Published on and written by Cyril Jarnias
Relocating to Aruba for a few months or several years means choosing a sunny, relatively safe, and very international living environment. But for any expat, the real question comes up very quickly: What is the value of the local healthcare system, how does insurance work, and what to do in case of an emergency or chronic illness?
Aruba has a quality healthcare system, but accessing it isn’t intuitive for newcomers, and not all care is automatically covered. To avoid bad surprises, it is essential to understand from the start the structure of the healthcare offerings, insurance requirements, and necessary preparations before your stay.
This guide brings together the essential elements of the Aruban healthcare system, specifically from the point of view of an expat, a digital nomad, or a foreign retiree.
Understanding the Healthcare Landscape in Aruba
Aruba is a small island, but with a surprisingly strong medical infrastructure for its size. The healthcare system is largely public, strongly supported by the government, and accessible to both local residents and foreigners who live and work legally on the island.
Aruba offers high-quality healthcare for the region (modern hospital, equipment, specialists, clinics, mental health). Wait times for essential care are generally short and costs reasonable compared to North America or Europe. However, hospitalization or medical evacuation can be very expensive without insurance.
Multilingualism is another significant advantage. In most facilities, Dutch is the official working language, but medical staff also speak fluent English, Spanish, and Papiamento, sometimes with knowledge of German and French. For an expat, the language barrier is therefore low, especially in major facilities.
However, Aruba faces specific public health challenges, notably a high rate of diabetes and obesity, partly linked to local dietary habits rich in fried foods. People with chronic illnesses, especially those with diabetes, must ensure before leaving that their follow-up can be properly managed on-site, both from a medical and medication access standpoint.
The Public System: The Mandatory AZV Health Insurance
For anyone who lives and works legally in Aruba, including expats, enrollment in the public AZV health insurance (Algemene Ziektekosten Verzekering) is in principle mandatory. It is a universal health insurance that funds the majority of basic care on the island.
How AZV Works for an Expat
Access to AZV is not automatic upon arrival. You must first be registered in the population register, the Censo. Only once this registration is validated, and provided you have legal resident status with the right to work, does enrollment in AZV become possible (and imposed).
AZV is funded by shared contributions between employers, employees, and the government. The overall rate is about 11.5% of annual income, with a cap on income subject to contribution and a split of the rate between employer and employee. For a locally hired expat employee, these contributions are typically withheld at source, like for an Aruban employee.
Once enrolled, an AZV policyholder benefits from broad coverage including: general practitioner consultations, appointments with many specialists, hospitalization, a wide range of medications, and mental health services within the public framework.
What AZV Covers (and Does Not Cover)
AZV is designed to guarantee access to essential care on Aruban territory, but it is not intended to cover everything. Some items remain excluded or only partially covered, which particularly concerns expats accustomed to more comprehensive private plans.
The key points to remember are:
| Coverage Element | Covered by AZV | Important Details |
|---|---|---|
| General Practitioner (family doctor) | Yes | Entry point to the system, mandatory for referrals to specialists |
| Specialists (cardio, derm, etc.) | Yes, with referral | Coverage within accredited hospitals and centers |
| Hospitalization in a standard room | Yes | In the public general hospital Dr. Horacio Oduber |
| Essential medications | Yes | According to list and medical indications |
| Public mental health | Yes | Via public psychiatry and psychology services |
| Care abroad | No | Outside Aruba is not covered by AZV |
| Private room, hotel-like comfort | No | Patient’s responsibility or via supplemental insurance |
| Adult dental care | Partially / No | Many services to be paid out of pocket or via supplemental insurance |
| Eyeglasses, vision | No | Generally excluded |
In practice, AZV secures access to routine and emergency care on-site, but does not cover potential evacuation to another country or treatments performed outside the territory. For an expat, this creates a major vulnerability point: a complicated heart attack, highly specialized surgery, or cancer requiring technical capabilities not found on the island can lead to a costly transfer to Curaçao, Colombia, the United States, or the Netherlands.
Why Private Insurance is Often Needed in Addition to AZV
Even well protected by AZV, an expat can face significant costs in several situations:
Discover the specific benefits often included in high-end plans for extended international health coverage.
Organization and coverage of medical transport to another country for care not available locally.
Organized and medically equipped return to the patient’s country of origin to continue treatments there.
Choice of a private facility or higher-standard room for more comfort during hospitalization.
Coverage for major procedures (implants, prosthetics) and care little or not reimbursed by basic plans.
Access and coverage for specialized treatments or consultations outside Aruba.
This is why it is highly recommended for expats to take out a complementary international health insurance policy. Insurers like Cigna Global or Allianz International are frequently cited among companies whose policies are well accepted by Aruban facilities, especially private clinics and certain overseas care services.
A common combination for a salaried expat is to be covered by AZV for basic care on the island, and by private international insurance for everything beyond that scope (private hospitals, care outside Aruba, evacuation, etc.).
The Private System: Clinics, Quick Care, and Tailored Services
Alongside the public sector, Aruba has developed a network of private clinics that particularly meet the needs of expats, long-term tourists, and residents seeking comfort or speed.
Most Important Clinics and Medical Centers
The pillar of the hospital system remains the Dr. Horacio Oduber Hospital, the large general hospital in Oranjestad. But many outpatient or minor emergency services are found in private centers.
Notable examples include:
| Facility | Location | Main Role |
|---|---|---|
| Dr. Horacio Oduber Hospital | Oranjestad | Public general hospital (288 beds, 24/7 ER, wide range of specialties) |
| Centro Medico Rudy Engelbrecht | San Nicolas | Medical center with consultations, 24/7 ER, numerous specialties |
| Urgent Care Aruba (UCA) | Noord (Noord Medical Center, and Punta Brabo site) | Non-life-threatening emergencies, on-site lab, walk-in welcome |
| MedCare Clinic | Noord | General and specialized medicine |
| Noord Medical Center | Noord | Primary and urgent care |
| Posada Clinic Aruba | L.G. Smith Blvd | Hemodialysis center (vacation dialysis) |
| Aeson Health | J.E. Irausquin Blvd | In-clinic, hotel, or online consultations, rapid tests |
These private facilities have several assets valued by expats: reduced wait times, multilingual staff, simplified procedures, and for some, established experience with international insurance companies. Urgent Care Aruba, for example, largely operates without appointments, has an accredited lab on-site, offers hotel visits, and states that it accepts most travel or international insurance.
Payment and Relationship with Insurers
In most private clinics, especially for an expat or visitor, the principle remains direct payment: consultation, tests, medications are paid for in cash or by bank card, then potentially reimbursed later by the insurer. Some international insurance contracts allow for direct settlement between the insurer and the facility, but this is not guaranteed.
For expats, it is crucial to always have an emergency financial reserve, even with insurance coverage. At the same time, it is imperative to carefully keep all documentation, such as detailed invoices and medical reports, to facilitate reimbursement procedures with your insurer.
In Case of Emergency: Numbers, Ambulance, and Medical Evacuation
Emergency management in Aruba is well-structured for an island of its size, with a single number, a well-equipped general hospital, and established air evacuation services.
What to Do in Case of a Medical Emergency
For any serious medical emergency (trauma, suspected stroke, acute chest pain, respiratory distress, etc.), the number to call is 911. This single number provides access to an ambulance, firefighters, or the coast guard.
The police can be reached at 100, but for a health issue, it is indeed 911 that should be used. The ambulance will transport you, depending on the situation, to Dr. Horacio Oduber Hospital or to an appropriate center.
Hospital emergency services are open 24/7 with a doctor on-site and specialists on call. The facility is wheelchair accessible. Furthermore, most major hotels have an on-call general practitioner or a partnership with a clinic, facilitating the care of expats or visitors.
Medical Evacuation Abroad
Some cases exceed the island’s technical capacity: complex heart surgery, certain cancers, major trauma requiring very heavy intensive care, etc. In these situations, an air transfer can be organized to Curaçao, Colombia, the Netherlands, Puerto Rico, Venezuela, or the United States, depending on agreements in place and the pathology.
Specialized companies like Pro-Air Ambulance handle these evacuations. Their planes are equipped like flying intensive care units, with medical personnel on board. They also handle ground transport to the airport and manage all customs and immigration formalities, both at departure and arrival.
All of this comes at an extremely high cost, often several tens of thousands of dollars. Without insurance including medical evacuation coverage (often recommended at a minimum of 250,000 USD), these costs remain the responsibility of the patient or their family. This is probably the most significant financial risk for an expat in Aruba, far ahead of a simple consultation or an ER visit.
Pharmacies, Medications, and Managing Long-Term Treatment
For an expat living with a chronic illness – diabetes, hypertension, cardiovascular disease, autoimmune disease, stable psychiatric disorder – the continuity of medication treatment is essential. Aruba is well-equipped with pharmacies, but there are specific rules to know.
Organization of Pharmacies (“botikas”)
Aruban pharmacies, called botikas, are well-stocked and offer most common medications, including generics. They are generally open Monday through Saturday, from about 7 AM to 7 PM. On Sundays, evenings, and holidays, an on-call system ensures that at least one pharmacy per district remains open 24/7 in rotation.
In Aruba, many common medications, like acetaminophen, are not sold in supermarkets. They are available exclusively in pharmacies, which can surprise new arrivals.
Foreign Prescriptions and Local Prescribing
A crucial point for expats: Aruban pharmacies cannot dispense a medication based on a prescription issued by a foreign doctor not authorized to practice on the island.
Concretely, this means that an American or European patient arriving with a prescription from their usual doctor cannot have it filled directly. They must first consult a local doctor, who will issue a prescription compatible with Aruban regulations.
Some clinics, such as Urgent Care Aruba, facilitate prescription renewals for foreign visitors. The process requires presenting either a copy of the currently valid prescription or a signed letter from the original treating doctor clearly detailing the treatment. After paying the consultation fee, the patient receives a local prescription that can then be filled at a pharmacy on the island.
This step may seem burdensome, but it is essential to remain legal and avoid any customs or legal problems.
Arriving with Your Medications: Precautions
Even before worrying about on-site renewal, it is highly recommended to arrive in Aruba with a sufficient reserve of medications, ideally for at least two to three months, in their original packaging. The general rules to follow are:
| Good Practices for Traveling with Medications | Reason / Comment |
|---|---|
| Keep medications in their original box with label | Allows identification by authorities and doctors |
| Keep treatments in carry-on luggage | Limits risk of lost luggage or extreme temperature variation |
| Carry a copy of the prescription and a doctor’s letter | Useful in case of inspection, for local renewal, or an emergency |
| Carry only a “for personal use” quantity (30–90 days) | Avoids being suspected of illegal importation |
| Do not mix several medications in the same bottle | Makes verification impossible for customs or doctors |
| Declare medications upon arrival if necessary | Caution especially for psychotropics, opioids, stimulants, etc. |
Certain substances (opioid painkillers, anxiolytics, ADHD stimulants, steroids, powerful sleeping pills) may be subject to strict control, even prohibited without special authorization. The Aruban health authorities, via the Inspectie voor Geneesmiddelen (Medicines Inspectorate), can provide information on a medication’s status. It is better to check in advance rather than risk confiscation, or even legal action.
Maternity, Dental, and Specialized Care
An expat’s needs are not limited to emergencies and acute illnesses. Giving birth on-site, getting children’s teeth treated, or organizing dialysis during a long stay are frequent situations.
Pregnancy and Childbirth
Aruba offers good care for pregnant women and newborns. The general practitioner is usually the first point of contact, then refers to gynecologists or midwives as needed. Childbirth takes place at the general hospital, where the infrastructure is suitable.
For an expat woman not covered by AZV or with insufficient coverage, it is important to know the order of magnitude of costs:
– A vaginal delivery costs on average between 3,000 and 4,500 euros;
– A cesarean section is typically between 6,000 and 8,000 euros.
Maternity costs abroad, not covered by French health insurance, can be high. Subscribing to an international insurance policy that includes maternity is therefore highly recommended. For any questions, a dedicated number (131) offers information and support to pregnant women, even in complex situations.
Dental Care
Dentistry in Aruba is of good quality, with many public and private practices capable of providing routine care, implants, prosthetics, esthetic work, etc. However, AZV does not always cover these services, particularly for adults, so many procedures remain the patient’s responsibility.
Some dental offices offer rates 2 to 3 times lower than those in North America, favoring dental tourism. However, without supplemental coverage, a full-mouth rehabilitation can cost several thousand euros.
Dialysis, Cardiology, and Major Care
Patients requiring hemodialysis can be cared for at Dr. Horacio Oduber Hospital or Posada Clinic. For a dialysis patient wishing to stay temporarily in Aruba (vacation dialysis), it is imperative to contact them several months in advance – three months is generally recommended – to secure a spot. Only HIV and hepatitis B negative patients are accepted in some centers, for transfusion safety reasons.
In cardiology, Aruba has a specialized institute, the Aruba Heart Institute, with a cardiac catheterization lab and links to international reference centers like the Texas Heart Institute. Nonetheless, the most complex cases often continue to be transferred to reference facilities abroad.
Mental Health and Psychological Support
Often overlooked in guides for expats, mental health occupies an increasingly visible place in Aruba. The island is home to several private psychology and psychotherapy practices, mental health structures, and organizations working with both local populations and foreigners.
An overview of structures and therapeutic services available on the island, offered by multilingual and certified professionals.
Aruba Clinical Services, Psyched Aruba, Spiritz Counseling, Centro di Desaroyo Humano, and Healthy Minds Aruba are among the main providers.
Individual, family, or couples therapy, CBT (Cognitive Behavioral Therapy) interventions, and support therapy.
Management of anxiety disorders, depression, PTSD, and challenges adapting to expatriation.
Training to Dutch or North American standards, with international certifications (EMDR, DBT, etc.).
Services available in multiple languages, including English, Dutch, Spanish, and Papiamento.
For expats covered by specific insurance (corporate plans, AZV+ extensions, health plans of large Aruban or international companies), some of these consultations may be partially or fully reimbursed. Other patients will have to finance their sessions themselves. Rates remain comparable or even lower than in Western Europe, but represent a significant budget for long-term follow-up.
Access to Medical Equipment, Mobility, and Home Care
Living in Aruba with reduced mobility or a disability is not incompatible with a good quality of life, provided logistics are anticipated. The island has specialized companies in the rental and sale of medical equipment.
Labco Medical, Essential Health Supplies, or other suppliers offer wheelchairs (including amphibious beach versions), mobility scooters, hospital beds, oxygen concentrators, crutches, walkers, safe bath equipment, and generally provide free delivery and pick-up at the residence or hotel.
LiteLife Medicab Aruba offers a door-to-door medical transport service with vehicles equipped with ramps or lift platforms and trained drivers. This service is particularly valuable for elderly expats, convalescents, or those with chronic illnesses.
In parallel, organizations like Trinity or Buurtzorg Aruba offer home care services: nursing, assistance with bathing, post-operative care, chronic disease management, support for the elderly. Here again, the question of financial coverage depends on residency status, affiliation with AZV, and the presence or absence of private international insurance.
Health and Travel Insurance for Expats and Visitors
While the specific COVID insurance requirement for tourists was lifted in 2022, Aruba remains very clear: insurance is highly recommended for anyone entering the island, and it is in fact essential for expats.
For short-term visitors, certain rules mention the requirement of minimal coverage for medical expenses and repatriation (e.g., around 15,000 USD). For long-term residents, it is rather the obligation to enroll in AZV that applies, with the option – strongly advised – of adding private international coverage.
International Insurance for Expats
Expats, digital nomads, and foreign retirees generally prefer international health insurance contracts covering:
– Outpatient and hospital care in Aruba’s private clinics;
– Medical evacuations and repatriations (ideally with a ceiling of 250,000 USD or more);
– Major care in a third country (USA, Europe, Latin America) if necessary;
– sometimes maternity, dental care, and vision.
Companies like Cigna Global or Allianz International are frequently cited as widely accepted on the island. Specialized international insurance brokers can help compare benefits, deductibles, and care networks.
Even when an Aruban facility accepts a given insurance, it may happen that they request direct payment if verification of coverage takes time. It is therefore prudent to be able to advance part of the costs and never rely solely on a hypothetical direct payment arrangement.
Travel Insurance for Temporary Stays
For temporary stays (extended tourism, short assignments, teleworking for a few months), comprehensive travel insurance remains the simplest tool: it combines emergency medical coverage, evacuation, trip interruption reimbursement, etc.
This is the average cost of comprehensive travel insurance for a ten-day stay in Aruba, representing a fraction of the total budget.
Typical Aruban activities – snorkeling, kitesurfing, windsurfing, quad bike tours – are sometimes excluded from standard contracts and require an “adventure sports” add-on. Here again, careful reading of the exclusions is essential to avoid being uncovered in case of an accident.
Prevention is Better Than Cure: Vaccines, Local Diseases, and Lifestyle
The medical preparation for relocating to Aruba is not limited to insurance. International health authorities (WHO, CDC, NaTHNaC, etc.) recommend reviewing your vaccination record several weeks before departure.
Basic vaccines (DTaP or Tdap, polio, MMR, varicella) should be up to date. Depending on the length of stay, living conditions, and risk profile, additional vaccines may be advised: Hepatitis A and B, typhoid, seasonal flu, and possibly rabies for very long stays or people in close contact with animals.
For travelers coming from a country where yellow fever is present, Aruba requires a vaccination certificate. This obligation applies to adults and children over 9 months. The certificate must have been issued at least ten days before arrival and is then valid for life.
On-site, the main infectious threat is not malaria (absent from Aruba), but mosquito-borne diseases: dengue, chikungunya, Zika. Prevention relies on simple actions, but must be applied rigorously: repellents containing DEET, covering clothing at dawn and dusk, mosquito nets if necessary.
Pregnant women or those wishing to become pregnant should discuss their plans with a doctor before traveling to an area where Zika virus has circulated, even if the risk fluctuates over time.
In Aruba, tap water is potable and of good quality, limiting the risks of digestive issues like traveler’s diarrhea. Food service generally adheres to good hygiene standards. However, it’s recommended to maintain basic precautions, such as ensuring food is sufficiently cooked and being cautious with very raw dishes.
Finally, the sun is probably the most underestimated “health risk” on the island. Intense UV radiation, heat, and deceptive wind require broad-spectrum sunscreen, abundant hydration, and breaks in the shade. For an expat living on-site, the risk isn’t limited to sunburn, but also includes chronic dehydration and accelerated skin aging.
Living in Aruba Serenely: Health Strategy for Expats
For an expat, the goal is not only to avoid disasters, but to ensure that daily medical life is smooth: finding a trusted general practitioner, knowing where to go in case of a problem, having access to medications, understanding how billing works.
A pragmatic approach could be summarized as follows:
– 1. Before Departure
– Update basic vaccines and discuss additional vaccines with a doctor or a travel medicine center.
– Obtain a medical summary in English or Dutch (medical history, current treatments, allergies).
– Check the legality of your medications in the Aruban context, prepare prescriptions and a medical letter.
– Take out international insurance covering at minimum hospital care, evacuation, and repatriation.
Upon your arrival in Aruba, complete your registration with the Censo and AZV if you are working legally. Quickly identify a general practitioner near you and locate the closest pharmacy. For non-life-threatening emergencies, note the location of a center like Urgent Care Aruba. In case of a chronic illness, organize the local renewal of your treatment without delay.
– 3. Long-Term
– Maintain a minimal reserve of basic medications at home.
– Keep emergency contacts up to date, including the number 911 and your insurance contacts.
– Do not neglect mental health: in case of adjustment difficulties, stress, or isolation, consult a psychologist or specialized service.
– Anticipate specific needs related to age, pregnancy, or an evolving condition (equipment, home adaptations, medical transport, etc.).
Aruba offers expats an advanced medical environment for a Caribbean island, including a modern hospital, efficient clinics, and a structured public system. The ecosystem of related services (medical transport, home care, mental health, equipment) is also very developed there.
The flip side is that a serious incident without insurance can turn into a financial abyss, especially if an air evacuation is needed. The key to living serenely as an expat in Aruba therefore lies in two words: anticipation and coverage. Once these aspects are secured, the island can truly deliver what it promises: a sunny daily life in a safe setting, without sacrificing quality care when needed.
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Cyril Jarnias is an independent expert in international wealth management with over 20 years of experience. As an expatriate himself, he is dedicated to helping individuals and business leaders build, protect, and pass on their wealth with complete peace of mind.
On his website, cyriljarnias.com, he shares his expertise on international real estate, offshore company formation, and expatriation.
Thanks to his expertise, he offers sound advice to optimize his clients' wealth management. Cyril Jarnias is also recognized for his appearances in many prestigious media outlets such as BFM Business, les Français de l’étranger, Le Figaro, Les Echos, and Mieux vivre votre argent, where he shares his knowledge and know-how in wealth management.
