Madagascar (MG)
World's fourth-largest island, Madagascar offers extraordinary biodiversity (90% of wildlife found nowhere else), one of the world's lowest costs of living, warm French-speaking culture, and unique opportunities in vanilla, ecotourism, and development sectors.
Insurance Guide
Which insurances you actually need in Madagascar, prioritised.
Madagascar has an extremely limited local insurance market and almost no consumer-facing insurance culture. For expats, international policies are essential — particularly international health insurance and medical evacuation (medevac) coverage, which is non-negotiable given the absence of advanced medical care in-country. The only truly mandatory local insurance is vehicle third-party liability (Responsabilité Civile — RC). Everything else must be sourced internationally. Local insurers (ARO, NY HAVANA, MAMA, SAHAM Assurance) offer basic products primarily designed for Malagasy nationals and businesses.
Legally Mandatory
- - Responsabilité Civile Automobile (RC Auto) — third-party vehicle liability insurance, mandatory for all registered vehicles
- - Employer liability insurance — mandatory for companies with employees (via labour law)
International Health Insurance
Covers private clinic consultations, hospitalisation, diagnostic tests, prescription medication, dental (with add-on), and repatriation in Madagascar and worldwide.
Who needs it: Every expat in Madagascar — public healthcare is not a viable option for expats.
Annual cost: USD 800–3,000/year (individual, depending on age and coverage tier)
Ensure your policy includes direct billing with Antananarivo private clinics (Clinique IARIVO, Clinique des Soeurs). Many NGO and diplomatic employers provide group health insurance — confirm coverage upon joining. Always read the policy exclusions carefully — plague, malaria, and pre-existing conditions are common exclusions on basic plans.
Medical Evacuation (Medevac) Insurance
Covers air ambulance and emergency medical transportation from Madagascar to Réunion, Mauritius, or South Africa for conditions that cannot be treated locally. Can also include repatriation of remains.
Who needs it: Every expat in Madagascar — this is the most critical insurance after health.
Annual cost: USD 300–600/year (individual); USD 600–1,200 (family)
A single medevac flight from Antananarivo to Réunion can cost USD 30,000–80,000, and to South Africa USD 60,000–150,000. Without insurance this is a financial catastrophe. International SOS has a fixed office in Antananarivo (+261 20 22 334 34) and a 24-hour alarm centre. Register with ISOS before arrival. Many international employers include medevac in employment packages.
Vehicle Third-Party Liability (RC Auto)
Mandatory third-party liability coverage for all registered vehicles. Covers injury or property damage to third parties caused by your vehicle.
Who needs it: Any driver or vehicle owner in Madagascar.
Annual cost: Ar 80,000–250,000/year (depending on vehicle type and insurer)
RC Auto is mandatory under Malagasy law. It must be displayed on the vehicle windscreen. Available at all local insurance offices and some petrol stations. For comprehensive cover (tous risques), prices are much higher and approval requires vehicle inspection.
Comprehensive Vehicle Insurance (Tous Risques)
Covers theft, collision, fire, and natural disaster damage to your own vehicle in addition to third-party liability.
Who needs it: Recommended for anyone with a vehicle worth more than USD 5,000, particularly 4WD vehicles.
Annual cost: Approximately 3–6% of vehicle value per year
Theft of vehicles and car parts is a real risk in Antananarivo. If driving an expensive 4WD (often the only practical vehicle for regional travel), comprehensive insurance is strongly recommended. Claims process in Madagascar can be slow and requires persistence. Photograph your vehicle thoroughly before insuring.
Personal Contents / Home Insurance
Covers theft, fire, and damage to personal belongings and furniture inside your rented or owned property.
Who needs it: Expats with valuable electronics, furniture, or jewellery.
Annual cost: Ar 100,000–400,000/year
Burglary is a real risk in Tana — most expat properties have guards (gardiens) and security gates, but insurance provides an additional safety net. Many landlords have basic building insurance; expats need separate contents cover. International policies (e.g., BUPA Global, AXA) may include worldwide personal effects cover.
Travel Insurance (Short-term)
Covers trip cancellation, lost luggage, emergency medical, and travel delays for trips outside Madagascar.
Who needs it: All expats for each trip home or to other countries.
Annual cost: USD 50–200 per trip, or USD 200–500 for annual multi-trip policy
Annual multi-trip travel insurance is cost-effective if you travel frequently. Confirm it covers pre-existing conditions. If your international health policy includes worldwide coverage, a basic travel policy covering cancellation and luggage may suffice.
Life Insurance
Lump-sum or income payment to dependants upon death.
Who needs it: Expats with dependants relying on their income, or those with significant debts.
Annual cost: USD 200–800/year (depending on coverage and age)
Local Malagasy life insurance policies have very limited payout amounts by international standards. An international life insurance policy from a global insurer is recommended for expats with dependants.
Comparison sites
Medical evacuation insurance is the single most important insurance in Madagascar — a serious accident or illness without it requires self-funding a USD 10,000–50,000+ air ambulance to Réunion, South Africa or home.
Do not rely on any local insurer for health coverage — even large Malagasy employers use international plans for their expat employees.
For motor insurance, local providers (ARO, NY HAVANA) offer basic RC cover — insist on the written attestation d'assurance certificate for police checkpoints.
Cyclone season runs November–April. If renting, confirm whether your landlord's property insurance covers your personal belongings — typically it does not.
Insurance
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