If you are an expat, navigating the healthcare system and health insurance in France can be daunting – it’s complex but once you understand it, it’s not that difficult. One of the key ingredient is health insurance. From the public system to private options and costs, let’s embark on a journey through healthcare insurance in France.
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French healthcare system and health insurance
At the heart of France’s renowned healthcare system lies the universal public healthcare coverage known as Protection Universelle Maladie (PUMa).This comprehensive system replaced France’s earlier healthcare framework, Couverture Universelle Maladie (CMU) in 2016, bringing about a simplification of coverage while expanding services to an even wider demographic.Â
France’s commitment to healthcare is a cornerstone of its society, consistently earning accolades as one the world’s premier systems. This extensive network ensures access to high-quality healthcare for every resident, regardless of nationality or financial status. PUMa reinforces this pledge, acting as the gateway to an array of medical services, offering peace of mind.Â
Who needs health insurance in France?
In France, health insurance isn’t a luxury, it’s a legal requirement. If you are living or working in the country, you must be covered by either the public system or a private insurer. This ensures that everyone, regardless of their background or nationality, has equal access the healthcare services.Â
If you are in any of the following situations, you are eligible for PUMa in France:
- Working: When you are living in France in a stable and regular basis, you automatically qualify for PUMa. Moreover, your dependants, such as children or a spouse, can also benefit of this coverage.Â
- Retired: When you’re living in France in a stable and regular manner after retirement, you’re entitled to PUMa. This ensures that even after your professional years, you have access to comprehensive healthcare.
- Job seeker: In the event that you’re seeking employment and aren’t receiving compensation from your home country, residing in France on a stable and regular basis makes you eligible for PUMa. This ensures that you have access to necessary healthcare services while you’re in the process of finding employment.
The case of foreign students: France categorises foreign students as short-term residents in terms of health insurance. This means that students must arrange for insurance coverage from their home country (unless they posses an EHIC) before they become eligible for enrolment in a French university.Â
If your UK employer has sent you to France temporarily (‘posted workers’): You can access healthcare using an EHIC, GHIC, or S1 form. Contact HMRC’s helpline for National Insurance enquiries for non-UK residents. Register your S1 with your local CPAM. You might also need a UK-issued A1 certificate, obtainable from HMRC. When using an EHIC or GHIC, remember to present the card during appointments.
Public health insurance in France
What does public health insurance cover?
The French public health insurance system, known as ‘Assurance Maladie’, covers a wide range of medical services, from doctor’s visits to hospital stays. It also includes prescription medications and certain specialised treatments. This robust coverage is a cornerstone of the French healthcare system.Â
How to apply for public health insurance in France?
Registering for public health insurance is relatively straightforward. As an expat, you’ll need to contact the local ‘Caisse Primaire d’Assurance Maladie’ (CPAM) office. Documentation requirements may vary, but generally, you’ll need proof of residence, identification, and work status.Â
This process is designed to be user-friendly and typically involves the following steps:Â
- Locate your nearest CPAM office: The first step is to find and get in touch with the nearest ‘Caisse Primaire d’Assurance Maladie’ (CPAM) office. These offices are spread across France and are primary points of contact for healthcare-related matters.
- Gather necessary documents: While the specific documentation required may vary slightly depending on individual circumstances, there are common elements you’ll need to prepare. These typically include proofs of residence, personal identification (like passport or ID card) and documents verifying your work status in France.Â
- Completing the application form: At the CPAM office, you’ll be provided with an application form for public health insurance. This form will ask for personal information, details about your employment, details about your employment status, and may include questions about your healthcare needs.Â
- Submit the application: Once you’ve completed the form, submit it along with the supporting documents. The staff at the CPAM office will guide you through the process and answer you may have.
- Waiting period and confirmation: After submitting your application, there might be a brief processing period. During this time, the authorities will review your application and documents. Once approved, you’ll receive a confirmation letter, which serves as proof of your enrolment in the public health insurance system.
Registering with a doctor
Residents covered by state medical insurance must designate a family doctor (‘médecin traitant’ in French) in order to qualify for reimbursement of their medical expenses. This choice comes with complete freedom, allowing you to select a doctor from any location or practice.
You can formally choose your doctor by either presenting your ‘carte vitale’ at the GP’s office or by sending a registration request via mail (in French). After this process, you will receive a ‘declaration de médecin traitant’.
Failing to register with a doctor can result in penalties, such as increased medical fees and reduced reimbursement rates. Patients aged 16 or younger can consult any doctor without concerns about financial penalties.
Private health insurance in France
The advantages of getting private health insurance coverage
Opting for private health insurance in France offers several distinct advantages for expats. While the public healthcare system is robust, many individuals choose to enhance their coverage with private insurance. This supplemental plan extends benefits beyond what the public system provides, including access to private hospital rooms, comprehensive dental care, and specific elective procedures that may not be covered by public insurance.
Private health insurance often guarantees shorter waiting times for non-emergency treatments, affording expats quicker access to healthcare services. Additionally, it grants a wider network of healthcare providers, including renowned specialists and medical facilities. This ensures that individuals have the flexibility to choose their preferred doctors and hospitals.
How does private health insurance work in France?
Private health insurance functions as a top-up to the public system. It covers the difference between what the public system reimburses and the actual cost of services. This can be particularly beneficial for expats seeking a higher level of comfort or specific medical services.
Companies that sell health insurance in France
Several insurance providers in France cater to expats. It’s advisable to compare policies, considering factors like coverage breadth, premiums, and customer service.
AXA
Coverage: AXA offers a wide range of health insurance plans tailored to various needs. This includes basic coverage for hospitalisation and emergencies, as well as more comprehensive plans covering outpatient care, dental, and optical services.
Starting price: Prices can vary depending on the level of coverage and individual factors. Basic plans can start from around 30 € per month.
Allianz
Coverage: Allianz provides a variety of health insurance options, including plans that cover hospitalisation, outpatient care, and dental treatments. They also offer specialised plans for families and seniors.
Starting price: Basic plans from Allianz typically start at around 40 € per month.
April International
Coverage: April International specialises in international health insurance and offers plans designed for expatriates. They provide comprehensive coverage for hospitalisation, outpatient care, and additional benefits like maternity and dental.
Starting price: Starting prices can range from 35 € to 50 € per month, depending on the plan and individual circumstances.
Cigna
Coverage: Cigna is a global health services company that offers a range of international health insurance plans. Their coverage includes hospitalisation, outpatient care, maternity, and dental services, among others.
Starting price: Prices can start from around 35 € per month for basic coverage.
Generali
Coverage: Generali provides various health insurance plans, including options for individuals, families, and seniors. Coverage includes hospitalisation, outpatient care, and additional services like dental and optical.
Starting price: Basic plans from Generali may start at approximately 30 € per month.
How much does health insurance in France cost?
The cost of health insurance in France varies depending on your chosen plan and insurer. Public health insurance contributions are typically deducted directly from your salary, while private insurance premiums can range from a few hundred to over a thousand euros per year.
Getting and using an S1 form for UK-founded healthcare in France
How to get an S1 form
If you’re eligible for state healthcare paid for by the UK, such as a UK State Pension or an exportable benefit, you may receive an S1 form. Contact HMRC National Insurance enquiries to determine your eligibility. Remember, not all UK benefits claimed abroad entitle you to UK-funded healthcare.
How to use an S1 form in France
Registration process: Once you have an S1 form, it must be registered at your local CPAM office. This grants you and your dependants healthcare entitlements akin to a French citizen. You’ll still be responsible for a portion of your medical costs, similar to other residents.
Top-up insurance: Consider getting ‘mutuelle’ coverage, which supplements costs not covered by state reimbursements. This additional insurance can be invaluable.
Additional benefits: You’ll also receive a UK-issued EHIC or GHIC for travel, along with the option for planned treatments in other EU countries.
Dependants and family members: Note that classifications may differ between France and the UK. Seek clarification from local authorities during your S1 form registration.
Changes with UK state pension: If you’re entitled to an S1 form as a State Pensioner’s dependant, your health cover ceases once you begin claiming your UK State Pension. Ensure your registered address is up to date with NHS Overseas Healthcare Services to receive a new S1 form for uninterrupted healthcare cover.
Informing authorities: You’re responsible for notifying NHS Overseas Healthcare Services of any address or circumstance changes.
Using the S1 form in France
Registration: Begin by registering your S1 with the local CPAM office. They provide online resources for assistance.
Temporary social security number: Expect to receive a temporary social security number by post within 1 to 3 months of registration.
‘Attestation de droits à l’assurance maladie’: This document affirms your entitlement to French state healthcare and your assigned social security number. With this, you can apply for your French state healthcare card, known as the ‘carte vitale’. Always carry it when visiting a doctor, pharmacy, or specialist provider.
Waiting period: Obtaining a carte vitale may take 6 months or more. For inquiries regarding your application, contact your local CPAM office.
Immediate healthcare: If you require healthcare before receiving your card, utilise your social security number. Request a ‘feuille de soins’ from your healthcare provider and send it to your CPAM office for reimbursement of any incurred expenses.
Useful resources
French public health insurance:
Official assurance maladie website. Visit the website here.
Information on public health insurance in English. Visit the website here.
Getting an S1 form:
NHS overseas healthcare services. Visit the website here.
Thinking about living in France?
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