Getting health insurance in France

Healthcare is one of the most important things to factor into any move abroad, especially if you’re retired, have children, or require proof of coverage for your visa. Luckily, if you’re living in France, you have access to a high-quality, comprehensive healthcare system. Read on to find out why most French residents have private health insurance on top of their public healthcare.

This article includes information on the following:

Cigna Global

Want access to the best private medical services in France? Speak to the healthcare professionals at Cigna Global today and find a policy that’s right for you. Take advantage of their global network of doctors, specialists, therapists and more with coverage tailor-made for you and your family. If you’re starting a new life in France, get peace of mind with Cigna Global.

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The French healthcare system and health insurance

France has a universal public healthcare system known as protection universelle maladie (PUMa). In 2016, PUMa replaced France’s previous healthcare system, couverture universelle maladie (CMU), simplifying coverage and extending service to more residents.

The new scheme makes it much easier for internationals to access state French health insurance (l’Assurance Maladie). However, most French residents also take out complementary healthcare insurance to cover additional costs, through private insurers.

Who needs health insurance in France?

Health insurance is mandatory in France. Even if you’re self-employed or from another country, if you live in France, you must be insured by either a public or private scheme. Newcomers from other nations may need to show proof of international health insurance, like Allianz Care, as part of the visa application process.

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Because state healthcare in France does not cover 100% of all costs, top-up insurance is very common. An estimated 95% of the French population has this complementary private insurance, usually through their employers, or by taking out a standalone policy with a company known as a mutuelle.

French public health insurance

Since 2016, PUMa guarantees health coverage to all legal residents who work or live in France for at least three months. Universal healthcare access is a right of all residents, regardless of age, medical history, and record of social security contributions (cotisations sociales).

Who does public health insurance cover?

Anyone with stable and regular residency in France for at least three consecutive months per year can register for health insurance. Your family or principal home must be in France, and you intend to live there for at least six months (183 days) a year. Children in France are automatically eligible for healthcare, regardless of nationality.

For visitors and short stays, EEA (European Economic Area) and Swiss citizens can typically use their European Health Insurance Card (EHIC). Non-EEA citizens should get insurance from a provider with an international scope, like Cigna Global.

Employees working in France are eligible for health insurance through their social security contributions (cotisations sociales). Freelance sole traders (micro-entrepreneurs) and limited company business owners (Société à Responsibilité Limitée) can access medical insurance in France through the independent social security system. State healthcare still covers unemployed residents, and low-earners are eligible for subsidies.

France considers foreign students short-term residents as far as health insurance is concerned. Therefore, students need to secure insurance from their home country (unless they have an EHIC) before they can enroll in a French university.

What does public health insurance cover?

France operates a co-payment system for public healthcare, with a percentage of all medical costs reimbursed through state health insurance. The percentage you receive depends on the type of treatment you had. For example, it’s usually 70% for doctors, dentists, midwives, and most specialists.

Reimbursement for staying in a French hospital is 80% of the costs. For prescriptions, it can be up to 100% for expensive medications. Vaccines are covered at 65%, with certain ones (like COVID-19) at 100%. Public insurance covers eye care and hearing aids at 60%. Mental healthcare and sessions with a psychologist are covered under a special treatment process that begins with visiting a general doctor for a recommendation.

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For more on how much healthcare costs in France, see this table from l’Assurance Maladie for the official 2023 coverage and reimbursement rates.

How to apply for public health insurance in France

The first step to getting health insurance in France is to join the social security system or visit your local CPAM (Caisse Primaire d’Assurance Maladie) in order to get your carte vitale (health card). You must present the carte vitale any time you receive medical treatment to be quickly and easily be reimbursed for your healthcare costs within one week.

Employers typically register their employees with social security and arrange healthcare formalities for them, but it’s worth double-checking. A special social security scheme applies only to self-employed people working in France.

After activating your health insurance, you may need to manually apply for the carte vitale. After you receive it, you must update your carte vitale each year by inserting it in the green box at a local CPAM office, hospital, or pharmacy.

For more information on how to apply as an unemployed or retired individual, or someone with modest income, see the appropriate section below.

Registering with a doctor

Residents covered by state medical insurance must register with a family doctor (médecin traitant) to get reimbursement for their medical costs. This comes with full freedom of choice, so your doctor can be located anywhere and in any kind of practice.

You can officially register with your doctor either by simply presenting your carte vitale in the physician’s office or by mail (in French). Once you’ve registered, you will receive a declaration de médecin traitant.

Failure to register with a doctor can lead to penalties, like higher medical fees and lower reimbursement rates. Patients age 16 or younger can visit any doctor without fear of financial penalty.

French private health insurance

Many French residents top up their coverage with a private health insurance policy known as a mutuelle. Some mutuelles cater to workers with specific professions and others to English speakers.

Employers often offer a place in a mutuelle as part of your benefits package. Students can choose coverage from their parents’ mutuelle or their own.

The advantages of getting private health insurance coverage

French public health insurance covers almost all types of medical treatment, but only at a certain percentage of the cost. Anytime you visit a doctor, dentist, or other professional, you’ll be reimbursed for a set amount and left with about 10-40% to pay from your own pocket. Private health insurance can help cover the remaining costs that public healthcare does not.

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Expats moving to France from outside the EEA for work or study may need to prove they have appropriate private coverage before they can enter the country. In this sense, private coverage can help you during the transition period before you get a carte vitale.

How does private health insurance work in France?

In France, private health insurance acts as a complement to your existing public coverage, paying all or part of what you are not reimbursed by the state.

French employers sign up their employees for complementary, or top-up, health insurance, so they don’t have to do anything to receive it. However, you may pay a monthly premium for the insurance, splitting this cost with your employer (who must pay at least 50% by law). Check with your HR department to see what happens to your private coverage if the contract ends, as this varies by company.

Private insurers reimburse the remaining amount of your general healthcare costs, including hospital treatment and emergency room visits. Reimbursements only refer to state-fixed tariffs, such as the standard charge for a consultation with a doctor. For prescriptions, private insurance may offer partial or total refunds.

Some specialists carry a surplus charge that the individual must pay if their mutuelle doesn’t cover it. Keep this in mind when you see policies that claim 100% coverage, as that can be misleading. The mutuelle does not cover surplus amounts, and therefore, this is payable by the individual.

Companies that sell health insurance

Some of the largest health insurance companies that operate in France as well as globally include:

• Allianz Care
• APRIL International
• Cigna Global

The Munich-headquartered financial services company offers international health insurance plans for expatriate students, professionals, couples and families. Depending on the policy, Allianz Care covers everyday medical expenses, emergency treatment, dental consultations, maternity, surgery, and outpatient fees.	APRIL International is a health and travel insurance provider operating in 180 countries. Their range of insurance products is tailored to the needs of expats, whether you’re relocating your family, studying for a semester abroad, enjoying a working holiday, or simply travelling. 130,000 expats already trust APRIL International.	The American health services company serves expats and globally mobile individuals in more than 200 international jurisdictions. Cigna Global’s policies are easily customized to coverage and cost requirements and customers can pick from three coverage levels, modular plans, and several cost-share options.
Get a quote	Get a quote	Get a quote

How much does French health insurance cost?

Anyone working in France has social contributions (cotisations sociales) automatically deducted from their salary or wages to cover health insurance. Visit Cleiss (Centre des liaisons Européennes et internationales de sécurité sociale) for the full list of health insurance contribution rates as of 1 January 2023. The French government amends the percentage of cotisations sociales deductions yearly.

Several factors influence health care costs, such as income level and household size. It averages out at 8% of your net income above a minimum threshold set by the state.

Private care costs depend on the type of coverage required and factors such as the applicant’s age; however, few mutuelles ask for your health details before approval. It’s always good to research and compare plans before moving to obtain the best insurance coverage.

Health insurance for seniors

As mentioned above, everyone living in France is entitled to free public healthcare after three months in the country. For pensioners, their healthcare costs are covered by the state automatically upon retirement and acceptance of a pension through the National Old-Age Insurance Fund (Caisse Nationale d’Assurance Vieillesse – CNAV).

However, there are a few reasons why older people might wish to take out private health insurance. For example, it can cover the portion of costs that the state doesn’t provide for. Retirees to France might also find it useful for taking care of expenses during their first three months there. Providers include:

• Allianz Care
• APRIL International
• Cigna Global – offers a dedicated plan for seniors

Health insurance for unemployed and low earners

In France, unemployed individuals have their healthcare costs covered by the state in the case of illness or maternity. Coverage is not automatic, however, so you must manually apply for it with an official form (in French).

Individuals working in France but making below a certain amount of money per year are still entitled to state healthcare. On top of that, you can likely receive additional complementary insurance to cover any co-payments. This special top-up insurance available to those with modest incomes is known as complémentaire santé solidaire (complimentary solidarity health).

To assess your eligibility for complementary healthcare, use this calculator from l’Assurance Maladie.

Healthcare vocabulary in French

Below are some French medical terms to help you set up your health insurance in France, find a doctor, or visit a hospital.

For more, this online voice pronunciation guide can help you on your journey to learning French.

Useful resources

• L’Assurance Maladie (AMELI) – the French government’s health insurance department
• Cleiss – France’s 2023 social security contribution rates
• Service-Public.fr – official French government site dedicated to public information about social healthcare