet bowl because it will block the pipes. You won’t find warning signs about this, especially in English, but you are expected to know the routine. A basket or bucket will normally be placed next to the toilet to collect paper. Have some change ready for restroom attendants, who earn little.

Sanitary protection is a fast growing business in Peru, but almost a fifth of the female population still does not use it. Often this is an issue of the sanitary towels not being available locally. Tampons are rarely available in any region of Peru, except in Lima.

The drinking water in Peru is only safe to drink once you have boiled it for between one and three minutes. Alternatively, use a specialist water filter. Most people just use bottled water, but only purchase this from reliable retailers. Check the bottles are sealed. Some vendors, especially along the roadside, fill empty plastic bottles with local water, which may give you diarrhea, typhoid or cholera. Similarly, avoid juice drinks and ice from these vendors.


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Expat Health Insurance Partners


Bupa Global

At Bupa we have been helping individuals and families live longer, healthier, happier lives for over 60 years. We are trusted by expats in 190 different countries and have links with healthcare organisations throughout the world. So whether you're moving abroad for a change of career or a change of scene, with our international private health insurance you will always be in safe hands.

Cigna

Cigna has worked in international health insurance for more than 30 years. Today, Cigna has over 71 million customer relationships around the world. Looking after them is an international workforce of 31,000 people, plus a network of over 1 million hospitals, physicians, clinics and health and wellness specialists worldwide, meaning you have easy access to treatment.