Healthcare system

Healthcare Basics

Healthcare and health insurance for seniors in France

Explore options for senior healthcare and health insurance in France, including specialists, treatments, and assisted living.

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Updated 7-10-2024

France is a popular destination for retirees, with a large proportion of immigrants over the age of 55. So, if you spend your retirement there, you’ll be part of a growing community.

For international seniors, understanding the intricacies of the French healthcare system is a priority. Fortunately, the country’s comprehensive healthcare system aims to provide quality care for its aging population.

Find out about healthcare and health insurance options available to seniors, and learn how to make informed decisions about your health and well-being in the following sections:

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Healthcare for seniors in France

What is the current state of health of seniors in France?

More than 10% of the French population is over 75. France has an average life expectancy of 82.3 (PDF, figure from 2022), higher than that of the European Union (EU). However, life expectancy has fallen since 2019 and has yet to recover. Furthermore, the country has a higher gender mortality gap than anywhere else in Western Europe, except Finland.

The most widespread chronic diseases (in French) in France are:

  • Cardio and neurovascular diseases
  • Neurodegenerative diseases
  • Respiratory conditions such as COPD

France has several initiatives to take care of its elderly population. For example, retirees get priority for healthcare checkups, and the French government provides information points for older people. These services provide information on defining your needs, adapting your home, care solutions, combating isolation, your rights, and more.

How can expat seniors access French healthcare?

France has public healthcare, which any resident can access after three months of living there. However, if you receive a state pension from the EEA, Switzerland, or the UK, you must complete an S1 form to receive social security in France. This is available from your health insurance authority.

Citizens of the European Economic Area (EEA) and Switzerland can use their European Health Insurance Card (EHIC) to receive emergency medical treatment at the same cost as French nationals. Those from the UK can use their Global Health Insurance Card (GHIC).

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Some countries have bilateral agreements with France, allowing their residents to access healthcare, but others should find out if their home country covers health costs abroad and consider taking out private health insurance.

Telemedicine

Telehealth consultations, or online health services, have become more popular since 2020. Although they are more popular among younger patients, they valuable for those with reduced mobility or living in rural areas. They are now reimbursed at the same rate as in-person consultations (70%).

Health insurance for seniors in France

Public health insurance

Everyone who has lived in France for more than three months can access public healthcare through France’s Universal Health Protection (protection universelle maladie – PUMa). You can apply for public health insurance online and learn more about health insurance for different situations on the French public service website.

PUMa reimburses patients for their healthcare costs. This usually amounts to 70% but can be anything from 60–100%. Those on a low income can benefit from supplementary solidarity health (complémentaire santé solidaire), which tops up the co-payment.

Private health insurance

Since public health insurance generally only covers a portion of costs, many people in France take out additional health insurance through a private insurer, known as a mutuelle. This can also be useful for older people living in France, as some policies cover treatments and procedures not covered by public insurance.

When comparing different health insurance providers, check that they cover pre-existing health conditions and healthcare needs. Some health insurers have specific terms for seniors, and you may need to take a questionnaire before getting a quote. Furthermore, coverage can be more expensive for older people.

Plans tailored to seniors specialize in covering common conditions and pre-existing illnesses. These can give you peace of mind when considering your healthcare options. International brands offering health insurance for seniors in France include Cigna Global.

Travel insurance for seniors

When visiting France, older people should check whether their existing insurance provider covers international travel and overseas medical coverage. Nationals of some countries, such as those in the EU, Switzerland, and the UK, can use their EHIC or GHIC for emergency care.

However, if you are not covered, it’s essential to purchase a travel insurance policy with urgent care included. Look for the following:

  • Emergency medical treatment
  • Hospitalization
  • Medical evacuation

Some travel insurance companies might not cover certain conditions, so check before buying. Those staying long-term in France should sign up for public healthcare and consider private coverage.

Specialist healthcare for seniors in France

France has numerous medical professionals who specialize in healthcare that affects older people. These include:

  • Geriatricians
  • Cardiologists
  • Neurologists
  • Oncologists
  • Ophthalmologists
  • Rheumatologists
  • Endocrinologists
  • Psychiatrists and psychologists

You usually require a referral from your doctor to access appointments with these medical professionals. However, if you have private insurance, you may be able to speak to someone directly, especially at a private clinic. Check with your provider to find out.

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Generally, Puma covers 70% of your healthcare costs for specialists when accessing them with a referral.

You can keep up with the latest developments in geriatric medicine by following the French Society for Geriatrics and Gerontology (Société Française de Gériatrie et Gérontologie – SFGG, link in French). This organization works in policy, research, education, and advocacy and publishes useful resources.

Vaccines for older people in France

One of the ways that older people can protect their health is by taking the recommended vaccinations. France offers the following vaccinations to seniors:

VaccineWhenReimbursed?
COVID-19Any time, plus boosters when recommended100%
Diptheria, tetanus, and polioAt age 65 and every 10 years afterward65%
Seasonal fluEvery year100% for over 65s and people with some chronic illnesses (not reimbursed for others)
Zona (Shingles)Between the ages of 65 and 7430%

If you’re unsure about which vaccines you need, get in touch with your healthcare provider. Bear in mind that it’s also essential to check which vaccinations are necessary before traveling abroad. In France, health insurance does not cover vaccines for travelers.

Dentistry for seniors in France

France offers high-quality dental care in both the public and private sectors. Services include preventative and restorative care and periodontal treatment. Puma generally covers 60% of dental rates, including crowns and dentures.

As public health insurance covers a smaller proportion of costs, it’s worth considering dental insurance. For example, Cigna Global‘s senior policy offers dental coverage.

Vision and hearing care for seniors

If you notice problems with your vision while in France, you can visit the following medical professionals:

  • Ophthalmologist (ophtalmologiste) – a doctor specializing in eyes and vision. This specialist may examine your eyes, diagnose disorders, prescribe treatment, and perform surgery on the eye. You may need a referral from your general doctor for your first appointment.
  • Optician – this professional can make prescription glasses and lenses from a doctor’s prescriptions. They may also check your vision.

Although the ophthalmologist provides the initial prescription, the optician may renew and adapt it over the years. Once you’re over 42, it’s recommended to replace your glasses and lenses every three years.

You can receive up to 100% reimbursement for frames up to €30 and the lenses of your glasses. However, contact lenses are only reimbursed at 60%.

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Meanwhile, seniors struggling with their hearing can be referred to a hearing care professional (in French). They will ask you questions about your situation, examine your ears, and advise you on the different options available. They’ll give you a quote for hearing aids if necessary, which you can try out for 30 days, and organize follow-up tests.

There are two types of hearing aids:

  • Class I: Less expensive devices, reimbursed 100% by public insurance
  • Class II: More advanced equipment, reimbursed 60% by public insurance

Cancer and cancer screenings for seniors

Cancer is the leading cause of death in France, with 24.5% of deaths in 2020 to blame for the disease. As a result, France has had initiatives over the years to improve diagnosis and treatment. For example, the French Cancer Control Strategy 2021–30 includes prevention, improving prognosis, and reducing preventable cancers by 60,000 cases per year.

The most common forms of cancer in France in women are breast, colorectal, lung, and uterus, while men are most likely to experience prostate, lung, colorectal, and bladder cancer.

As part of France’s strategy against cancer, the country has screening programs for several groups, including over-50s.

Age-related cancers and screening in France

Some types of cancer are more common as people age, so France has several screening programs:

  • Colorectal cancer: People from 50–74 are invited every two years for a screening. This involves an initial test for blood in stool – you can get a kit from your doctor, online, or from a pharmacy, and the cost is covered by health insurance.
  • Breast cancer: Women aged 50–74 are invited for a mammography every two years. You should receive the results at the end of your appointment.

You can learn about prevention, treatment, research, and more from the Institut National du Cancer (National Cancer Institute – link in French). As it’s essential to detect cancer early for effective treatment, if you experience any unusual symptoms (in French), contact your doctor.

Neurodegenerative diseases

Around 1.5 million people in France are affected by neurodegenerative diseases including Parkinson’s Disease and Alzheimer’s. France has had several strategies and plans in place over the years, including the National Degenerative Disease Strategy (Stratégie Nationale Maladies Neurodégénératives) 2024–2028. This plan proposes several research and policy measures, but at the time of writing, it is yet to be enacted.

Both Alzheimer’s and Parkinson’s disease are classed as ‘long-term illnesses‘ (affection de longue durée – ALD), and social security covers 100% of approved costs for treatment. However, you may incur additional costs for alternative treatments and therapies, so check with your insurer.

Alzheimer’s and dementia

Alzheimer’s Disease and other types of dementia involve a progressive loss of memory and impaired cognitive functions. It’s thought that around 750,000 people are diagnosed per year in France, a figure which could double by 2050 due to the country’s aging population.

France emphasizes the importance of early diagnosis – initial symptoms may include:

  • Change in behavior or personality
  • Forgetfulness and losing things
  • Difficulty with language
  • Difficulty performing familiar tasks
  • Loss of orientation
  • Impaired judgement
  • Loss of motivation
Close-up of a nurse holding a senior man's arm as he holds a ball
Photo: Matthias Zomer/Pexels

Contact your general doctor if you notice any of these symptoms. They can carry out initial examinations to rule out other conditions. Following the first appointment, they may monitor you to keep track of your symptoms. You may also be referred to a specialist or for a memory consultation.

After additional examinations, the general doctor and specialist build a care pathway and may share information on therapeutic trials. A team of medical professionals provide treatment, which may include:

  • bodily care
  • rehabilitation and physical activity
  • cognitive support

Parkinson’s Disease

Parkinson’s Disease is the second-most common neurodegenerative condition in France, with 25,000 new cases each year in France. Patients are diagnosed at an average age of 58. Organizations in France have been contributing to research into Parkinson’s, improving knowledge of the condition and diagnosis and assessing environmental risk factors.

Characteristic symptoms include:

  • Difficulty initiating movement
  • Slowing down of gestures
  • Increasingly small and difficult writing
  • Rigid arms or legs
  • Tremors when muscles are relaxed

If you experience symptoms, contact your doctor, who can refer you to a neurologist. They diagnose the condition through questions and examinations, and you may undergo medical imaging (such as an MRI) to rule out other illnesses.

Following diagnosis, the doctor provides a consultation to create a personalized care plan. Treatment can include medication, physiotherapy, speech therapy, and occupational therapy. In severe cases, neurosurgery may be an option.

Chronic disease management

Chronic diseases and long-term conditions can affect your quality of life as a retiree in France. Fortunately, the country is well-equipped to help patients manage many conditions linked to age, including cardiovascular diseases, diabetes, and arthritis. Furthermore, many conditions allow for 100% health coverage.

Cardiovascular diseases

Cardiovascular diseases include hypertension, coronary artery disease, and stroke. There are several prevention programs in the country, and many focus on giving up smoking, good nutrition, and exercise. Should you experience unusual symptoms, talk to your doctor who can refer you to cardiologists and other specialists.

For more support, visit the French Cardiology Federation (Fédération Française de Cardiologie), which advises on prevention, different treatments, and life with these conditions.

Diabetes

Diabetes affects about one in five men aged 70–85 and one in seven women aged 75–85 in France, and numbers have increased in recent years. Diagnosis involves blood tests and other examinations, and your doctor may provide you with equipment to monitor blood sugar levels.

When treating diabetes, the doctor may begin by prescribing a balanced diet and regular physical activity. If this is ineffective, they may then prescribe medication or insulin. You’ll likely have several appointments with a medical professional per year.

The French Diabetes Federation (Fédération Française des Diabétiques) offers a wealth of resources and advice.

Arthritis and other musculoskeletal disorders

Rhuematoid arthritis involves chronic inflammation of the joints, causing symptoms such as joint pains for longer than six weeks for 30 minutes at a time. It is more common in women than in men.

Contact your doctor for diagnosis – they will examine your joints and order a blood and radiology test to diagnose your condition.

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Treatments usually involve medication to prevent pain and inflammation, surgery, and rehabilitation. This might include physiotherapy, occupational therapy, and equipment to aid everyday life.

You can also access support through the French Association of Polyarthritics and Chronic Inflammatory Rheumatism (Association Française des Polyarthritiques et des Rhumatismes Inflammatoires Chroniques – AFPric).

Mental healthcare services

Although reported depression rates among older people in France tend to be lower than other age groups, it is also underdiagnosed – over-65s are the population most at risk of suicide. If you or someone you know is in distress, you can reach the national suicide prevention number at 3114.

For longer-term care, you can visit your general doctor, who can refer you to a medical psychological center (centre médico-psychologique) or another specialist. However, be aware that waiting times are long, and sessions may be in French.

For more information on accessing mental healthcare treatment, visit our article on Mental healthcare in France.

The French government website pour les Personnes âgées suggests several ways to prevent isolation, which can lead to depression. For example, Sortir Plus from the Agirc-Arrco pension fund supports people over 75 by sending a guide to assist them on their outings and Petit Frères des Pauvres is a network of volunteers who organize visits and activities with seniors.

Rehabilitation and physical therapy

Senior French residents who need assistance with mobility, strength, balance, and coordination can visit a physical therapist (kinésithérapeutes). This can be beneficial for conditions such as arthritis, osteoporosis, and Parkinson’s.

Public health insurance covers 60% of the costs with a prescription, but if you wish to contact the physiotherapist directly, you’ll need to pay the full amount or have it covered by your mutuelle.

Rehabilitation services after surgery usually take place in rehabilitation centers and hospitals.

Care at home for seniors

Older people who wish to continue living at home but require assistance are entitled to a range of care. If you are independent and only need help to facilitate daily life, the following organizations can help you:

  • Retirement funds
  • The local town hall or community social action center

They may be able to provide meal delivery and travel assistance among other services.

Personalized autonomy allowance (APA)

However, over-60s who need more help can benefit from the personalized autonomy allowance (allocation personnalisée d’autonomie – APA). To receive the allowance, you must be:

  • over 60
  • living in your home, a family member’s home, or at a facility
  • living in France in a stable and regular way
  • in need of assistance for essential acts in life or in a state of health requiring regular supervision

The process for applying depends on your department, but during assessment, you will receive a GIR (groupe iso-ressources) score from 1 to 6. This score indicates how much help you need, and if you score between 1 and 4, you are entitled to APA, regardless of income.

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Your doctor can advise whether you need home care, which might include:

  • Home nursing service (SSIAD): this service allows you to continue living at home if you do not wish to move to new accommodation. It’s also used after hospitalization or to avoid the need for it. These teams provide hygiene, comfort, and nursing care, such as dressings and injections.
  • Nursing health center (centre de santé infirmier): state nurses provide nursing, comfort, and hygiene care at your home or at the center.
  • Private nurse (infirmier libéral): these nurses provide nursing care and are usually reimbursed by social security at 60%.
  • Hospitalization at home (hospitalisation à domicile – HAD): this service is for more complex medical situations involving medical and paramedical care. It may be used after surgery, for follow-up care, cancer treatment, and other situations.

Other independent living options

If you would rather not move to accommodation aimed at seniors, there are several other options. These include:

  • Living (or temporarily staying) with a loved one – as a carer, they may be entitled to support and funding, which you can read about in the next section.
  • Foster care (accueil familial) – families approved by department council host older people temporarily, permanently, or on a flexible timetable. They provide accommodation and meals, and can assist with everyday activities. It can be either temporary, permanent, or at given times.
  • Inclusive housing – this group living arrangement provides older people with private living spaces and social projects. Residents can still take advantage of SSIAD.
  • Social housing – if your current accommodation becomes too expensive or difficult to manage, government-subsidized housing may be an option.
  • Intergenerational housing – these complexes have apartments designed for more than one type of household (e.g., seniors, families, and students)
  • Grouped housing – these small sets of independent housing have central locations, accessible facilities, common spaces, and affordable rents. Some may have additional services such as meal delivery.
  • Beguinages – these historic and modern homes for seniors offer a safe, friendly environment with adapted housing.

You can find more information online (in French) about how to apply and the costs. Depending on your aid plan, your allowance will be paid to you or the service itself.

Support for caregivers

Those caring for an older person may benefit from the daily allowance (allocation journalière du proche aidant – AJPA), which provides leave from work for up to 66 days. It also pays €64.54 per day (2024). You may also be entitled to tax deductions.

Community support includes carers cafés and information points. France also offers free training for caregivers, which consists of several modules for managing life and handling professional care and everyday activities.

Nursing homes

Unfortunately, French nursing homes have faced severe allegations of inadequate care and mistreatment in recent years. Therefore, France is taking several measures to improve nursing homes, including inspections and setting up a platform for reporting abuses. The country is also investing in nursing home facilities to renovate buildings and offer more places.

France is home to several types of assisted residences.

Independent residences

Independent residences (résidences autonomie) are retirement homes where people live in their own apartments with shared community spaces. They provide laundry and catering services, internet, security, events, and activities. You can either rent a studio (F1) or a two-room apartment (F2).

The admission criteria are that you must be over 60 or have a loss of autonomy of GIR 5 or 6. Couples who wish to live in an independent residence must both adhere to this. This accommodation is intended for seniors with financial or mobility difficulties rather than serious medical needs.

Serviced residences

Serviced residences (résidences services) are private housing complexes with amenities, communal areas, and activities. In principal, they are quite similar to a residence autonomie, but the main difference is that they are privately operated and occupants can own their home.

Accommodation establishments for dependent elderly people

Accommodation establishments for dependent elderly people (établissements d’hébergement pour personnes âgées dépendantes – EHPADs) are nursing homes with in-room care for over-60s who require daily help and medical support. Residents have a bedroom and private bathroom, although some offer double rooms for couples. Services provided include:

  • Accommodation
  • Entertainment and things to do
  • Support with activities
  • Catering
  • Laundry services
  • Daily medical and paramedical care
Beaulieu Retirement home in France
An EHPAD in France (Photo: Dominik/Wikimedia Commons)

They are equipped to assist people living with Alzheimer’s and other diseases. The price depends on the person’s GIR dependency rate.

Long-term care units

Over-60s who require constant medical monitoring may move to a long-term care unit (unités de soins de longue durée – USLDs). They are usually attached to hospitals, and you may be admitted after hospitalization or follow-up care. Otherwise, a practitioner may refer you.

Costs for assisted living in France

The costs for the different types of assisted living in France are as follows:

  • Independent residences – lower rent than market rate, start at €400–500 in Paris for an F1
  • Serviced residences – market rate for rental or purchase
  • EHPADs – A daily rate for accommodation and dependency that the patient must cover. The care rate is covered by health insurance. In Paris, fees are around €2,500–€7,500 per month.
  • USLDs – work in the same way as EHPADs.

Independent residences, EHPADs, and USLDs can be paid by housing assistance, social assistance for accommodation (aide sociale à l’hébergementASH), and APA. On the other hand, serviced residences are not eligible for ASH.

Palliative and hospice care

Palliative and hospice care services provide support for individuals with terminal illnesses and their families. These services focus on improving the quality of life, managing pain and symptoms, and offering psychological and emotional support.

Most hospitals in France have palliative care units or departments. Nursing staff can also provide it at home. In addition, France has hospices across France offering comprehensive care and a comfortable and supportive environment. Options include:

  • Home hospitalization (HAD)
  • Identified palliative care bed (Lit identifié de soins palliatifs) – hospitalization where medical and paramedical teams provide support and care
  • Palliative care units (unité de soins palliatifs) – entire departments dedicated to palliative care and end-of-life support

The Société Française d’accompagnement et de soins palliatifs (French Society for Support and Palliative Care – SFAP) provides a directory of care providers and support associations.

Advance directives

Advance directives (directives anticipées) are written statements that patients provide that express end-of-life treatment wishes. They are used before a patient can no longer express how they want to be treated. They provide wishes to continue, limit, stop, or refuse certain medical treatments or procedures.

Should you create an advance directive, inform your doctors and loved ones. It’s also essential to ensure it’s on file if you’re hospitalized for a serious illness or entering elderly care facilities. Otherwise, keep a copy at home.

These directives are binding, but they are not followed in life-threatening emergencies or if they are inappropriate or inconsistent with the medical situation. You can cancel yours at any time.

Euthanasia and assisted suicide are not permitted in France.

Alternative and complementary care

In France, a variety of alternative and complementary therapies are available, which can improve your well-being and, in some cases, your health. You can use these alongside conventional medicine to enhance your treatment. Some popular options include:

  • Acupuncture
  • Homeopathy
  • Osteopathy
  • Chiropractic care
  • Naturopathy
  • Herbal medicine
  • Aromatherapy
  • Yoga and meditation
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In most cases, these therapies are not reimbursed by state health insurance, so you’ll need to rely on private insurance to cover the costs. It’s essential to make sure that your practitioners are qualified and members of professional societies such as the National Council of the Order of Physicians (Conseil national de l’Ordre des médicins – CNOM).

Healthcare apps for seniors

There are various useful apps to manage your healthcare as a senior in France. These include:

Useful resources

Author

Sarah Fairman

About the author

Originally from rural England, Sarah has lived in Russia, Canada, and Uzbekistan before arriving in the Netherlands in 2017. She has a passion for languages (English, Dutch, French, Russian, Spanish, and Ukrainian) and has written for several cultural and legal publications.

Sarah has been using her writing, research, and editing skills at Expatica since 2021.