Key points
- Peru runs a mixed system fragmented into several subsystems, with little integration among them and disparities between affiliation schemes.
- Insurance coverage rose from 37% in 2004 to 83% by the end of April 2017, led by the Integral Health Insurance (SIS), created in 2001 to fund care for Peruvians who, due to poverty, did not have health insurance.
- In 2015, SIS covered 43% of the population, EsSalud — the social security subsystem for formal workers — covered 25%, other insurance about 5%, and 17% of Peruvians were uninsured.
- Households paid 27.0% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database).
- Life expectancy at birth was 78.4 years in 2023, and health spending was 5.6% of GDP in 2023 (WHO Global Health Estimates; World Bank, WHO Global Health Expenditure Database).
Direct answer: Peru runs a mixed system fragmented into several subsystems, with little integration among them. Insurance coverage rose from 37% in 2004 to 83% by the end of April 2017, led by the Integral Health Insurance (SIS), created in 2001 to fund care for Peruvians who, due to poverty, did not have health insurance. In 2015, SIS covered 43% of the population, EsSalud — the social security subsystem for formal workers — covered 25%, and 17% of Peruvians were uninsured. Households paid 27.0% of health spending out of pocket in 2023. Life expectancy at birth was 78.4 years in 2023 — and healthy life expectancy 67.1 years — and health spending was 5.6% of GDP in 2023 (WHO Global Health Estimates, October 2026; World Bank, WHO Global Health Expenditure Database).
At a glance
| Item | Detail |
|---|---|
| Model | Mixed — fragmented subsystems (SIS + EsSalud) |
| Who pays | General taxation (SIS subsidised regime) + payroll contributions (EsSalud) + household contributions (SIS semi-contributory regime) + out-of-pocket payments; government and compulsory schemes accounted for 63.6% of health spending in 2023 |
| Who delivers | Ministry of Health (MINSA) public facilities, EsSalud facilities, the Sanidad de la Policía Nacional and the Sanidad de las Fuerzas Armadas, and private providers |
| What is free at the point of use | Services covered by SIS for people affiliated to it — the subsidised regime is funded from general taxes for people who cannot afford insurance; people outside any scheme pay out of pocket |
| Life expectancy at birth | 78.4 years (2023, WHO Global Health Estimates) |
| Health spending | 5.6% of GDP (2023, World Bank, WHO Global Health Expenditure Database) |
| Source for the model and coverage | OECD Reviews of Health Systems: Peru 2017 |
Figures are a snapshot checked 7 November 2026, not a live feed. No country is ranked as best.
How the system works
The Peruvian health care system is fragmented into several subsystems, with little integration among them. Disparities between different affiliation schemes exist, leading to socio-economic and geographical inequalities. The Ministry of Health (MINSA) runs the public facilities, and the National Health Superintendence (Superintendencia Nacional de Salud, SUSALUD) regulates the system.
The largest subsystem is the Integral Health Insurance (Seguro Integral de Salud, SIS), created in 2001 to fund health services for Peruvians who, due to poverty, did not have health insurance. SIS has two regimes: a subsidised regime funded from general taxes, and a semi-contributory regime funded by household contributions plus taxes, whose financing sources were established in 2011. In 2013, SIS was expanded to cover vulnerable groups including all children aged 0–5, school-age children and pregnant women. The second subsystem is EsSalud, the social security subsystem for formal workers, which also runs pensions and welfare. Separately, the Police and the Army are covered by the Sanidad de la Policía Nacional and the Sanidad de las Fuerzas Armadas, each owning and operating its own facilities. Private insurance covers only a small proportion of the population.
Coverage has grown fast but remains incomplete. Insurance coverage increased from 37% in 2004 to 83% by the end of April 2017. In 2015, SIS covered 43% of the population, while EsSalud covered 25% and the remaining types of insurance represented 5% of coverage — and 17% of Peruvians were uninsured. Peru’s policy goal is to reach full universal health coverage by 2021.
Who pays, and what people pay
General taxation pays for the SIS subsidised regime, payroll contributions pay for EsSalud, and household contributions plus taxes pay for the SIS semi-contributory regime. Government and compulsory schemes accounted for 63.6% of health spending in 2023 (World Bank, WHO Global Health Expenditure Database). What patients pay is substantial: out-of-pocket spending was 35% of total health expenditure in 2013 (OECD Reviews of Health Systems: Peru 2017), against an OECD average of 19.4%, and households paid 27.0% of health spending out of pocket in 2023. Of household spending on health, 40.1% was for the purchase of drugs, 43.3% for the payment of private health services, and 11.6% for public services. In 2012, 5% of households incurred catastrophic health expenditure. SIS has introduced capitation-based payment in primary care to encourage population health management, after regions complained of payment delays of more than six months under the old system.
What is free, and what is not
Free at the point of use: services covered by SIS for people affiliated to it, funded from general taxes for people who cannot afford insurance. What is not free is the margin, and it is wide: people outside any scheme — 17% of the population in 2015 — pay for care directly, and even insured households pay heavily for medicines and private services, which together took 83.4% of household health spending.
How it compares
Peru spends 5.6% of GDP on health (2023), below the OECD average of 9.3% (2024), and its life expectancy of 78.4 years is 2.7 years below the OECD average of 81.1 years (2023). Peru is not in the OECD tables, so its figures come from WHO and World Bank sources for 2023 rather than the OECD’s 2024 dashboards. Its distinguishing feature is the fragmentation: several subsystems that barely integrate, with SIS as the safety net for the poor — and a coverage story that moved from 37% in 2004 to 83% in 2017, still short of the full universal coverage the government aimed for by 2021. Compare countries side by side in the Health System Comparison tool, or read the other profiles in the country index.
Frequently asked questions
Is healthcare free in Peru?
SIS pays for care for people affiliated to it — the subsidised regime is funded from general taxes for people who cannot afford insurance — but 17% of Peruvians were uninsured in 2015, and households paid 27.0% of health spending out of pocket in 2023.
What is SIS?
The Seguro Integral de Salud (Integral Health Insurance), created in 2001 to fund health services for Peruvians who, due to poverty, did not have health insurance; in 2015 it covered 43% of the population.
What is EsSalud?
The social security subsystem for formal workers, covering 25% of the population in 2015; it also runs pensions and welfare, and owns and operates its own facilities.