French Healthcare System – Health Insurance for Expats

Moving abroad always comes with tons of paperwork. One of the most important things you’ll have to take care of as soon as you are living abroad is your health insurance. As an expat in France, you are quite lucky and don’t have to spend all your money on medical costs, as France’s healthcare system is amongst the most subsidized and affordable in the world. Let’s see what exactly this country has to offer you.

French Healthcare in a Nutshell

  • The French healthcare system for foreigners (from outside the EU) is called PUMA (Protection Universelle Maladie);
  • All French residents are obliged to have health insurance;
  • The average cost of a doctor’s visit is €23 (without coverage);
  • The approximate cost of a headache remedy is €2,20 (16 x 500mg);
  • The French social security system covers 70% of the cost of your treatment.

How Does France’s Healthcare System Work?

This question has been on my mind since the moment I decided to move to France. It took me a while to get up and finally take care of everything I need – not only because paperwork is super annoying, but also because it’s so incredibly hard to find info on this topic. Now that I know everything, I can finally share my experience with you! So, let’s start with an overview of the French healthcare system. It will help you understand what you must do and why.

Public Health System in France

Every French resident must be covered by public healthcare. The costs are regulated by the law and depend on your personal income. This means you will pay a specific percentage of your earnings to the “sécurité sociale” (social security). As all employees benefit from company subsidized plans, your employer is paying another part of these contributions.

The French social security system covers 70% of the costs if you should need treatment. In case you have long-term medical problems, even 100% can be covered by the state. But what happens to the remaining 30%? Well, you’ll have to pay them yourself unless you subscribe to some kind of additional private health insurance.

Private Health System in France

As a French resident who subscribed to public health insurance, you can also subscribe for a so-called “mutuelle”. This complementary health insurance in France can cover the missing 30% of your treatment costs that are not paid by the public insurance. Not every insurance includes every kind of treatment! Figure out what you might need in the future and choose your “mutuelle” based on this.

If you work for a company, they should already be paying a “mutuelle”. This means that at least half of the additional cost can be covered by your employer.

Healthcare in France for Expats

Healthcare in France is based on an insurance system and as already mentioned, it’s mandatory to have health insurance when you’re living in France. If you are not employed (yet) or you work as a Freelancer, you will not be able to subscribe to public health insurance. In this case, you need to make sure that you are covered by a private local or expat health insurance.

It’s been only a few years now that expats living in France have access to a new healthcare system for foreigners called PUMA (Protection Universelle Maladie). It allows you to access public healthcare after you’ve been a French resident for three months.

If you have trouble finding a job in France and the income of your household falls below a certain amount, you may be eligible for the CMU-C which is a free health insurance coverage.

How to Benefit From Paid Sick Leave?

In case you get sick and can’t go to work, the first thing you should do is go and see a doctor. If you stay at home, there’s no way you can claim paid sick leave. The doctor will give you an official sick note (if not, ask for it!) that you can send to your employer. That’s all for a regular sick leave. Easy, right?

Anyway, to be entitled to paid sick leave (up to six months), in general you must have worked for at least 150 hours in the last 90 days or, in the last six months, paid social security contributions that equal 1.015 times the minimum hourly wage.

How to Register for the French Healthcare System?

If you start working in France and you’re lucky, your employer will register you for social security. After this you can register for French healthcare. For people who were born outside of France this is usually not the case, so you must do it all by yourself. But don’t worry, registering for social security and healthcare in France is not as complicated as it seems in the beginning, and if you’re lucky it will not even take 15 minutes. Just follow these steps:

  1. Open a French banc account! Without you won’t make it far…
  2. Find your local CPAM office (Caisse Primaire d'Assurance Maladie), for example on the Amelie website.
  3. Gather all the papers they’ll ask you for: passport, proof of residence, proof of address (e. g. a recent utility bill), birth certificate, visa (if you need one), and proof of income if you want to apply for CMU-C.
  4. At the same office, register for the national health card (carte vitale).

Once you have your “carte vitale”, don’t forget to take it to the doctor every time you go to see one! This is necessary to access free healthcare or claim reimbursement after your appointment.

Pro tips:

  1. You can send all your papers to your local CPAM by mail. You can find the address on the Amelie website.
  2. Don't hesitate to follow up on your case. Here's the phone number for the English-speaking hotline: +33 9 74 75 36 46
  3. Make sure all your copies are perfectly readable. Don't print a scan, provide a birth certificat with a clear stamp, etc. Don't laugh. My papers got rejected for all of this.

How to Find English-speaking Doctors?

In the beginning – if you don’t speak French super well – a doctor’s appointment can be a real challenge. But especially in big cities, finding English-speaking doctors is so easy. Here is some advice to make the research easier.

First, never forget to ask your friends or colleagues. Some of them probably had the same problem when they moved abroad, so they can give you advice or even recommend a doctor. If not, you can continue with a simple Google search or look for an embassy in your city and ask them for a list of doctors.

If you speak a little bit of French, I recommend checking out Doctolib. It’s an online portal to look for doctors in your area. The website only exists in French, but you can filter by English-speaking doctors in your city. Furthermore, it’s probably the easiest way to make a doctor’s appointment in France.

To see a specialist, you must make an appointment with your general practitioner first. He’ll give you a referral to a specialist if he thinks that it’s necessary.

Helpful French Medical Phrases

In case you don’t speak a single word French, here are the most important words you need to know.

  • Medical insurance – assurance maladie
  • Prescription – ordonnance
  • Hospital – hôpital
  • Emergency – urgence
  • General practitioner – médecin généraliste
  • Doctor – médecin
  • Medicine – médicament
  • Sick – malade
  • Sick leave – arrêt maladie
  • I need to make an appointment with the doctor. – Je voudrais prendre un rendez-vous avec le médecin.