How does healthcare work in the Caribbean, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in the Caribbean?

• As in many other parts of the world, the quality of healthcare in the Caribbean varies greatly between islands and countries. This is due to differences in economic situations, population size and colonisation.
• Some islands (such as the Cayman Islands, Dutch Caribbean, Barbados, Bahamas, French Antilles) generally have modern and good healthcare facilities, while others (such as Haiti, Saint Vincent & the Grenadines and Dominica) suffer from underfunding and limited access.
• In general, private healthcare is often better for foreigners than public healthcare.
• Many expats also ultimately opt for specialist healthcare abroad - for example the US, Colombia, Puerto Rico or Europe.
• Pharmacies are readily available on most islands.
• Basic medicines are usually in stock, but specialist or chronic medicines are sometimes limited.

How does the public healthcare system work in the Caribbean?

• Public healthcare is often more limited in quality, staff and materials. On small islands, there may be long waiting times (sometimes a doctor is only flown in a few times a week or month), or certain care is completely absent.
• In countries such as Jamaica and Haiti, public care is often very overloaded.
• The French islands have a French healthcare system, which means that EU citizens receive almost free care.
• The Dutch islands have a Dutch model, which differs from the European Dutch model.
• Barbados (British Commonwealth) has a relatively well-functioning public system.

How does the private healthcare system work in the Caribbean?

• Private care is better equipped, offers faster access and often has English-speaking staff (although this is the case in some countries anyway).
• In countries such as Barbados, the Cayman Islands, Saint Lucia & Trinidad, Aruba, Curaçao, private care for expats is very modern.
• Private care is a lot more expensive, which is why most foreigners living in the Caribbean opt for their own international health insurance.

How is the general practitioner arranged in the Caribbean?

• General practitioners are not present everywhere like in Europe; you often go straight to a clinic or hospital.
• On the Dutch and French islands, the general practitioner fulfils the role of gatekeeper for specialist care. Here you can easily register with a general practitioner's practice.
• Saint Kitts and Nevis and Barbados do have general practitioners, but the system is less formally organised.
• On smaller islands, doctors are often generalists who can treat all kinds of things.

How is the dentist arranged in the Caribbean?

• Dental care is usually not included in public systems, but private practices are easily accessible in tourist areas.
• Prices can be quite high.
• The quality varies: good in Aruba, Curaçao, Barbados, Cayman Islands, less reliable on smaller or poorer islands.

How is pregnancy care arranged in the Caribbean?

• Quality depends greatly on the island. In tourist and wealthy areas, care is often excellently organised. Expats sometimes also choose to give birth in the US or Europe.
• Good care is available on the larger islands such as Barbados, Trinidad, Aruba, Curacao, Martinique, Guadeloupe.
• On the smaller islands, the supply is limited. Sometimes people go to a larger island or abroad for the birth.
• Expats often choose private clinics with English-speaking guidance.
• Especially in Haiti, pregnancy care is very limited and a pregnancy or birth is often risky.

How safe or unsafe is a trip or stay in the Caribbean?

What should you pay attention to in terms of safety in the Caribbean?

• In general, the Caribbean is relatively safe for expats, especially islands such as Aruba, Bonaire, Curaçao, the Cayman Islands, Martinique and Guadeloupe. These islands have a stable political climate, low crime rates and a good infrastructure. Petty crime such as pickpocketing sometimes occurs in tourist areas, but you do not have to worry about serious violence. 
• Islands such as Barbados, Saint Lucia, Antigua and Grenada are also reasonably safe, but in certain neighbourhoods or late at night it is wise to be extra alert. Theft and petty crime occur especially in capital cities.
• In countries such as Haiti, Jamaica (especially Kingston) and parts of Trinidad (Port of Spain) it is a lot less safe. Armed robberies, drug-related violence and corrupt police can occur here. Expats therefore often choose to stay in guarded residential areas or with international organisations and travel by private transport.
• In some countries, the hurricane season causes major problems.

What should you look out for in terms of diseases in the Caribbean?

• In many ways, the Caribbean is a wonderful and pleasant place to live, but there are health risks to be aware of. These are mainly related to tropical diseases, intense sunlight, and in some areas the humid climate.
• Mosquito-borne diseases are common on almost all Caribbean islands, especially during the rainy season (usually between June and November).
• Dengue: common, especially on islands such as Puerto Rico, Dominica, Jamaica, Haiti, Saint Lucia and the Dominican Republic.
• Chikungunya & Zika: these have been less active in recent years, but outbreaks still occur. 
• Malaria: rare in the Caribbean; only very limited in rural areas of Haiti, for example.
• Leptospirosis: can occur after flooding or contact with contaminated water, especially in Haiti and Dominica.
• Another risk is the sun. The UV index is very high throughout most of the Caribbean, often 10 or higher. This increases the risk of sunburn, heat exhaustion or even stroke and eye problems.

What should you pay attention to when it comes to traffic in the Caribbean?

• Road safety in the Caribbean varies. On islands such as Aruba, Curaçao, Bonaire, the Cayman Islands, Martinique and Guadeloupe, the road network is well maintained and traffic is fairly structured. Many expats choose to rent or buy a car; public transport is limited but taxi systems are reliable.
• In other countries such as Barbados, Grenada and Saint Lucia, the roads are often narrow, winding and poorly lit, especially outside of the cities. Driving here can be challenging, especially for those not used to left-hand traffic (as in Barbados). Traffic accidents are relatively common, usually due to poor road conditions, overcrowded buses or not-so-careful drivers.
• In Haiti, parts of Jamaica and Trinidad, traffic is often chaotic and you can't expect people to adhere to traffic rules. There is also a lot of traffic and the roads are poorly maintained. Public transport is not always safe or reliable here, and the use of private transport with a driver is strongly recommended.

What work and travel insurance policies are suitable for short and long stays in the Caribbean?

• Is the trip to the Caribbean and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for the Caribbean if you are going to live there for a while?

• Because local public health coverage is often limited and costs for private or international clinics can be high, international health insurance is generally strongly recommended for a (long-term) stay in the Caribbean.
• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.