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Expat guide to health care in the Bahamas

Located just off the coast of Cuba and Florida, U.S., the Bahamas is a sunny paradise rich in both history and culture.

Expats eager to escape to the Bahamian sun will be pleased to hear that its health care system is of a high standard and continues to be improved upon thanks to regular government investments and health care initiatives.

Introduction to the Bahamas

Just 393,000 people live in the Bahamas despite it being home to 700 islands and several bustling cities. However, with its seemingly endless white-sand beaches and clear blue seas, it's easy to understand why the Bahamas is such a popular location for eager expats looking to make an escape for island life.

The majority of the population of the Bahamas live on New Providence Island, the home of the Bahamian capital, Nassau, which has a population of 223,000. Other popular islands among expats are Grand Bahama and Abaco.

The official language on the islands is English, although a wide variety of other languages such as French and Creole are also commonly spoken throughout the country.

Cost of living

The Bahamas is the second most expensive country in Latin America to live with the cost of living being nearly 30% more on average than that of the U.S. Since the majority of goods have to be imported, the price of everyday necessities is a lot higher than they are in mainland countries.

On the other hand, those who live in the Bahamas do not have to pay income tax, capital gains or estate tax, balancing out the expensive living costs for some expats.

Panoramic view of Nassau, Bahamas Panoramic view of Nassau, Bahamas

An introduction to health care in the Bahamas

The Bahamian government is making a conscious effort to improve its health care system, investing around 8% of its GDP into health care in 2018, and building new hospitals and facilities.

The National Health Insurance Bahamas (NHI Bahamas) programme was launched in 2016 and offers Bahamian residents access to primary health care, free at the point of service. While the government is initially paying for the care offered, this will start to change from late 2020: NHI members and their employers will be required to pay up to 1.5% of their income — those out of work will be exempt from these charges. 

However, many Bahamians still struggle to access the health care they need. The majority of inhabitants of the Bahamas do not have health insurance and are unable to afford the high costs of secondary (specialists such as cardiologists) and tertiary medical care (such as in-patient speciality care, surgeries or procedures). In recent years, the island’s population has experienced increased incidents of lifestyle-related diseases such as type 2 diabetes and coronary heart disease, the latter being the cause of almost 14% of deaths in 2018, leading to a rising demand for health care services.

To help resolve the health care access issue, the National Health Insurance Authority, the organisation that oversees NHI Bahamas, put forward the following vision in 2018:

  • Strengthened primary care
  • High-cost care coverage
  • Wellness programming
  • An employer-sponsored national health insurance system.

Despite this, the majority of Bahamians are still without coverage and either fail to get the medical treatment they need or struggle to afford the costs without going into bankruptcy.

While the health care system may be flawed, health care in the Bahamas is widely considered to be of a high standard. Its medical staff are highly trained and experienced professionals, many of which have obtained their qualifications in the U.S., Canada or Europe, and its facilities are equipped with modern, state-of-the-art technology.

Public health care in the Bahamas

As of 2016, all Bahamians and legal residents have been able to register for free primary health care under the NHI Bahamas programme, which is funded by the Bahamian government. Residents do not have to contribute towards this initiative through income taxes, although it is widely thought that a tax may soon be introduced to help fund the programme.

The programme covers basic primary health care such as:

  • Physical examinations
  • Screenings for high-risk behaviour and mental wellness
  • Screenings for oral health and visual impairments
  • Routine examinations for newborns and young children
  • Height, weight and BMI checks
  • Early diagnosis and treatment of common diseases.

There are 28 health centres, 33 main clinics and 35 satellite clinics located on the main inhabited islands where these public primary health care services are delivered. For those living on smaller islands without medical facilities, travel by boat or helicopter is required.

While the NHI Bahamas programme is a leap forward in terms of providing basic health care for its residents, it does not cover health care costs such as pharmacy services, in-patient care whilst in the hospital, chemotherapy, child delivery and emergency care for heart attacks and broken bones. As such, these treatments and services still have to be paid for by the individual, or covered by a health insurance policy.

However, the majority of the population in the Bahamas do not have health insurance. Before residents started to enroll for NHI Bahamas, in 2017, 70% had no insurance and the average person paid around $2,300 each year for health services. The government predicts that the NHI Bahamas scheme will reduce this to about $1,000.

Private health care in the Bahamas

Many expats choose to take out private health insurance as this will give them access to the more specialised hospitals in the Bahamas. Since many specialists, including medical professionals visiting from the U.S., work from the private clinics in the Bahamas, it is a good idea for those with more serious conditions to consider a private health care plan.

Hospitals in the Bahamas

The Public Hospitals Authority in the Bahamas oversees the quality of the three public hospitals on the Bahamas islands. These three hospitals are the Princess Margaret Hospital, the Sandilands Rehabilitation Centre, both on New Providence island, and the Rand Memorial Hospital on Grand Bahama. All three hospitals have modern infrastructure and the care available is considered to be of a significantly high standard.

There are also two main private hospitals in the Bahamas, both on New Providence island:

  • Doctors Hospital
  • Lyford Cay Medical Facility.

These private hospitals offer both general and emergency services as well as more specialised care for those with severe conditions. Additionally, the Bahamas has private walk-in clinics, practitioners, and medical offices available to those with private health insurance.

Even if you have insurance, it is best to make sure you have enough cash with you when you go to any of these hospitals or when you are travelling, as they may require payment upfront. If you are insured, you will be reimbursed for this afterwards.

While the health care system in the Bahamas is a mix between public and private, it is not uncommon to be transferred to either type of hospital, depending on their availability. Medical professionals across the Bahamas in both the public and private sectors can speak English.

Mental health care in the Bahamas

The Bahamas has one psychiatric hospital that deals with both geriatric care and mental health - the Sandilands Rehabilitation Centre, on New Providence island. However, there are also psychiatric facilities in several other hospitals on the islands.

Health insurance is recommended for the treatment of mental health conditions as the free health care service in the Bahamas only covers mental health assessment and screenings.

Giving birth in the Bahamas

Giving birth in the Bahamas can be very expensive without expat health insurance. Costs run into the thousands: a caesarean section costs up to $5,100 and a delivery room including nurses will cost around $1,450.

The main public hospital on the islands, the Princess Margaret Hospital, only has 13 beds in the Neonatal Intensive Care Unit, meaning those with high-risk pregnancies often prefer travelling to the U.S to give birth if this is possible. Despite this, giving birth in the Bahamas is thought to be safe since its medical professionals are highly trained and able to offer the best care.

The infant mortality rate in the Bahamas has decreased from nearly 16 deaths per 1,000 births in 2000 to just over 10 per 1,000 in 2018, largely thanks to advancements in medical facilities and government initiatives to help educate people about the spread of disease.

Emergency services in the Bahamas

Two numbers can be used to reach emergency services: 919 and 911. The U.S. emergency number, 911, is in place due to the high number of U.S. tourists and residents. These numbers can be called from anywhere in the Bahamas.

Expats living on smaller islands in the Bahamas should have plans in place in case they need to travel to one of the main islands for medical treatment. Many smaller islands have either limited or non-existent medical facilities and of those that do have clinics, many are only open one or two days a week. Even on New Providence, where most medical facilities are concentrated, travelling to the hospital can be difficult — traffic is usually very congested and ambulances have little to no advanced life support or stabilisation equipment.

Aetna International members in the Bahamas can make great use of the Care and Response Excellence (CARE) team who can help to organise travel for treatment as well as emergency evacuation. 

Aetna International’s CARE team ensures that the right doctor is altered as quickly as possible in an emergency where the necessary care is either unreachable or non-existent. If this is the case, The CARE team will organise a rapid response and evacuate the patient as quickly as possible to wherever the right medical attention can be reached.

Pharmacies and medication in the Bahamas

Pharmacies can be found in most shopping centres, although prescriptions from a medical professional are required to purchase any medicines. For those living on smaller islands, travel to another island may be required to access this service.

Some expats find that their medication is illegal or hard to obtain in their new home, and it’s important to check both of these factors before relocating. Our CARE team help Aetna International members manage their medication, from checking availability to finding replacement and sourcing. 

Health hazards in the Bahamas

There are some health risks to be aware of when relocating to the Bahamas:

  • Dengue fever is transmitted by mosquitoes, which often live near or inside homes. Most people recover from Dengue fever but complications can arise that require further treatment. Residents can protect themselves from this disease by using mosquito repellents or netting.
  • Zika is another mosquito-transmitted disease present in the Bahamas. Zika can cause birth defects, so pregnant women, or those hoping to become pregnant, should consult with a doctor on what extra precautions to take to avoid this infection.

Natural disasters

It is important to be aware of the Bahamas’ vulnerability to earthquakes, hurricanes and torrential rain due to its location and geography. Due to poor infrastructures, natural weather disasters have previously caused billions of dollars’ worth of damage and have claimed many lives. The most recent natural disaster was Hurricane Dorian, which hit the Bahamas in September 2019, and is the strongest storm on record to have ever occurred on the islands.

The National Emergency Management Agency is a government agency that aims to help residents of the Bahamas navigate the potential negative impacts of such disasters and emergencies. The agency takes on many responsibilities, including:

  • preparing the community for emergencies
  • assessing residents' plans should a disaster occur
  • organising recovery coordination.

As an expat in the Bahamas, it is a good idea to ensure that your health care policy covers emergency evacuation and repatriation, if available. 

Vaccinations required for moving to the Bahamas

All travellers and expats should have had the following vaccines:

  • Measles-Mumps-Rubella (MMR)
  • Diphtheria, Tetanus and Pertussis (TDAP)
  • Chickenpox
  • Polio

Some travellers are required to have had the following vaccinations. It is best to check with your national embassy to ensure you have received the required vaccinations for your circumstances:

  • Hepatitis A
  • Typhoid
  • Hepatitis B
  • Rabies (especially if working with animals)
  • Yellow Fever (only if coming from a country with risk of Yellow Fever transmissions such as some countries in Africa and South America).

Living in the Bahamas and travelling for treatment

Being just 50 miles away from the coast of Florida, many foreign residents — especially those who have come from the U.S and still retain their U.S health insurance — choose to travel from the Bahamas to the U.S for treatment. For those considering this as an option, it is a good idea to ensure that your health insurance plan will cover the cost of this travel. 

*All costs are accurate as of June 2020.

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