How does the healthcare system work in Peru, and which travel insurance, health insurance or expat insurance do you need?

How does the health and healthcare system work in Peru?

• The quality of health care varies greatly between the public and private sectors and urban and rural areas.
• Because of living conditions (e.g. poor sanitation, infections) there is still a big difference in health between the relatively small group of richer Peruvians and the large group of poorer people.
  • That contrast is still strong, for example, between maternal health in rural (poor) versus more urban environments.
  • Many Peruvians also face meager access to quality dental care, leading to common problems such as tooth decay and gum disease.
• The Peruvian government and many NGOs are working together to improve infrastructure and make changes to the health system. Many organizations also work on the front lines of health care, providing medicine, education and support. Especially in poor or less accessible areas, where the need is greatest.
• In Peru, you often still find a mix of modern and more traditional medicine.
  • Western medicine and traditional medicine are not mutually exclusive in Peru, but complement each other. And are used in the same way.
  • Many indigenous people continue to perform medical practices used by their ancestors.
  • In many parts of the country, shamans (“curanderos”) help maintain balance between body and soul.
• Specific (emergency) treatments may require medical evacuation, from locations outside Lima to Lima or from Lima to another country.
• Emergency care is available 24/7 in the larger cities.
• As an expat, you have the same rights regarding health care as locals. Some treatments are free, but in many cases expats and expatriates turn to private care.
• In general, you'll find the best care in capital Lima and in more densely populated areas on the coast. These mostly private hospitals often also offer ambulance services, which you can use if you are already a client of the hospital, or by calling the hospital directly and paying for the service.

How does the public health care system work in Peru?

• In Peru, residents can choose between two types of public insurance.
  • The first layer of health care is the subsidized system SIS (Seguro Integral de Salud). It provides universal assistance to low-income people.
  • Then you also have EsSalud, which is paid for by employers. This is mandatory for every employee, both in the private and public sectors.
• Public health care is developing in Peru, but mostly still of a different standard:
  • Waiting times are often very long and care is not of high quality.
  • Medical facilities are often limited, especially outside Lima. The Peruvian government facilitates projects in which (graduate) doctors and health workers in their first year provide -obligatory- primary care outside major Peruvian cities.
  • Be careful with blood transfusions, these are often not safe.  

How does the private health care system work in Peru?

• In Lima and Cusco you will find good private health care, which is therefore often preferred among expats and emigrants.
• Sometimes you have to pay in advance in cash, keep that in mind. Or you may be asked for a credit card guarantee, even if you have (travel) insurance. As a foreigner, you may have to pay a fee at the entrance to the hospital or clinic to gain access.
• The chances that you can get into private care with doctors who speak English are still a lot higher than in public care.
• The cost of private treatment can be quite high.  

How is the general practitioner arranged in Peru?

• General practitioners are often called “doctors” or el “medico/la medica.
• You also encounter the term “medico familiale. They work in community teams in the public system and independently in the private system.
• A visit to the family doctor is approachable, not expensive.
• You find medicos both in the public and private health care system.  

How is the dentist arranged in Peru?

• Dental care is good, mostly inexpensive and accessible.
• Dental care is available at both public and private clinics. Private dental care is not always cheap.
• In rural and remote regions, dental services are more scarce.
• “Dental tourism,” a trip to Peru for specific high-quality dental care, is common. Lima offers many good facilities and clinics for this purpose.
• Improving oral health is one of the focal points in Peruvian health care, especially targeting children and low-income communities. Precisely because it also affects overall well-being. 

How is the pregnancy, obstetrics & maternity care arranged in Peru?

• Most births take place in the hospital. There is plenty of support and staff. 
• Home birth is also an option, but is less common. 
• A third option is a birth center. It is a center with a home-like feel and good midwives. 
• Cesarean section is also still relatively common. 
• There is good prenatal care. 
• For high-risk pregnancies, you can go to Lima, Arequipa and Trujillo. 
• Abortion is mostly illegal, with some exceptions. 

How safe or unsafe is a trip or stay in Peru?

What should you pay attention to in terms of safely in Peru?

• Peru is relatively safe compared to other countries in Latin America, but there are obviously areas of concern.
• In the cities, theft is a big problem and robberies also occur.
• Certain areas of Lima are no go areas: crime is high and the police are very active.
• There are also many unregistered cabs, which take advantage of tourists/expats.
• Protests are pretty common, and sometimes they last from days to weeks. Usually they are peaceful, but it may be wise to avoid these kinds of gatherings and monitor the situation through media.
• In Peru you have “The Shining Path,” a domestic insurgency group involved in drug smuggling. They have been less active in recent years and chances are slim, but it is better to avoid the areas where they are active.
• Be especially careful in the border area with Colombia and around the Amazon River. In the border area with Brazil, there are many illegal coca plantations and drug trafficking. There is also illegal gold mining.
• Floods and landslides are relatively common in Peru, partly under the influence of “El Niño. Through roads and train connections are then closed, for example to Machu Picchu, Cusco, Puno and Arequipa.
• Earthquakes can also occur in Peru; keep an eye on local and national media and know what to do if an earthquake hits your area.
• Always check the latest safety advice.

What should you pay attention to in terms of diseases in Peru?

• Altitude sickness is common in Peru. Watch for symptoms such as headache, nausea, lethargy (dullness, sleepiness) and dizziness.
• Several tropical diseases are common. So be sure to get the necessary vaccinations or medications in advance.
• The drinking water is not safe to drink.
• Never accept tea or any other herbal concoction from people you're not familiar with: a well-known “trick” to rob you.

What should you pay attention to in terms of traffic in Peru?

• One of the biggest safety risks is the risk of road accidents. Fatal accidents often occur because of driving.
• Be careful when walking on the streets. Not much consideration is given to pedestrians. 
• Bus accidents are also common, especially at night. So make sure you book your bus trip with a good transportation company. 

Which work and travel insurance policies are suitable for short and long stays in Peru?

• Is the trip to Peru and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for Peru if you are going to live there for a while?

• Insurance is not mandatory, but it is highly recommended. Public care is not of good quality and private care can be expensive. Read more about insurances for abroad on Expatinsurances.org.