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The Cook Islands health system is primarily funded from general taxation. The annual health budget is determined by the Cook Islands Government. The appropriation for the 2020/21 fiscal year is $18.4 million and represents 8.1% of government spending. The health workforce absorbs a majority of that budget ($11.9 million). Te Marae Ora also receives assistance from development partners, the largest being New Zealand ($1.2 million) and World Health Organization (WHO) ($300k). 

Of the health budget, 51% is allocated to hospital health settings, 35% to community health settings with the remainder administered through the Planning and Funding Directorate.

Te Marae Ora uses this funding to plan, purchase and provide health services including hospitals, public health services, national services such as screening programmes, child and maternal health, and patient referrals. Most health services in the Cook Islands are free or subsidised.

Detailed information on the funding provided for health in Budget 2020/21 can be found on the Ministry of Finance and Economic Management website

Te Marae Ora Audited Annual accounts

Eligibility for subsidised health services

To be eligible for subsidised health services, you need to be:

  • A Cook Islander
  • A permanent resident or honorary resident of the Cook Islands
  • Married to a Cook Islander or permanent resident, and lived in the Cook Islands for more than six months
  • Work permit holder (including spouse and children) who has lived and paid taxes in the Cook Islands for over six months
  • Non-Cook Islands woman who is pregnant or has given birth to a child from a Cook Islands partner

All visitors to the Cook Islands including tourists, short-term consultants (less than six months) and anyone who is not included above, will be required to pay for some services.