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 How is the healthcare system organised in Tunisia? How much does it cost and what cover does Tunisian social protection provide? Here is some information on the state healthcare system in Tunisia. 

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The public healthcare system

Health insurance is managed by the “Caisse Nationale d'Assurance Maladie”. The welfare scheme in Tunisia is compulsory for the entire population. It differs according to socio-professional category.
The insured’s spouse and minor children are entitled to Social Security benefits and therefore to health insurance.
To receive benefits from Social Security, you must either:
- have worked at least 50 days during the last two quarters,
- have worked at least 80 days during the last four quarters.
What cover does Tunisian healthcare system provide?
State-owned health facilities and hospitals provide free services to all Tunisian citizens and residents.
The costs incurred within the public health centres are reimbursed if the insured attends one of three levels of infrastructure within the public system:
- health centres providing primary care,
- district and regional hospitals,
- university hospitals.
The insured may also be treated privately if the services are approved and if they are treating:
- severe and/or chronic conditions requiring full health insurance cover. This is known as APCI (Affections Prises en Charge Intégralement or Fully covered conditions).
- some cases of hospitaliation and surgery.
The terms and levels of cover are determined by:
- type of care: public or private,
- payment terms: per treatment or procedure or a lump sum
- type of cover: cash advance or third party payment,
- the level of cover desired: amount reimbursed, payment caps, reference price of drugs etc.
There is an agreement between France and Tunisia enabling seconded French nationals to keep their entitlement to French Social Security benefits for three years, as long as they are employed by a French company. Only expatriates are required to join the Tunisian Social Security system.
How much does healthcare cost in Tunisia?
Contributions at 1st October 2010 were 6.75% shared between the employee and employer. 2.75% is paid by the employee directly from their salary and 4% by the employer.
What you need to do:
Employers are required to enrol their employees in the Social Security scheme (CNSS) within a month of their arrival in the company. Check that this has been done because enrolment in the National Health Insurance Fund is compulsory in order to obtain healthcare cover.

The private healthcare system

The private healthcare system in Tunisia has significantly expanded in terms of infrastructure as well as capacity and healthcare personnel. The private sector offers, for example, high-quality cosmetic surgery, spas and thalassotherapy to attract foreigners.
Similarly, dentists and opticians are found almost exclusively in the private sector.
Some services in the private sector are covered by health insurance.
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