Antigua and Barbuda insurance for nomads

English is the official language, so navigating care is straightforward.

The main public facility is the Sir Lester Bird Mount St. John's Medical Centre in St. John's (still widely called Mount St. John's, renamed in 2021), a roughly 185-bed referral hospital with emergency, surgical, maternity and diagnostic services. It is the only public hospital on Antigua; Barbuda has just a small eight-bed facility, so anything beyond routine care means a trip to Antigua first. Most nomads use the private clinics for day-to-day needs, including the Adventist Health Care Centre and the Caribbean Medical Centre in St. John's, where waits are shorter and the experience more predictable.

Off-island evacuation

The emergency number is 911 (999 also works) and you ask for an ambulance. The island caveat is the one that matters: the UK Foreign Office states plainly that the main hospital handles many treatments but serious cases may need emergency evacuation off the island, and that treatment is costly. That evacuation, usually a medical flight to the US or a larger Caribbean hospital, is the bill that makes evacuation cover non-negotiable here. A practical point on payment: private clinics commonly expect prepayment and may not bill a travel insurer directly, so you pay and then claim. Pharmacies are available in St. John's and the main towns, but bring enough of any essential medicine with a doctor's letter, as specific brands may not be stocked.

For short stays, US, British, Canadian and Australian visitors enter visa-free, commonly for up to six months, with the exact length set by the immigration officer on arrival.

Your passport should be valid for at least six months, and you need an onward or return ticket plus proof you can support yourself. Travel insurance is not a legal entry requirement for tourists, though given the off-island evacuation reality it is strongly advised.

Nomad Digital Residence visa

To stay and work remotely, the Nomad Digital Residence (NDR) visa lets you live in Antigua and Barbuda while working for an employer or clients outside the country. It runs two years, expects a declared income of at least US$50,000 a year, and costs US$1,500 for a single applicant, US$2,000 for a couple and US$3,000 for a family of three, with an extra US$650 per additional dependent. Foreign income is not taxed locally. Insurance is a prerequisite for approval: applicants must show medical insurance covering the full period of stay, and the government is explicit that benefits from your home country do not apply to care received in Antigua and Barbuda. No fixed minimum sum is published, so the practical question is not the headline number but whether the policy includes medical evacuation. We lay out the details on the Antigua and Barbuda digital nomad visa page.

• Off-island evacuation. With one public hospital on Antigua and an eight-bed facility on Barbuda, serious cases are flown abroad, so a policy with medical evacuation is genuinely important, not a formality.
• Hurricane season. The Atlantic season runs June to November; storms can intensify fast and disrupt flights, power and medical services, so build in flexibility and follow local warnings.
• Mosquito-borne disease. Dengue, Zika and chikungunya are all present, with dengue the main traveller risk; use repellent, especially around dawn and dusk.
• Private clinics want prepayment. Many will not bill your insurer directly, so keep accessible funds and itemised receipts to claim back later.
• Tap water and post-storm flooding. Tap water quality varies, so many residents filter or buy bottled; after heavy rain or hurricanes, avoid wading in floodwater (leptospirosis risk rises).