This helpful guide to the French healthcare system includes everything from finding a doctor or specialist to going to the hospital, dentist, or A&E.The French healthcare system covers both public and private hospitals, doctors and other medical specialists who provide healthcare to every resident in France. This is regardless of age, income, or status, which makes the French healthcare system highly accessible, even for foreigners. This helpful guide, provided by Aetna International, explains everything you need to know about accessing the French healthcare system, including:
- Overview of healthcare in France
- Healthcare costs in France
- Health insurance in France
- How to register for healthcare in France
- Private healthcare in France
- Going to the doctor in France
- Women’s healthcare in France
- Children’s healthcare in France
- Hospitals in France
- Going to the dentist in France
- Health centers and health clinics in France
- Pharmacies in France
- Mental healthcare in France
- Other forms of healthcare in France
- What to do in an emergency in France
- Useful French medical phrases
- Useful resources
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Overview of healthcare in France
The French healthcare systemFrance has a high quality healthcare system that offers universal coverage for all citizens, regardless of age or economic situation. It consists of an integrated network of public and private services including doctors, hospitals, and specialist providers. Residents are covered through mandatory health insurance contributions, with optional private insurance available for those who want additional coverage. Government-funded agencies cover more than 75% of health expenditures in France. The Ministry of Social Affairs and Health (Ministere des Solidarites et de la Sante) administrates public healthcare in France, with primary and secondary care services delivered by the various different healthcare providers. France offers a high level of preventative healthcare, with available services including addiction prevention, regular medical check-ups, and the promotion of physical activity and healthy eating. France is ranked 11th on the 2018 Euro Health Consumer Index and has been praised for its efficiency and outcomes. For example, the country has the lowest heart disease mortality in Europe, although it has been criticized for its over-reliance on prescription medication.
Who can access healthcare in France?Public healthcare in France is accessible by all residents through health insurance contributions. As of 2016, a new healthcare system for foreigners, known as Protection Universelle Maladie (PUMA), allows access to state healthcare after three months of residence. By law, all residents must have some for of health insurance, whether state or private. If your household income falls below a certain threshold, you may be eligible for free commentary health insurance coverage (CMU-C) or help in taking out supplementary private health insurance (Aide pour une Complémentaire Santé or ACS). If your application for legal residence has not been finalized, you may be eligible for State Medical Assistance (Aide Médicale d’Etat or AME). For more detailed information, visit the CMU website. Temporary visitors to France from the EU/EEA/Switzerland can access public healthcare if they have a European Health Insurance Card (EHIC). Retirees from the EU/EEA/Switzerland relocating to France can access healthcare services by completing a social security S1 form in their home country.
Healthcare costs in FranceThe healthcare system in France is funded partially by obligatory social security contributions (sécurité sociale); these are usually deducted from your salary. In 2016, employees paid around 8% of salary while employers paid around 13%. Healthcare in France is also partially funded by the government and the patient also pays a small contribution to their healthcare costs. State health insurance covers between 70-100% of costs for things such as doctor visits and hospital costs. Low income and long-term sick patients receive 100% coverage. Since the end of 2017, doctors and certain medical personnel are not allowed to charge upfront payments. Instead, they receive payment directly from the government or health insurer. According to recent figures, France is the highest spender on healthcare within the EU, in terms of GDP percentage. It currently spends around 11.5% of GDP. Only Switzerland (12.3%) spends more within the EU/EFTA nations. In terms of expenditure per capita, France ranks 11th out of EU/EFTA countries.
Health insurance in FranceAs in many European countries, healthcare in France is an insurance-based system. It is compulsory for French residents to register for health insurance. Foreign residents can access French health insurance through the PUMA system once they have been living in the country for three months. Those earning below a certain threshold can apply for complementary coverage called CMU-C (Complementary Solidarity Health as of 1st November 2019). Those not eligible for state health insurance, or who want a higher level of insurance coverage, need to take out private health insurance from a local or expat health insurance company. Read our Guide to health insurance in France for a more detailed account.
How to register for healthcare in FranceIf you have lived in France for longer than three months (and applying under PUMA), you can register for French healthcare via your local CPAM (Caisse Primaire Assurance Maladie) office. You can find your local CPAM office via the Ameli website (in French). If you are employed, your employer will first register you with French social security after which you can register for French healthcare. If you are self-employed, you need to contact the Regime Social des Indépendants (RSI) instead. You will need to show certain documents, which can include:
- your passport or valid ID;
- proof of residence;
- proof of address such as recent utility bill;
- marriage or birth certificates, if family are to be included;
- evidence of income, if applying for CMU-C.
Private healthcare in FranceIn France, many private doctors and specialists receive funding through the state insurance scheme. This mean that they will still provide their services through the public healthcare system. Likewise, those with public insurance can access most privately run hospitals. The costs of privately run services, however, will be higher. This means that, although your state health insurance will cover the same percentage of costs, you will have to pay more for the part that isn’t covered. Because of this, some French residents and expats take out supplementary private health insurance to cover the remaining amount. Private insurance can also cover specialist treatment or complementary therapies not available through public healthcare. Foreign residents will also need to take out private health insurance during their first three months in France, if they are not covered by the EHIC or some other form of insurance. Private health insurers offering supplementary coverage in France include:
Going to the doctor in FranceThe first line of healthcare in France is provided by family doctors or GPs (médecins généralistes). These doctors are mostly self-employed and work either alone or in group practices. You are free to choose whichever French doctor you prefer, but you must register with them as your ‘attending doctor’ or primary doctor (médecin traitant) in order to claim a full reimbursement via the French healthcare system. The médecin traitant can refer you onto other doctors and specialists, holds and maintains your medical records, and co-ordinates follow-up treatments. If you are referred by your médecin traitant around 70% of French healthcare costs, such as medical consultations or treatments, will be reimbursed. If you choose your own specialist then your medical fees may be higher and you will be reimbursed much less by the healthcare system in France. However, you don’t need a referral to see a gynecologist, pediatrician, or ophthalmologist but can consult them directly. If you are under 26 you can also see a psychiatrist without a referral from your médecin traitant.
Read more in our Guide on how to find a doctor in France.
Women’s healthcare in FranceGynecologists in France are accessible through public health insurance. You can choose your own gynecologist and you don’t need a referral from a doctor. French gynecologists can be found through the Ameli website. There is also a database where you can find recommended gynecologists and add recommendations for others. You should make an appointment with your gynecologist or doctor in France if you suspect you are pregnant. The majority of pregnancy costs are covered by insurance, but you need to declare the pregnancy to the Health Insurance Fund (Casse d’Assurance Maladie or CAM) and Family Allowance Fund (Caisse d’Allocations Familiales or CAF) within the first 14 weeks in order to receive health benefits. Contraception is readily available in France and around 65% of costs are reimbursed. You will need a prescription from a doctor, gynecologist, or midwife to get birth control pill, however, you can buy condoms in pharmacies and supermarkets. They are also available for free at many family planning centers and sexual health clinics. Emergency contraception is available without prescription, however most health insurance policies do not cover these costs. There is a breast cancer screening program for women aged 50 to 74. Routine examinations for breast cancer and cervical cancer are also available through gynecologists. They are recommended every 2 to 3 years from the age of 25 (cervical cancer) and 30 (breast cancer). Abortion laws in France have liberalized in recent years. Termination is legal within the first 14 weeks of pregnancy; doctors, hospitals, or private clinics can carry this out. Doctors have the right to refuse to carry out a termination, but they must refer the patient to a family planning center (centre de planification et d’education familial). For more detailed information, read our Guide to having a baby in France.
Children’s healthcare in FranceChildren in France can access free healthcare through the public health insurance of their parent/guardian. This includes free dental check-ups until the age of 18. In France, doctors and pediatricians administer child healthcare. Children have 20 free compulsory screenings from birth up until the age of 6, with yearly follow-up screenings recommended after this. These screenings check for health issues such as:
- genetic diseases such as sickle cell disease and cystic fibrosis;
- hearing disorders;
- visual disorders;
- language and learning problems;
- within 8 days of birth;
- after 9 months;
- after 24 months
- whooping cough;
- Hemophilus influenzae B;
- hepatitis B;
- meningococcus C;
- measles, mumps and rubella (MMR)
Hospitals in FranceThere are two types of French hospitals: state-run hôpitaux and privately run cliniques, although cliniques are often state approved and work under the healthcare system in France. Your doctor can refer you to either a state hospital or private clinic. French healthcare reimburses around 80% of hospital charges, however the ‘board and lodging’ costs of a hospital stay are not; this is where top-up insurance is useful. Read more in our Guide to major hospitals in France.
Going to the dentist in FranceYou are free to go to any dentist you like and you don’t have to go to the same person for all of your treatment. Most dentists work within the public French healthcare system, and costs are reimbursed in the same way as other medical treatment. Dental charges for most adults are reimbursed at 70%, while children’s check ups are reimbursed 100%. However, the state system does not cover some procedures – for example, orthodontics – and you will have to pay for this. Read our Guide to dental care in France for more information.
Health centers and health clinics in FranceMany French health professionals including doctors, dentists, and physicians work in health centers (centres de sante) across France. There are around 1,600 of these centers across the country in total, mostly in urban areas. If you see a specialist, it is possible they might be based at a centre de sante. You can search for a centre de sante close to you on the National Federation of Health Centers (Federation Nationale des Centres de Sante) website. There are also Family Planning Centers (centres de planification et d’education familial) which provide services such as birth control, parenting sessions, sexual health advice, and abortions. You can find out more information and search for services in your area on the Planning Familial website.
Pharmacies in FranceYou won’t have problems finding a pharmacy ((pharmacie) in France as there are more than 20,000 pharmacies in the country; double the number found in the UK. It is perhaps not surprising considering the tendency of French doctors to prescribe many medicines. Once you take your prescription to a pharmacy (a shop displaying a large green cross outside) you will need to pay a proportion of the cost of the medication, depending on the drug and your insurance cover. The amount reimbursed varies according to the type of medicine and can be 15, 30, 65 and 100%. In larger towns and in shopping centres, pharmacies are usually open from Monday to Saturday from 8.30am – 7.30pm; in smaller towns they may close for lunch between 12pm and 2pm. One pharmacy in each area will open on Sundays and during out-of-hours. To find this duty pharmacy, look in the window of other pharmacies, in the local newspaper, call 3237, or look online.
Mental healthcare in FranceThe healthcare system in France offers mental healthcare services that patients can access for free or benefit from large subsidies. However, there has been concern that services are not at an adequate level to cope with demand. According to recent studies, around 1 in 5 French people suffer from mental health problems. In January 2019, one hundred French psychiatrists sent a letter to the French health minister expressing concern over the level of mental healthcare provision. This is likely due to insufficient funding. Much mental healthcare in France is provided through Medical Psychological Centers (centre medico psychologique – CMP). These provide mostly free services covered by state health insurance. Some specialist services involve partial payment. Practitioners such as psychiatrists, psychologists, nurses, social workers, occupational therapists, and speech therapists run these centers. You will need a referral from your doctor for most treatment in the CMP. If you see a psychiatrist or psychologist outside of the CMP, you will be reimbursed at the same rate as for GP services if it’s a state-provided service. You will not get a reimbursement for the cost of private treatment unless you have private health insurance. You can find English-speaking therapists on the Counselling In France website. Many of these will provide only private services.
Other forms of healthcare in FranceThe French healthcare industry recognizes alternative and complementary medicine. According to one study, around 58% of French patients used some form of alternative treatment in 2017. The most popular types of alternative medicine in France are:
- herbal medicine;
- water cures;
What to do in an emergency in FranceIn a medical emergency go the A&E or ER (les urgences) of the nearest hospital. You can also call 112 (114 for hearing assisted), which is the free pan-European emergency number for any type of emergency, or one of the following numbers which are also free from any phone:
- 15 – SAMU (Service d’Aide Médicale d’Urgence) for serious medical emergencies with ambulances and specialist medical teams
- 18 – sapeurs pompiers are the fire brigade but they also respond to car accidents and emergency medical situations
- 17 – police (commissariat de police or gendarmerie)
- 112 – sea and lake emergencies (calling from land)
- 116 117 – out-of-hours doctor
Useful French medical phrasesSome useful phrases to learn, in case of an emergency, are:
- Besoin une ambulance: I need an ambulance
- J’ai eu un accident: I’ve had an accident
- Ma localité est…: My location is…
- Crise cardiaque: Heart attack
- Très malade: Very ill
- Je suis en train d’accoucher: I’m in labour
- Où est-ce qu’on peut trouver un cabinet médical? Where can I find a doctor’s surgery?
- Au secours : Help!
- French Ministry of Social Affairs and Health ((Ministere des Solidarites et de la Sante);
- Complementary Solidarity Health Fund (complementaire sante solidaire) – information about accessing healthcare for those on a low income;
- Ameli – website with healthcare information and advice. There is also an English-speaking advice line for information about French healthcare insurance: call 3646 from within France; +33 811 70 36 46 from abroad;
- Cleiss (Centre des Liasons Européennes et Internationales de Sécurité Sociale) provides information about healthcare in France and the social security system;
- National Federation of Health Centers (Federation Nationale des Centres de Sante) – find a local health center near you;
- Le Planning Familial – information on family planning and French Family Planning Centers;
- 3237.fr – find a 24-hour pharmacy