First published October 2023
Updated October 2025
France is renowned for its world-class public healthcare system, based on solidarity and universal access.
Every legal resident must have health coverage, whether through the public system (PUMa) or private insurance. For retirees, the rules differ depending on your nationality and income source, especially between EU/EEA/UK/Swiss citizens and those from outside Europe.
Table of contents
Joining the French healthcare system
The French public system, L’Assurance Maladie, is funded by a mix of social contributions and general taxes. All residents are required to be insured.
The minimum level of coverage is through the Protection Universelle Maladie (PUMa), which provides state healthcare access after a qualifying period of residence.
Those still covered by another European system (e.g., UK, Germany, Netherlands) may instead register via an S1 form, transferring coverage rights from their home country.
Healthcare eligibility for retired expats
Retired expats are eligible to register with Assurance Maladie, but how you qualify depends on your situation:
- If you’re relocating from the EU/EEA, the UK or Switzerland:
You can usually request an S1 form from your home country’s social-security authority. Once you register the S1 at your local CPAM (Caisse Primaire d’Assurance Maladie), your healthcare costs in France are funded by your home country, and you receive care on the same basis as French-insured residents. - If you’re relocating from outside Europe:
You can apply to PUMa after three months of stable, lawful residence in France. During this waiting period, you must hold private health insurance that covers medical and hospital care in France.
Applying for the Carte Vitale as a retiree
Once eligible, retirees apply for coverage by submitting:
- Cerfa 15763*01: Demande d’ouverture des droits (available via Service-Public.fr)
- Passport / residency permit, proof of address, proof of income, and bank details (RIB)
Send the completed file to your local CPAM. After registration, you’ll first receive an attestation de droits confirming your entitlement; your Carte Vitale arrives later (delays vary by region). Use the attestation for reimbursements until the card arrives.
> You might be interested in this article: Guide to the Carte Vitale for expats
How healthcare is funded in retirement
Retirees’ healthcare is financed in two main ways:
- Through PUMa (resident coverage)
- Access after 3 months’ residence.
- Depending on income, some retirees pay a cotisation subsidiaire maladie (CSM).
- CPAM reimburses most medical fees directly.
- Through the S1 system (for EU/EEA/UK/Swiss pensioners)
- Your home country funds your care.
- You register the S1 with CPAM.
- You’re covered on the same basis as French patients, though standard co-pays still apply.
- A mutuelle (top-up policy) is highly recommended.
What the state covers and what it doesn’t
France’s state health insurance reimburses a large share of costs, but not all:
| Type of Care | Standard CPAM Reimbursement |
|---|---|
| GP visit (tarif base 30 €) | 70 % (≈ 21 € refunded) |
| Specialist (sector 1) | 70 % of base tariff |
| Hospital stay | ~80 % (100 % for major procedures) |
| Dental / optical | Partial; wide variation |
Remaining costs, co-pays, non-covered services, and dépassements d’honoraires, are the patient’s responsibility unless supplemented by a mutuelle.
Enhance your coverage with a mutuelle
A mutuelle (complementary health insurance) covers the portion of expenses left unpaid by CPAM.
Typical benefits include:
- Doctors’ and specialists’ fees
- Hospital room upgrades and daily charges
- Prescription medicines
- Dental and optical care (glasses, implants, etc.)
Many mutuelles now comply with “100 % Santé”, meaning certain standard dental, optical, and hearing services are fully covered with no out-of-pocket cost.
Even S1 pensioners should consider a mutuelle to avoid paying co-pays or high private-clinic fees.
Private health insurance for visa applications
If you’re moving to France from outside the EU, private health insurance is required for visa and residence-permit applications.
- Short-stay (≤ 90 days): must cover ≥ 30,000 € in medical expenses + repatriation, valid throughout Schengen.
- Long-stay (VLS-TS visa): must provide comprehensive medical + hospital coverage in France for the full visa duration (not just emergency care).
Once you’ve been legally resident for 3 months, you can apply for PUMa and eventually switch from private to public coverage.
Healthcare in France for UK pensioners
If you receive a UK State Pension, you’re eligible for the S1 scheme.
How it works
- Request an S1 form from NHS Overseas Healthcare Services (UK).
- Register it at your local CPAM in France.
- You’ll be enrolled in the French system, with your care funded by the UK government.
You’ll pay the same co-pays as French residents, and you can add a mutuelle for full reimbursement.
This arrangement covers medically necessary treatment and long-term conditions but not certain non-essential or elective services.
👉 Official guidance: UK Gov – Healthcare in France
Healthcare in France for US Retirees
Unlike retirees from the UK or EU, US pensioners are not eligible for the S1 scheme or any reciprocal healthcare arrangement. This means that access to French public healthcare is not automatic, but it is still possible once you become a resident.
How it works
- Before moving:
You must have private health insurance that covers medical and hospital care in France for your long-stay visa (VLS-TS).- Coverage should be comprehensive, not just travel insurance.
- It must last for the full duration of your visa and include care in France (not only emergencies).
- After 3 months of legal residence:
You can apply to join the French state healthcare system (PUMa) if you are living in France full-time and can prove stable, lawful residence (rental contract, bills, etc.).
- Apply through your local CPAM using the form Cerfa 1576301 – Demande d’ouverture des droits*.
- Once approved, you’ll receive an attestation de droits, followed by your Carte Vitale.
- Paying for healthcare:
- As a resident retiree, you may owe a contribution known as the cotisation subsidiaire maladie (CSM), depending on your total income.
- You’ll pay the same co-pays as French residents: typically 70% reimbursed by CPAM, 30% out-of-pocket unless you have a mutuelle.
- Enhancing your coverage:
Because CPAM only reimburses part of your medical costs, most expats, including US retirees, take out a mutuelle (complementary health insurance) to cover remaining expenses such as dental, optical, and hospital fees.
This arrangement gives American retirees the same access and reimbursement rates as French residents once registered, but without automatic coverage from the US government. Your US Medicare policy does not cover care in France, so private or local French coverage is essential.
Key takeaways
- All retirees must have health coverage — via PUMa, S1, or private insurance.
- Three-month rule: Inactive non-EU retirees join PUMa after 3 months of stable legal residence.
- S1 holders (EU/UK/EEA/Swiss): Register the form at CPAM for immediate access.
- Mutuelle: Recommended for everyone to cover co-pays and private-care extras.
- Visa insurance: Must be comprehensive; Schengen visitors need 30,000 € minimum cover.
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