Healthcare in Cambodia

If you’re considering moving to Cambodia, សូមអបអរសាទរ (congratulations)!

This sunny nation of 16.7 million is filled to the brim with beautiful temples, natural wonders, and stunning beaches, as well as some of the kindest people on the planet.

And despite the fact that its infrastructure and cities have developed at a rapid pace since the end of the Vietnamese occupation in 1989, the cost of living is still extremely low – particularly for anyone with American dollars.

But before you become one of the 207 US expats enjoying life in Cambodia (source: UN, 2019), you’ll want to understand what kind of healthcare you’ll have access to once you arrive.

And if you want to join the 16,700 people in Cambodia who have private health insurance (source: The Law Reviews, 2021), check out our list of recommended healthcare providers.

From there, you can request free quotes from whichever company suits your needs.

Cambodian healthcare: key stats

Ancient stone faces in the Bayon Temple at Angkor Wat

How does Cambodia’s healthcare system work?

Since the overthrow of the genocidal Khmer Rouge government and the end of the subsequent civil war, Cambodia has strived for a universal healthcare system.

Cambodia’s constitution, created after the country’s first democratic election in 1993, states: “The health of the people shall be guaranteed.

“The state shall give full consideration to disease prevention and medical treatment. Poor citizens shall receive free medical consultation in public hospitals, infirmaries and maternities.”

This admirable principle has taken the form of three different programs financed by the National Social Security Fund (NSSF), which is run by the government.

1. Social Health Insurance

The mandatory Social Health Insurance (SHI) initiative covers 3.1 million workers at both big and small businesses, and is funded equally by employers and employees.

This contribution was initially $1.60 per month for everyone, but is now 2.6% of each worker’s wage, up to a maximum of 40,800 riels ($10).

There are high hopes for SHI, which was launched in 2016 after a feasibility study and pilot stage that lasted a combined nine years.

2. The Health Equity Fund

The Health Equity Fund (HEF) provides healthcare for Cambodia’s poorest citizens. It currently serves 3.2 million people, or 19% of the population.

The program is part of a poverty identification system known as IDPoor, which has reduced the country’s poverty rate by more than two-thirds, from 47.8% in 2007 to 13.5% in 2015, according to the BMJ.

3. Community-Based Health Insurance

Community-Based Health Insurance (CBHI) schemes offer health insurance to informal workers – that is, people who aren’t employed by a company, which in Cambodia mainly refers to those working in agriculture, fishing, or forestry.

There are nine CBHI initiatives, but between them they only cover 1% of the population – which is troubling, since 85% of people work in the informal economy, according to the UN.

These three public healthcare programs don’t cover anyone for expensive services like dental care, dialysis, heart surgery, organ transplants, or non-primary services such as fertility treatments.

They do however provide the following free or heavily subsidized services:

• Consultations with a doctor
• Medical care in NSSF-contracted facilities for up to 180 days
• Outpatient care
• Emergency care in all facilities, including ones not contracted by the NSSF
• Screenings
• Prescriptions
• Certain vaccines
• Sick pay covering 70% of your wage
• Maternity care from conception to post-birth
• Treatment of chronic conditions, including cancer
• Physical rehabilitation services, including physiotherapy

Is healthcare free in Cambodia?

Yes, but only for its poorest residents, through the HEF scheme. For all other people in the country, as with most universal health systems, you can only access public healthcare if you pay a monthly tax.

In Cambodia’s case, this means giving 2.6% of your salary to the government, with a monthly upper limit of just $10.

Healthcare in Cambodia for foreigners

Healthcare insurance is compulsory for everyone in Cambodia with a formal job, which most expats have when they move to the country.

But foreigners are advised to opt for private healthcare regardless, especially as 67.1% of all patients in Cambodia choose private health services when the time comes.

However, just 0.1% of the population – a mere 16,720 people – actually have private medical insurance to cover them in this situation. If you want to join them, check out our list of recommended healthcare providers.

From there, you can request free quotes from whichever company suits your needs.

Quality of healthcare in Cambodia

Cambodia’s healthcare system ranks 151st in the world, according to a 2018 study published in The Lancet and funded by the Bill and Melinda Gates Foundation.

That puts it a massive 122 places below the US, which sits in 29th, and below other nations that are less well-off than Cambodia, such as Sudan, Tajikistan, and Yemen.

The country struggles with shortages of healthcare professionals and equipment, with just one physician for every 5,000 people, a nurse or midwife for every 1,429 people, and a hospital bed for every 1,111 people.

This is partly because medical personnel are generally underpaid – meaning many people avoid working in the sector, and around half of those who do end up simultaneously working for both public and private facilities, leading to burnout.

Cambodia would likely have a better public healthcare offering if the government spent more than 6.03% of its GDP on healthcare.

The US spends a frankly unnecessary 16.89%, but a more comparable figure is the 10.99% spent by the Central African Republic – the third-poorest nation on Earth – or the 7.74% spent by Burundi, the world’s poorest country.

Cambodia at least allocates more funding to its healthcare system than the three countries it borders – Vietnam, Laos, and Thailand – do to theirs, but it still has a worse system than Vietnam and Thailand.

The low quality of public healthcare in Cambodia leads 67.1% of patients to opt for private healthcare.

However, because only the richest 0.1% of the population have private insurance, people are left to pay any costs on their own.

That’s why a huge 57.5% of health expenditure is paid out of pocket.

That’s five times higher than out-of-pocket spending in the US – and considerably more than all three of Cambodia’s neighbors.

Do I need health insurance in Cambodia?

If you have a job in Cambodia, you’re legally compelled to sign up to the public healthcare system, and put 2.6% of your wage towards funding this government program.

If you don’t have a formal job in your new home, you won’t have to be a part of the public healthcare system – but if you make that choice, you also won’t benefit from its services.

In terms of staying healthy while you’re in Cambodia, we would strongly recommend acquiring private medical insurance, whether or not you have a job.

Dengue Fever, Malaria, and Zika are all relatively common across the country, so it makes sense to cover yourself for any situation.

Plus, the poor quality of public healthcare means you’ll likely end up opting for private health services anyway – and if you don’t have a policy, you’ll just pay higher, out-of-pocket fees.

Benefits of private medical cover in Cambodia

• You’ll enjoy shorter waiting times
• It covers more of your potential costs
• You’ll have more peace of mind
• You’ll receive the highest level of care possible
• Medical equipment is more up to date
• Having fewer unexpected expenses means you can budget your healthcare in advance
• Staff will be more likely to speak English
• The paperwork is also more likely to be in English

How much does health insurance cost in Cambodia?

For an individual

You should expect to pay around $1,136 per year for private cover in Cambodia, which comes to £95 per month.

It’s worth getting a few different quotes though, as prices can vary massively.

For a family

To cover a family of four in Cambodia, it’ll cost you around $3,526 per year.

That means you’ll pay about $2.40 per day, per person to secure peace of mind – and a better level of care, if you ever need it.

Advice for expats moving to Cambodia

• Gorge yourself on the cheap, delicious street food
• The exchange rate for Americans is amazing, so bring some savings to supplement your salary, and live a life of luxury
• The official Cambodian language, Khmer, is extremely hard to learn, but if you at least pick up a few words, it’ll make things easier
• The flipside of this eternally sunny nation is that it’s constantly hot and humid
• Visit Angkor Wat as soon as possible, but spend a few days investigating the entire site, which covers 150 square miles
• The expat community is very tight-knit – join their Facebook groups and you’ll make plenty of friends
• Losing face is a big deal here, so don’t get angry or humiliate anyone in public

What’s next?

If you want to protect yourself and your family with private health insurance in Cambodia, check out our list of recommended healthcare providers.

From there, you can request free quotes from whichever company suits your needs.