Guide to getting health insurance in France in 2026

Your health 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 live 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:

Health insurance in the French healthcare system

France has a universal public healthcare system. Protection Universelle Maladie (PUMa) is the legal framework that guarantees personal health coverage to people who work in France or meet the stable and regular residence conditions. The public health insurance system is administered through l’Assurance Maladie, often referred to colloquially as la Sécu.

In 2016, PUMa replaced France’s previous healthcare system, Couverture Universelle Maladie (CMU), simplifying coverage and extending service to more residents. It is managed on the grounds by the CPAM, which has a comprehensive website and local offices everywhere to handle contact with French residents.

Do I need private health insurance in France?

It’s essential to be aware that French public health insurance generally reimburses only part of eligible healthcare costs. Most residents therefore have complementary health coverage (mutuelle) to reduce the amount left to pay. The exact reimbursement depends on the contract, and even a responsible complementary plan does not necessarily cover every patient charge.

• Private-sector employers must provide employees with collective complementary health cover and fund at least 50% of the premium, although exemptions from joining exist in some situations. Public-sector arrangements follow separate rules.
• People on modest incomes may qualify for the Complémentaire santé solidaire (C2S), subject to residence and income conditions.
• Others can buy an individual mutuelle from a complementary health insurer, such as Feather.

Can foreigners get French health insurance?

Foreign residents can access French state health insurance through PUMa when they work in France or meet the stable and regular residence conditions. If you work in France, affiliation can begin immediately once your application is accepted. If you are not working, you generally need three months of stable residence before your rights open, although exceptions apply. Non-EEA and non-Swiss nationals must also prove that their stay is regular. Some international residents remain insured by another country under European or bilateral social security rules instead.

The official authority that informs foreigners and manages bilateral social security benefits, including health insurance for internationals, is Cleiss (Centre des liaisons Européennes et internationales de sécurité sociale).

Who needs health insurance in France?

Health insurance is mandatory in France. Even if you’re an expat or immigrant, if you live in France, you must have medical insurance from either a public or private scheme – or both.

If you are a newcomer from another country, you may need to show proof of health insurance during the visa application process. In our article about the French healthcare system, we explain how to ensure that you are covered when you move:

• if you are temporarily staying in France and remain insured in an EU/EEA country or Switzerland, a valid European Health Insurance Card (EHIC) can cover medically necessary state healthcare under the applicable rules
• if you are eligible for a UK GHIC, it can cover medically necessary state healthcare during eligible stays, but it is not a substitute for travel insurance
• if another country remains responsible for your healthcare, you may be able to register an S1 certificate in France; this is commonly relevant to eligible pensioners, posted workers, cross-border workers, civil servants, and their dependants
• if you are not covered by a public or home-country scheme, or your visa category requires private cover, through an international health insurance company such as Feather, Allianz Care, APRIL International, or Cigna Global

You can get more information on your individual requirements by contacting Cleiss. If you remain insured by another eligible country, an S1 form is a certificate of entitlement to healthcare outside the country where you are insured. It is issued by the competent health insurance authority and must be registered with the health insurance authority in France.

Summary of who can access public health insurance

Before we dive into the details below, here’s a quick overview of who needs what type of health insurance:

What is your status?	Can you access French public health insurance?	Do you need complementary or private health insurance?
Employee working in France	Usually yes. If you work in France and meet the applicable regular-stay requirements, PUMa affiliation can begin immediately once your application is accepted; there is no three-month residence wait.	Private-sector employees are generally covered by a compulsory employer complementary plan, subject to limited exemptions. Other workers should check their own arrangements.
Posted worker or employee insured abroad	It depends on which country’s social security legislation applies. An A1 and/or S1 may be relevant. Ask your employer and check with Cleiss.	It depends on the cover maintained by the competent country and any complementary policy.
Job seeker or other inactive resident	It depends. If another country remains responsible for your healthcare, an EHIC or S1 may apply. Otherwise, a person who is lawfully and stably resident in France can generally qualify for PUMa on the residence basis after three months. Nationality alone does not decide eligibility.	You may need private cover during a waiting period or if your immigration status requires it. Once in PUMa, a mutuelle can reduce out-of-pocket costs.
Student	EU/EEA/Swiss students with a valid EHIC generally remain covered by their home system. Depending on their situation, students without an EHIC may use an S1 or register in France. Other foreign students generally register through the foreign student service of Ameli.fr. UK students should check their GHIC eligibility and individual registration position.	Optional complementary cover may reduce costs not paid by the responsible public scheme.
Retiree	If another country remains responsible for your healthcare, it may issue an S1 to register in France. If no S1 applies, a lawfully resident retiree may instead qualify through PUMa after meeting the residence conditions. Bilateral agreements can change the position.	A mutuelle or international policy can reduce remaining costs, depending on the cover already in place.

2026 reforms and recent policy changes

Several healthcare rules changed in late 2025 and 2026. The points below reflect the position as of 17 August 2026.

1. New PUMa financial participation: amount still pending

The 2026 Social Security Financing Act created a new financial participation for certain PUMa beneficiaries. It is not a blanket fee for all non-EU visitor-visa holders. According to Service Public’s current PUMa guidance, it applies to people who meet all three conditions: stable and regular residence in France, no professional activity, and exemption from CSG, CRDS, and the health-insurance contribution under an international convention.

As of 17 August 2026, the decree setting key details, including the amount, is still awaited. Therefore, there is no official €300–€600 flat fee that can be stated as the current amount, and the law should not be presented as making payment of a fixed sum a universal prerequisite for receiving a Carte Vitale.

2. Complementary health premiums and the 2026 insurer contribution

The 2026 Social Security Financing Act introduced a 2.05% contribution on complementary health insurers. The same provision states that, for 2026, the amount of complementary health insurance contributions cannot be increased compared with the amount applicable in 2025. Earlier industry forecasts of average premium rises should therefore not be presented as the governing 2026 rule.

3. Medical tariffs, hospital charges, and wheelchairs

• GP consultations: From 1 January 2026, the standard sector 1 GP consultation tariff is €30. Specialist tariffs vary by specialty, sector, and care pathway, so there is no single 2026 specialist fee.
• Hospital daily charge: Since 1 March 2026, the forfait hospitalier is €23 per day in a hospital or clinic and €17 per day in a psychiatric department. Assurance Maladie does not reimburse this charge, although a complementary policy may cover it.
• Wheelchairs: Since 1 December 2025, eligible wheelchairs are fully covered by Assurance Maladie, including manual, electric, and sports wheelchairs. A prescription is required and the reimbursement pathway depends on the equipment.

4. The digital Carte Vitale is available nationwide

Since 18 November 2025, the carte Vitale app has been available to insured people throughout France. It complements rather than replaces the physical card. Activation options depend on your identity document, and acceptance still depends on the healthcare professional having compatible equipment.

5. Current fixed patient charges

Two separate annual caps are important. The €2 participation forfaitaire applies to doctor consultations and certain medical acts, radiology, and laboratory tests, with a €50 annual cap per person. Separately, the medical franchise is €1 per box of reimbursed medicine, €1 per paramedical act, and €4 per medical transport, with its own €50 annual cap. Exemptions apply in certain situations.

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Summary table of 2026 changes

Feature	2026 position	What to know
New PUMa financial participation	Created by the 2026 law for a defined group of inactive beneficiaries	Amount still awaiting a decree as of 17 August 2026
Complementary health premiums	2026 law states premiums cannot be increased compared with 2025	Insurers also face a 2.05% contribution in 2026
GP consultation tariff	€30 for a standard sector 1 GP consultation	Specialist tariffs vary
Hospital daily charge	€23/day in hospital or clinic; €17/day in psychiatric care from 1 March 2026	Not reimbursed by Assurance Maladie; a mutuelle may cover it
Wheelchair coverage	Full coverage since 1 December 2025 for eligible prescribed equipment	Includes manual, electric, and sports wheelchairs
Digital Carte Vitale	Available nationwide since 18 November 2025	Physical card remains valid
Fixed patient charges	€2 participation forfaitaire; medical franchises of €1/€1/€4 depending on item	The participation forfaitaire and medical franchise each have a separate €50 annual cap

French public health insurance

Since 2016, PUMa has provided continuous health coverage to people who work in France or who reside there on a stable and regular basis. People qualifying through work can be affiliated immediately once their application is accepted; inactive residents generally need three months of stable residence before their rights open. PUMa rights are personal for adults and are designed to continue through changes in work or family circumstances.

Who can register for French public health insurance?

If you are not working, PUMa generally requires you to have lived in France on a stable and regular basis for at least three months before your rights open. To keep residence-based rights, you generally need to live in France for at least six months of the year. If you are from outside the EEA and Switzerland, you must also provide a valid residence title or other document proving that your stay is regular.

The three-month residence period does not apply in the same way when you qualify through professional activity: if you work in France and your PUMa application is accepted, affiliation can begin immediately. Certain other groups, including refugees, can also satisfy the residence-stability condition without waiting three months.

Under PUMa, adults have health-insurance rights in their own name rather than as dependants of another insured adult. Minor children can be attached to an insured parent or guardian; from age 16, they can request personal handling of their health-insurance rights, and from 18 they are insured personally.

French public health insurance for employees

Employees working in France (both nationals and non-nationals) are eligible for state health insurance through their social security contributions (cotisations sociales). These payments come out of their salary automatically. You have the right to public medical insurance as soon as you start working – workers do not have to wait three months.

Private-sector employers must provide a collective complementary health plan (mutuelle) to employees and fund at least 50% of the premium, although employees can be exempt from joining in certain situations. Public-sector complementary health arrangements follow different rules.

If you are on a work mission from a foreign company, then your situation may be more complicated. It all depends on how the company is registered in France. So the best course of action is to ask your employer directly, or contact Cleiss.

Medical insurance for freelancers and entrepreneurs in France

Self-employed people, including micro-entrepreneurs and certain company directors, are covered through French social security according to their legal and professional status. Their social contributions help fund health coverage; the Cleiss overview for self-employed workers explains the main rules.

Do you have rights to French state health insurance if you are unemployed?

If you lose your job while already covered by PUMa and continue to meet the applicable conditions, your health rights are designed to continue without interruption. If you are newly arriving in France without a job, you may need to apply on the basis of stable and regular residence using the S1106 form and supporting documents.

If you are moving to France as a job seeker, your entitlement depends on which social security system is responsible for you and whether you meet the French residence and immigration conditions:

• If another EU/EEA country or Switzerland remains responsible for your healthcare, an EHIC may cover a temporary stay and an S1 may apply if your competent health authority issues one.
• If no other country remains responsible, a lawfully resident person can generally qualify for PUMa on the residence basis after three months of stable residence. Being from outside the EU/EEA does not by itself make an unemployed resident ineligible, but non-EEA and non-Swiss nationals must prove regular residence.

Unemployed residents and other people on modest incomes may qualify for the Complémentaire santé solidaire (C2S), depending on their residence status and household resources.

Pensioners and their health benefits in France

People who are already insured in France generally continue to have healthcare coverage in retirement. The pension and health-insurance bodies involved depend on your career and pension arrangements.

As for foreigners who wish to retire to France and live their golden years on the Riviera, access to French public health insurance is not as straightforward:

• If another EU/EEA country, Switzerland, or the UK remains responsible for your healthcare as a pensioner, its competent health authority may issue an S1 certificate for you to register in France.
• If no S1 or bilateral arrangement applies, a lawfully resident retiree may instead qualify through PUMa after meeting the residence conditions. Contact Cleiss for country-specific rules.

Many seniors choose complementary or international health insurance to reduce out-of-pocket costs, particularly for hospital, optical, dental, or hearing care. Compare age limits, reimbursement levels, exclusions, and premiums carefully. International providers operating in France include Cigna Global.

French health insurance for students

In France, minors can be attached to an insured parent or guardian. From age 16, a young person can request that their health-insurance rights be handled personally; from 18, they are insured in their own name.

International students enrolled in a French higher education institution must make sure they have valid health cover, but the route depends on nationality and existing social security rights.

• Minor children of foreign residents with rights to French healthcare may also benefit from their parents’ affiliation to La Sécu.
• Students from the EU/EEA or Switzerland with an EHIC valid through the academic year generally remain affiliated to their home-country health system and do not register on the foreign-student website.
• EU/EEA or Swiss students without an EHIC should check whether their competent institution can issue an S1. If they have neither an EHIC nor an S1, they may need to register in France through the foreign-student service.
• Other foreign students generally register via the special foreign student service of the French health insurance system. UK students should check whether they qualify for a UK Student GHIC and whether French registration is required for their situation.

Students can also choose complementary health insurance to reduce eligible costs left after the responsible public scheme has reimbursed its share.

Coverage for tourists and short-stay visitors in France

For visitors and short stays, eligible EEA and Swiss visitors can typically use an EHIC for medically necessary state healthcare. Eligible UK visitors can use a GHIC, although the NHS recommends separate travel and medical insurance as well. Other travellers should check the France-Visas assistant to see whether medical insurance is a visa requirement for their trip. International providers include Cigna Global and Feather.

Asylum seekers and refugees

Asylum seekers can access PUMa after three months of residence in France; during those first three months, urgent-care arrangements can apply. They cannot use the AME scheme simply because they are asylum seekers. Recognition as a refugee is not a blanket prerequisite for the Complémentaire santé solidaire (C2S): eligibility depends on the applicable residence and resource conditions. Our healthcare article gives more information on access to care.

What does French public health insurance cover?

France uses reimbursement rates and official reimbursement bases rather than paying every healthcare bill in full. The amount reimbursed depends on the type of care, the provider’s sector, and whether you follow the coordinated care pathway. For example, from 1 January 2026 a standard sector 1 GP consultation costs €30 and is reimbursed at 70% of the reimbursement base before the €2 fixed participation is deducted.

A stay in a French hospital is generally reimbursed at 80% of the statutory hospital costs, although exceptions and additional patient charges apply. Reimbursement rates for medicines, vaccines, optical care, and hearing aids vary by item and scheme. For mild to moderate mental-health needs, Mon soutien psy allows direct access to a participating psychologist; a prior referral from a GP is no longer required.

For current rates, see l’Assurance Maladie’s reimbursement summary.

How to apply for public health insurance in France as an expat

What to do before your move

Before moving, check which system will be responsible for your healthcare. Cleiss can explain European and bilateral social security rules, while France-Visas sets out any insurance evidence required for your visa category.

If you remain insured by another eligible country, ask the competent health authority whether it can issue an S1 form. The S1 is not available to every mover: it is used when one country remains responsible for your healthcare while you live in another. Register the certificate with the French health insurance authority after arrival.

How to register for health insurance once you are in France

Joining the French social security system, obtaining a social security number, and registering for public health insurance for most foreign residents begins with contacting your local CPAM (Caisse Primaire d’Assurance Maladie).

What documents will you need to register for French health insurance?

The documents depend on your nationality and the basis on which you qualify. Foreign-born applicants generally need the S1106 application, a copy of an identity document or valid residence document where applicable, and evidence showing why they are entitled to healthcare in France. Civil-status documents may also be required to obtain a definitive social security number.

For a standard request to open rights, you will generally use form S1106 (PDF), also known as Cerfa 15763. Follow the checklist on the form and the Ameli guidance for people born abroad for the supporting documents relevant to your situation.

In some instances, the first port of call may be a bit different, and you will need to present specific additional documents:

• Expat workers will typically be registered to PUMa by their employer, but it’s worth double-checking.
• International students generally use the foreign-student registration service when French registration is required. The documents differ depending on nationality and existing health cover.
• Retirees, students, posted workers, and other internationally insured residents need an S1 only when the competent health authority of another country has issued one for their situation.
• Asylum seekers must show their ADDA, delivered by the prefecture.

La Carte Vitale

La Carte Vitale is the physical health-insurance card used to transmit billing information to Assurance Maladie and facilitate reimbursement. After your rights and definitive social security number are in place, you can order a physical Carte Vitale. The optional carte Vitale app is also available nationwide, but the physical card continues to exist.

Present your physical Carte Vitale or the app when the healthcare professional can accept it. If electronic transmission is not possible, a paper feuille de soins can be used instead.

How to get reimbursed for medical care in France

A Carte Vitale speeds up the transmission of your claim, but it is not itself a payment card.

When you present the card or app, the healthcare professional can send an electronic feuille de soins to your health insurance fund. In the usual reimbursement model, you pay the healthcare professional and Assurance Maladie then reimburses the covered share to your registered bank account. If your complementary insurer is linked electronically, it can receive the reimbursement information needed to process its share.

If the healthcare professional offers tiers payant, you do not have to advance all or part of the amount covered by Assurance Maladie and, where applicable, your complementary insurer. The exact reimbursement processing time varies, so check your Ameli account rather than relying on a fixed one-week timeframe.

If the professional cannot transmit electronically, they can give you a paper feuille de soins to complete and send to your health insurance fund. Paper claims generally take longer to process than electronic ones.

Registering with a doctor

People aged 16 and over are encouraged to declare a médecin traitant so they can follow the coordinated care pathway and receive the normal reimbursement level. Declaring one is not an absolute condition for receiving any reimbursement, but you are generally reimbursed less if you do not follow the pathway. Certain specialists can be consulted directly in defined situations.

Your doctor can usually make the declaration electronically using your Carte Vitale, or you and the doctor can complete the paper declaration form and send it to your health insurance fund.

Private health insurance in France

Many French residents top up their coverage with complementary health insurance known as a mutuelle. Plans can target workers, students, pensioners, or international residents, and their reimbursement levels vary by contract. Feather offers a complementary plan for expats, fully in English.

The advantages of getting private health insurance coverage

Complementary health cover is widespread in France: the French public statistics service DREES reports that 96% of the population is covered by complementary health insurance.

Reducing out-of-pocket costs

Complementary health insurance can reimburse all or part of the amount left after Assurance Maladie, depending on the contract. A responsible contract generally covers the standard ticket modérateur, but it does not reimburse the €2 fixed participation or medical franchises. Coverage of excess fees also depends on the policy.

Getting the best private medical care without excess fees

Some doctors, particularly sector 2 practitioners, can charge fees above the official reimbursement tariff. These are known as dépassements d’honoraires. Assurance Maladie calculates reimbursement from the applicable reimbursement base rather than simply refunding a fixed percentage of whatever the doctor charges.

If you regularly use doctors who charge excess fees, check how your complementary policy expresses reimbursement, for example as a percentage of the official reimbursement base or as a fixed amount.

Higher-tier complementary plans may reimburse a larger share of eligible excess fees, but limits and exclusions vary by contract.

Enjoying better healthcare services

Depending on the contract, complementary cover can include benefits such as a private hospital room, additional maternity benefits, or stronger optical, dental, and hearing-aid reimbursement. Responsible contracts also participate in the regulated 100% Santé baskets for eligible optical, dental, and audiology care.

International health insurance for expats in France

International or full private health insurance can be useful, and in some cases necessary, for foreigners moving to France. Whether you need it depends on your visa category, employment status, existing social security rights, and when your French public coverage starts:

• Some visa and residence categories require proof of private medical insurance. Check the France-Visas assistant for the documents required for your exact nationality and purpose of stay.
• People qualifying for PUMa through professional activity can be affiliated immediately once their application is accepted, while inactive residents generally face a three-month residence period before PUMa rights open.
• Adults have individual PUMa rights rather than being attached to a spouse. Each adult must meet the relevant work or residence conditions in their own name.
• Some residents remain insured by another country’s system under European or bilateral rules, while others may need private coverage because they do not yet meet PUMa conditions.

Depending on the policy, international health insurance may offer features that are useful to globally mobile residents, such as:

• broader geographical cover outside France
• higher reimbursement limits or broader benefits than a basic plan
• international customer support or direct-billing arrangements, depending on the provider

Visit our health insurance quotes page to compare plans with global health insurance providers.

How do you apply for private medical insurance in France?

Signing up is straightforward: whether you need to obtain full coverage or you have PUMa and only need a mutuelle top-up, all you have to do is shop around for a private health insurance plan that suits your needs, register with them directly, and voilà.

It really pays off to compare offers, as coverage can sometimes really be tailored to your situation.

If you work in the French private sector, ask your employer about the company’s compulsory complementary health plan before buying an individual mutuelle. Employers must offer this cover to employees, although statutory exemptions can allow some workers not to join.

For a private-sector employer plan, the employer must pay at least 50% of the premium. The employee normally pays the remainder unless the employer contributes more.

If your employment ends, you may be able to keep the employer plan temporarily under the statutory portability rules, depending on the circumstances. Check with HR and the insurer before your contract ends.

Private and international health insurance providers in France

There are many complementary health insurers in France. If you are covered by the French public system, you can compare mutuelle plans by reimbursement level, exclusions, waiting periods, and price. Comparison sites such as mutuelle.fr can help. Feather offers cover aimed at expats, fully in English.

For expats who need full international cover rather than only a French complementary plan, international health insurance companies operating in France include:

• Allianz Care
• APRIL International
• Cigna Global
• Feather

How much does French health insurance cost?

Is public health insurance in France really free?

PUMa is not a private insurance policy with a standard monthly premium, but that does not mean healthcare is cost-free. The French system is financed through social contributions, taxes, and other public funding, and patients can still face co-payments and other charges.

Employees in France contribute to the wider social security system through mandatory social contributions linked to their salary or wages. Visit Cleiss for the current French social contribution rates.

Some people covered by PUMa who have little or no professional income but sufficient investment or property income can owe the cotisation subsidiaire maladie (CSM), whose calculation uses a statutory formula rather than a flat 8% of net income. Separately, the 2026 law created a new financial participation for certain inactive PUMa beneficiaries exempt from CSG, CRDS, and the health-insurance contribution under an international convention; as of 17 August 2026, the decree setting its amount is still awaited.

How much does private health insurance cost in France?

The price of complementary health insurance varies widely, so a fixed national monthly range quickly becomes outdated. Use live quotes for your profile and compare the reimbursement levels rather than relying on a generic price estimate.

The costs of private health insurance depend on:

• the level of coverage required
• the reimbursement level for items such as excess fees, optical care, dental care, and hospital costs
• factors such as age, employment status, and place of residence

Do not assume that all private or international medical policies follow the same underwriting rules. French employer complementary health contracts must be solidarity-based, which means the insured person cannot be required to complete a health questionnaire or be priced according to their health status. International or other private medical insurance products may follow different rules, so check the policy terms before applying.

It’s always good to research and compare plans before moving to obtain the best insurance coverage.

Useful resources

• Service Public – PUMa – current eligibility, residence conditions, and the pending 2026 financial participation
• L’Assurance Maladie – reimbursement rates – current official reimbursement rates by type of care
• Ameli – foreign student registration – official registration process and exceptions for international students
• Ameli – Carte Vitale and app – ordering, using, and updating the physical and digital Carte Vitale
• Service Public – Complémentaire santé solidaire – residence, income, and application rules for C2S
• Cleiss – official information on French and international social security coordination
• Your Europe – social security forms – official EU explanation of the S1 and other portable documents
• France-Visas assistant – official visa requirements, including insurance documents where applicable