Healthcare in France: What Expats Need to Know
- A New Life
- Sep 9
- 4 min read
One of the first questions many expats ask when considering a move to France is: what happens if I get sick?
The good news is that France is home to one of the most respected healthcare systems in the world. Renowned for its quality, accessibility, and relatively low costs, it consistently ranks near the top of international studies on life expectancy and medical outcomes. But for newcomers, understanding how it all works can feel overwhelming.
The French system is built on the principle of universal coverage. Everyone who becomes a legal resident — whether they are working, retired, or simply settling in for a new life — has the right to state healthcare. The system is funded by social contributions and taxes, but unlike in some countries, patients are often expected to pay upfront for their care and then receive reimbursement directly into their bank accounts. This is where the Carte Vitale, France’s green health card, comes in. With a simple swipe at the doctor’s office or pharmacy, reimbursements are triggered automatically, usually within a few days. A digital version of the card is now being rolled out, making access even smoother.
Who is entitled to use the system depends on your status. EU citizens have it easiest, arriving with their European Health Insurance Card for temporary stays, and then joining the French system after three months of residency. Since Brexit, Britons must apply for residency visas, but UK pensioners benefit from an agreement that lets them transfer their healthcare rights via the S1 form, meaning the UK continues to pay while they receive care in France. Americans and other non-EU nationals must usually begin with private health insurance to secure their visa, but once they are settled and have three months of stable residence behind them, they too can apply to join the French system under PUMa, the universal healthcare scheme. For employees and the self-employed, the process is tied to work: contributions to the social security system automatically entitle them to healthcare.
Registering is one of the most important early steps for any expat. It begins with contacting your local CPAM office, providing documents like your passport, proof of address, and French bank details. At first you’ll receive a temporary social security number and an “attestation de droits,” which confirms your rights. With these in hand, you can start claiming reimbursements. Eventually, the prized Carte Vitale arrives, streamlining the process from then on. It can take months, so keeping receipts and submitting paper claims in the meantime is essential.
How much will you actually pay? That depends on the treatment. A standard GP visit costs €30, with the state reimbursing 70% (minus a small €2 fee). Hospital stays are about 80% covered, although there is a modest daily charge for accommodation. Prescription medicines are tiered: some life-saving drugs are reimbursed in full, while less essential ones may only be partly covered. Preventive care such as cancer screenings, maternity care, and treatment for long-term conditions is often fully funded.
To cover what the state does not, most residents take out a mutuelle — a top-up insurance policy that fills the gap. These policies are not compulsory, but around 95% of people in France have one. A mutuelle might cover the 30% left unpaid by the state, as well as extras like private hospital rooms, dental prostheses, hearing aids, or glasses. Since 2021, the 100% Santé reform has gone even further, guaranteeing full coverage for essential dental, optical, and hearing treatments when combined with a qualifying mutuelle. Costs vary, but on average a working family pays around €1,500 per year, while retired couples may pay more. For employees, mutuelles are often subsidised by employers, which helps reduce the cost.
Different expat groups face slightly different situations. UK retirees with S1 forms enjoy some of the easiest access, as they avoid paying French social charges on pensions. Early retirees without an S1 must either rely on private health insurance or join PUMa and pay a contribution based on their passive income. Second-home owners, meanwhile, are treated as visitors and must rely on EHICs, GHICs, or private travel insurance. Students, both EU and non-EU, follow separate rules with student health cover. Once fully registered, however, expats can apply for a CEAM card — the French equivalent of the EHIC — to access care when travelling within Europe.
Pharmacies play a vital role in the system. They not only dispense prescriptions but increasingly provide teleconsultation booths, where patients can connect with a doctor online. Vaccinations, basic health checks, and advice are also commonly available at the local pharmacy, which makes them a hub of everyday healthcare.
In an emergency, help is never far away. Dial 15 for medical emergencies, 18 for the fire brigade (who also respond to accidents), or 112 for the Europe-wide emergency number. By law, hospitals cannot refuse urgent treatment, even if you have not yet completed your registration.
For expats, the message is clear: France offers world-class healthcare, but you need to take the right steps to access it. Register with CPAM as soon as you arrive, apply for your Carte Vitale, and choose a mutuelle that matches your needs. The system may seem complex at first, but once in place, it provides security and peace of mind. Whether you’re a young professional, a retiree, or a family building a new life, you can rest assured that your health will be in good hands in France.