Healthcare Basics

The French healthcare system

From insurance costs to going to the hospital, dentist, or emergency room, discover all you need to know about the French healthcare system.

French healthcare
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By Gary Buswell

Updated 27-5-2024

In France, state health insurance covers public and private hospitals, doctors, and other specialists who provide medical care to both citizens and internationals. In fact, it is considered one of the most comprehensive healthcare systems in the world because it covers everyone regardless of income level. Unemployed persons, retirees, and newcomers awaiting their residence permits are all guaranteed access to French healthcare.

Read on for more information, including:

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Overview of healthcare in France

The French healthcare system

Public healthcare in France is accessible to all citizens and residents. As of 2016, a new healthcare system known as Protection Universelle Maladie (PUMa) replaced the previous couverture universelle maladie (CMU). PUMa extended coverage to French citizens who have additional needs, and expanded access to state healthcare for foreigners after three months of residence.

An older woman registering at the reception of a hospital and nurse asking her to fill out a form
Photo: andresr/Getty Images

According to 2020 data, France is the second highest spender on healthcare within the EU, in terms of GDP percentage. It spent 12.2% of its GDP on healthcare that year, surpassed only by Germany with 12.8%.

The Ministry of Social Affairs and Health (Ministère de la Santé et de la Prévention) administrates public healthcare in France, with primary and secondary care services delivered by various providers. France offers a high level of preventative healthcare, with available services including addiction prevention, regular medical check-ups, and the promotion of regular physical activity and nutritious food choices.

Who can access healthcare in France?

By law, all residents of France must have some form of health insurance, whether state or private. If your household income falls below a certain threshold, you may be eligible for free health insurance coverage (complémentaire santé solidaire). If your application for legal residence has not been finalized, you may be eligible for State Medical Assistance (Aide Médicale d’Etat – AME).

Temporary visitors to France from the European Economic Area (EEA) and Switzerland can access public healthcare if they have a European Health Insurance Card (EHIC). Retirees relocating to France from the EEA and Switzerland can access healthcare services by completing a social security S1 form in their home country.

France classifies foreign students as short-term residents as far as health insurance goes, meaning they don’t qualify for public coverage. Therefore, international students without an EHIC should take out an international insurance policy, like with Cigna Global, if they wish to enroll in a French university.

French healthcare costs

The healthcare system in France is funded partially through social security contributions (sécurité sociale) usually deducted from your salary. In 2023, employees pay 7% of their salary toward health coverage while employers pay 13%.

Medical treatment and tests are partially paid for by the government, but the patient is responsible for the remaining amount. French state health insurance covers 70–100% of necessary treatments like doctor visits and hospital stays. Low-income and long-term sick patients typically receive 100% coverage.

Eurostat reports that only 12.7% of French residents reported having unmet healthcare needs due to financial reasons as of 2019. This figure is modest compared to over 25% of residents in Portugal and Finland.

French health insurance

Like many European countries, healthcare in France is an insurance-based system and it is mandatory for all residents. Through PUMa, internationals are eligible for state healthcare after living in the country for three months. Those earning below a certain threshold can apply for complementary coverage called complémentaire santé solidaire.

Closeup of a patient's hand as they give their carte vitale to the doctor

Those not eligible for state health insurance – or who want a higher level of coverage – need to take out a private top-up plan from a local or global health insurance company, like Allianz Care. Proof of coverage is required for almost all types of French visas before you can enter the country.

How to register for French healthcare

If you have lived in France for longer than three months, you can register for French healthcare via your local CPAM (Caisse Primaire d’Assurance Maladie) office. Find your local CPAM office via the Ameli website.

If you are employed, your employer will first register you with the French social security system. If you are self-employed, see the Cleiss website for special rules to follow to get healthcare coverage.

You may need to show certain documents in order to register, which can include:

You will also need to choose a primary care doctor and submit a declaration (declaration de médecin traitant) to your insurer before accessing healthcare in France.

Once you register, you should receive a carte vitale within about a week. This is a green health insurance card bearing your photo and embedded with a chip that contains important information about you as a patient. You will need to take your carte vitale with you to all medical appointments in order to access free healthcare or claim a reimbursement.

Private healthcare in France

Many private doctors and specialists in France receive funding through the state insurance scheme, allowing them to provide services through the public healthcare system. Likewise, those with public insurance can access most privately run hospitals. The price of privately run services, however, will be higher. This means that although your state health insurance covers the same percentage of costs, you must 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 unavailable through public healthcare. Foreign residents must also take out private health insurance during their first three months in France if the EHIC or other insurance does not cover them.

Private health insurers offering supplementary coverage in France include:

French doctors and specialists

The first line of healthcare in France is provided by family or general doctors (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 them as your primary physician (médecin traitant) in order to claim a full reimbursement via the French healthcare system.

Your médecin traitant refers you to other doctors and specialists, holds and maintains your medical records, and coordinates follow-up treatments. If your médecin traitant refers you, insurance will cover 70% of your healthcare costs, such as medical consultations or treatments. If you choose your own specialist then your medical fees may be higher and you will be reimbursed much less.

Keep in mind that you don’t need a referral to see a gynecologist, pediatrician, or ophthalmologist, you can consult them directly.

Women’s healthcare in France

Gynecologists in France are fully accessible through public health insurance, meaning you don’t need a doctor’s referral to visit one. You can find French gynecologists on the Ameli website or through a database of feminist doctors.

Routine preventative screenings for patients who have are available through gynecologists. This starts from the age of 25 for cervical cancer and 50 for breast cancer.

A nurse performs a mammogram, the patient is holding onto the imagery machine with head turned away from the camera
Photo: Helen King/Getty Images

Contraception is readily available in France and around 65% of costs are reimbursed. You need a prescription from a doctor to get birth control pills. Condoms are for sale in pharmacies and supermarkets, and 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.

In France, abortion 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).

Insurance covers most pregnancy costs, but you must declare your pregnancy to Camieg and Family Allowance Fund (Caisse d’Allocations Familiales – CAF) within the first 14 weeks.

Children’s healthcare in France

Children in France are automatically eligible for healthcare, regardless of nationality. This includes pediatric care and dentistry up to age 18.

Children have 20 compulsory screenings from birth up until age 16, with yearly follow-ups recommended after this. These screenings check for health issues such as:

  • Genetic diseases, like sickle cell anemia and cystic fibrosis
  • Hearing disorders
  • Visual disorders
  • Language and learning problems
  • Diabetes

France has a detailed vaccination schedule for children aged 0 to 13. For children born after 1 January 2018, vaccinations are mandatory for:

  • Diphtheria
  • Tetanus
  • Polio
  • Whooping cough
  • Hemophilus influenzae B
  • Hepatitis B
  • Meningococcus C
  • Pneumococcus
  • Measles, mumps, and rubella (MMR)

French healthcare for seniors

France boasts a life expectancy of 85.2 for women and 79.3 for men. A quarter of the population is over 60, so Santé publique France promotes healthy aging and monitors chronic diseases. 

The French healthcare system covers all residents, and retirees are among the groups prioritized for health checkups (bilan de santé) and vaccinations, such as COVID-19, flu, and shingles.

While public healthcare covers most costs, private insurance offers more comprehensive care and quicker access to specialists. International health insurance companies operating in France include:

The French government also provides resources to navigate senior care, including explanations of the personalized autonomy allowance (Allocation personalisée d’autonomie – APA). This financial support allows older people to continue living at home, and assists with the costs of:

  • Home help
  • Equipment (e.g., stairlifts)
  • Hygiene supplies
  • Meals
  • Transport expenses
  • Day centers
  • Family caregiver expenses

For those needing more extensive care, retirement homes for over-60s (établissements d’hébergement pour personnes âgées dépendantes – EHPAD) offer residential support (including for people with neurodegenerative diseases), medical care, events, and activities. 

For advice and support on growing older in France, you can read more about healthcare for seniors in France or visit your local information center for older people (point d’information local dédié aux personnes âgées).

French dentists

In France, you are free to go to any dentist you like and you don’t have to go to the same provider for all of your treatments. Most dentists work within the public French healthcare system, and costs are reimbursed in the same way as other medical treatments.

Dental charges for most adults are reimbursed at 70%, while children’s checkups are reimbursed 100%. However, the state system does not cover some procedures – for example, braces – so you will have to pay for this out of pocket unless you have top-up coverage.

Hospitals in France

There are two types of French hospitals: state-run hôpitaux and privately run cliniques. Both are often state-approved and work under the healthcare system in France, so your doctor can refer you to either one.

A man stands at the end of a long, empty hospital corridor in Aix-en-Provence, France
Aix-en-Provence, France (Photo: Calmettes/BSIP/Universal Images Group/Getty Images)

French healthcare reimburses around 80% of hospital charges. However, the board and lodging costs of a hospital stay are not reimbursed; this is where top-up insurance is useful, such as with AXA.

Health centers and clinics

Many health professionals – including doctors, dentists, and physicians – work in health centers (centres de sante) across France. There are a total of 1,600 centres de sante in various cities around the country. If you need to see a specialist, it’s possible they might be based at a centre de sante. You can search for the one nearest you on the National Federation of Health Centers (Federation Nationale des Centres de Sante) website.

There are also sexual health centers (centres de santé sexuelle) that provide services such as contraception, parenting advice, sexually transmitted disease testing, and abortions. You can find out more information and search for services in your area on the Planning Familial website.

French pharmacies

You won’t have any trouble finding a pharmacy (pharmacie) in France as there are more than 20,000 across the country. French doctors typically don’t hesitate to prescribe medications when appropriate, so this increases the need for widespread pharmacies.

A pharmacy in Nice, France

Once you take your prescription to a pharmacy, you will be expected to pay part of the cost of the medication, depending on the drug and your insurance. The amount reimbursed by public healthcare is either 15, 30, 65, or 100%.

In larger towns and shopping centers, pharmacies are usually open Monday to Saturday from 8:30–19:30; in smaller towns, they may close for lunch between 12:00 and 14:00. One pharmacy in each area will open on Sundays and after hours. To find this pharmacy, look in the window of other pharmacies, call 3237, or check online.

Mental healthcare in France

In France, state mental healthcare is provided through psychological medical centers (centre medico psychologique – CMP). 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 medical services. However, 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 France

The French healthcare industry recognizes alternative and complementary medicine.

The most popular types of alternative medicine in France are:

  • Homeopathy
  • Acupuncture
  • Herbal medicine
  • Water cures
  • Chiropractic

People use these for minor ailments, chronic conditions, and preventive care. Anyone who practices alternative or complementary therapy in France must register with the Professional Society of Physicians (Société Francaise de Médecine Générale – SFMG). Many standard doctors and physicians in France offer some form of alternative therapy as a treatment option.

Treatments like homeopathy, acupuncture, osteopathy, and chiropractic can be covered by public health insurance if they are performed by qualified professionals. Insurance does not cover other treatments, such as reflexology.

What to do in an emergency

If you need immediate medical assistance, go the nearest hospital’s emergency room (urgences). You can also call 112 (114 for hearing assisted), which is the free pan-European number for any type of emergency. The following French emergency numbers are also free from any phone:

A bright red emergency room sign in France on the side of a concrete building

Overcrowded emergency rooms are a serious issue across Europe, and they often have very long waiting times if your case is not life-threatening. For help with a non-emergency medical incident that occurs outside of clinic hours, you can call 116 117 to speak to a doctor available 24/7.

Useful French medical phrases

Some useful phrases and vocabulary to learn are:

  • J’ai besoin d’une ambulance – I need an ambulance
  • J’ai eu un accident – I’ve had an accident
  • le cabinet médical – doctor’s office
  • un rendez-vous – an appointment
  • la douleur – pain
  • un rhume – a cold
  • crise cardiaque – heart attack
  • mal à la tête – headache
  • mal à la gorge – sore throat
  • mal au ventre – stomach ache
  • la fièvre – fever
  • la toux – cough
  • une ordonnance – a prescription
  • le vaccin – vaccine
  • une radio (graphie) – an x-ray

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

Useful resources

  • Ministère de la Santé et de la Prévention – French government agency that oversees healthcare
  • Complementary Solidarity Health Fund (Complementaire Santé 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 or +33 811 70 36 46 from abroad.
  • Cleiss – provides information about healthcare in France and the social security system
  • National Federation of Health Centers (Fédération Nationale des Centres de Santé) – find a local health center near you
  • Le Planning Familial – information on family planning and centers offering related services
  • 3237.fr – find a 24-hour pharmacy