As a French overseas department, Mayotte's healthcare system theoretically operates under the French model, but in practice, it faces unique challenges due to its insularity, rapid population growth, and high migratory pressure. The system is a 'mixed' model, combining public and some private provisions. The Caisse de Sécurité Sociale de Mayotte (CSSM) is the sole social security body, managing health insurance and other social benefits. While the Centre Hospitalier de Mayotte (CHM) in Mamoudzou is the main hospital and benefits from French funding, its capacity is limited, and the overall quality of care often falls below metropolitan French standards. Expats should be aware of potential language barriers, the need for upfront payments in many instances, and the possibility of medical evacuation for complex treatments.

The public healthcare system in Mayotte is managed by the Caisse de Sécurité Sociale de Mayotte (CSSM), which oversees health insurance, maternity, and disability benefits. For legal residents, registration with the CSSM provides access to state healthcare. This typically involves proving residency and lawful status. Once registered, individuals receive a carte vitale and a certificate of registration, which facilitates reimbursement for medical expenses. The system aims for 100% coverage of healthcare costs in certain situations, sometimes subject to income conditions.

However, the public system in Mayotte is significantly strained. The Centre Hospitalier de Mayotte (CHM) is the primary public hospital, but it is often overwhelmed and suffers from a severe shortage of medical professionals across various specialties, including emergency, general medicine, pediatrics, maternity, and neonatology. Waiting times for consultations and procedures can be long, and access to care in rural regions is extremely limited, with healthcare facilities concentrated in urban areas. The quality of care, while benefiting from French funding, does not consistently meet international standards. For highly specialized or complex medical conditions, patients are frequently transferred to hospitals in Réunion or mainland France.

While Mayotte's healthcare system is primarily public, private healthcare options exist, though they are less developed than in metropolitan France. Hospitals and private practitioners in Mayotte typically require upfront payment for services, regardless of whether you have health insurance. The main hospital, CHM, provides some basic specialist care, but dedicated private hospital networks are not prominently established. For any advanced or highly specialized private treatment, medical evacuation to Réunion or mainland France would be necessary.

Typical costs for private consultations can be estimated based on the average GP visit, which is around €14 (USD $15). However, costs for specialist consultations, diagnostic tests, and procedures in private settings can vary significantly and are generally higher. Expats seeking private care should be prepared for direct payment and ensure their private health insurance offers comprehensive coverage and direct billing options where possible.

Access to healthcare for foreigners in Mayotte depends on their residency status.

• Tourists and Short-Term Visitors: It is critical to have comprehensive travel health insurance that covers local treatment and emergency medical evacuation. For EU/UK citizens, a Global Health Insurance Card (GHIC) or European Health Insurance Card (EHIC) can cover medically necessary state healthcare, but it is not a substitute for travel insurance, which covers costs like medical repatriation or private care.

• Residents and Workers: Foreign nationals planning to live and work in Mayotte must be legal residents to register with the Caisse de Sécurité Sociale de Mayotte (CSSM). Employers are responsible for registering their employees with the CSSM. The registration process involves submitting an application to the CSSM, along with supporting documents such as a passport and proof of lawful residency.

• Recent Changes for Non-EU Long-Stay Visitors: As of late 2025, French lawmakers approved an amendment to the 2026 social security budget introducing a new 'minimum healthcare contribution' for non-EU nationals on long-stay visitor visas to access public healthcare. This measure is expected to take effect in 2026 and means that private health insurance will be mandatory until official affiliation with the public system is granted after this contribution is paid. This change aims to ensure fair participation in the social system for those not contributing through employment taxes.

There are no specific reciprocal health agreements beyond the standard French system provisions for EU/UK citizens.

Expats in Mayotte have several insurance options, depending on their employment and residency status:

• Mandatory Public Contributions (CSSM): If you are employed and a legal resident in Mayotte, you will typically contribute to the Caisse de Sécurité Sociale de Mayotte (CSSM) through your employment. This provides access to the public healthcare system.

• Voluntary Private Plans: Given the limitations of the public system, many expats opt for voluntary private health insurance. These plans offer access to private practitioners and facilities, potentially reducing waiting times and offering a higher standard of comfort. However, upfront payment is often required.

• International Health Insurance: This is highly recommended for expats. Providers like Cigna Global and Bupa Global offer comprehensive international health insurance plans that cover emergency and routine healthcare worldwide, including medical evacuation. These plans are flexible, with customizable options for coverage limits, deductibles, and additional benefits like dental and vision. While specific monthly premium ranges for Mayotte are not available, international health insurance premiums vary widely based on age, coverage level, and medical history.

• Employer-Provided Plans: Some employers in Mayotte may offer health insurance as part of their benefits package. It is crucial to understand the extent of coverage provided by such plans, especially regarding international medical evacuation.

For non-EU nationals on long-stay visitor visas, private health insurance is mandatory until they can officially affiliate with the public system after paying the new 'minimum healthcare contribution' expected in 2026.

Healthcare costs in Mayotte can vary, and expats should be prepared for out-of-pocket expenses:

• GP Visits: An average General Practitioner (GP) visit is approximately €14 (USD $15).
• Specialist Consultations: Costs for specialists will be higher than GP visits, but specific figures are not readily available. Upfront payment is generally required.
• Hospital Stays: While public hospital stays are covered for those affiliated with CSSM, private room upgrades or services not covered by the public system will incur costs. For those without public insurance, hospital treatment requires upfront payment.
• Prescriptions: Pharmacies in Mamoudzou follow French pharmaceutical standards, and stock is generally adequate, though perhaps not as extensive as in mainland France. Prescription costs will vary, with partial or full reimbursement for those covered by CSSM or private insurance.
• Dental and Vision Care: These are often not fully covered by public health insurance and may require significant out-of-pocket payments or specific private insurance add-ons.

It is important to note that hospitals and private practitioners in Mayotte require upfront payment for services, even if you have travel health insurance. Therefore, having accessible funds or a robust international health insurance plan with direct billing capabilities is crucial.

Mayotte's emergency medical services are vital, especially given the limitations of general healthcare access. The primary emergency numbers are:

• 15: SAMU (Service d'Aide Médicale Urgente) for medical emergencies and ambulances.
• 17: Police for law enforcement emergencies.
• 18: Sapeurs-Pompiers for fire and rescue.
• 112: European Emergency Number for all general emergencies.

When calling, be prepared to provide your exact location, a contact number, and a clear description of the emergency. Be aware that English-speaking operators may not be available, so basic French phrases could be beneficial.

Emergency care, such as that provided by SAMU, remains accessible to all, including foreigners. However, for ongoing treatment or if hospitalization is required, facilities will typically demand upfront payment, even if you have travel health insurance. For serious medical emergencies or conditions requiring specialist treatment not available on the island, medical evacuation to Réunion or mainland France is a standard protocol. In some cases, evacuation to South Africa may also be required. Ensure your international health insurance includes comprehensive medical evacuation coverage.

The quality of healthcare in Mayotte presents significant challenges compared to international standards and even mainland France.

Strengths:

• As a French overseas department, Mayotte benefits from French funding and staffing standards, making its main hospital (CHM) better equipped than neighboring Comoros.
• Efforts are being made to improve the system, including the development of digital health and telemedicine to address doctor shortages and improve access, particularly during health crises.

Weaknesses:

• Limited Capacity and Staff Shortages: The public healthcare system's capacity is very limited, and there is a severe shortage of medical staff, particularly in emergency, general medicine, pediatrics, maternity, and neonatology.
• Access and Waiting Times: Access to healthcare services is generally poor, especially in rural areas, and waiting times for care can be long. The main hospital in Mamoudzou is often overwhelmed.
• Infrastructure and Conditions: Poor living conditions, inadequate sanitation, and lack of running water for much of the population significantly impact public health. The island faces a high prevalence of chronic, infectious, and parasitic diseases.
• Mental Health: Adult psychiatric care is nearly nonexistent, and access to private psychologists is limited and expensive, with cultural barriers further hindering care.
• Expat Access Barriers: Difficulties in accessing healthcare for people without residency permits due to high migratory pressure are a significant public health challenge. Unlike mainland France, Mayotte does not have a State Medical Aid program for those in irregular situations, creating financial barriers.

Overall, Mayotte's healthcare system is significantly less robust than that of mainland France, and while it is stronger than some immediate neighbors, expats should be prepared for a system with considerable limitations and potential for medical evacuation for serious conditions.