How Healthcare Works in France

Who this is for

Key tradeoffs

Important considerations that affect most people in this situation.

The public healthcare system

France operates a universal healthcare system through Sécurité Sociale. Coverage is based on residence, not employment, making it accessible to most legal residents.

• PUMA (Protection Universelle Maladie) provides basic coverage to all stable, legal residents of France. You qualify after 3 months of residence
• Sécurité Sociale reimburses a percentage of approved medical costs (typically 70% for doctor visits, higher for hospital care and serious conditions). You pay upfront, then get reimbursed
• You choose your own médecin traitant (primary doctor) and can access specialists either through referral or directly (with lower reimbursement for direct access to specialists)
• The Carte Vitale is your health insurance card. It's a green card with a chip that stores your insurance information and streamlines reimbursement
• Hospitals include both public (hôpitaux publics) and private (cliniques). Both can be accessed through the public system, though private hospitals may have additional fees
• Prescriptions are partially covered. Pharmacies are widespread, and pharmacists can advise on minor conditions

Complementary insurance (Mutuelle)

Most French residents pair Sécurité Sociale with a mutuelle—private complementary insurance that covers what the public system doesn't.

• Mutuelle typically covers: the remaining 30% of standard care, plus better dental coverage, optical (glasses/contacts), and sometimes alternative therapies
• Employers often provide mutuelle as a benefit. If you're employed in France, your employer is required to offer complementary coverage
• Self-employed and non-working residents purchase individual mutuelle policies. Costs range from €30-100+/month depending on coverage level
• Major mutuelle providers: MGEN, Harmonie Mutuelle, Malakoff Humanis, Alan (digital-first). Many smaller regional options exist
• Coverage levels vary—basic plans cover essentials; premium plans include private rooms, full dental, and optical budgets
• CSS (Complémentaire Santé Solidaire) provides free or low-cost complementary coverage for low-income residents

Registering for healthcare

Registration happens through CPAM (your local health insurance office). The process requires documentation and patience.

• Apply to CPAM after 3 months of stable residence in France. You can apply earlier but processing may wait until you meet the residence requirement
• Required documents typically include: passport, visa/titre de séjour, proof of French address, proof of residence duration (rental contract, utility bills), birth certificate with certified translation
• Non-EU citizens may face additional scrutiny. Having your visa situation clearly documented helps
• Processing time: weeks to several months. During this period, pay out of pocket and keep all receipts for retroactive reimbursement
• Once approved, you'll receive an attestation (paper proof) first, then your Carte Vitale (usually within a few months)
• EU citizens with an EHIC/GHIC can use it for temporary coverage while waiting for permanent registration
• The ameli.fr website and app manage your account, reimbursements, and Carte Vitale once registered

Using French healthcare

Once registered, accessing care is straightforward. Understanding the system's structure helps you navigate it efficiently.

• Choose a médecin traitant (primary care doctor) and register this choice with your CPAM. Higher reimbursement when you follow the parcours de soins (care pathway) starting with your primary doctor
• Direct specialist access is possible but reimbursement is lower. Some specialists (gynecologists, ophthalmologists, psychiatrists) can be accessed directly at full reimbursement
• Appointments can be booked directly with doctors or through Doctolib (widely used online booking platform). Same-day appointments are possible, especially in cities
• Tiers payant — at pharmacies and some doctors, you only pay the non-reimbursed portion upfront if you have your Carte Vitale. Otherwise, you pay full price and get reimbursed
• Hospital care — for planned procedures, your doctor coordinates referrals. For emergencies, go to urgences (emergency room) at any hospital
• SOS Médecins provides house calls for non-emergency situations when doctors' offices are closed

What healthcare costs

French healthcare is affordable once you're in the system. Understanding the cost structure helps you budget.

• Standard doctor visit (généraliste): €26.50 base rate, 70% reimbursed = €7.95 out of pocket before mutuelle
• Specialist visits: €30-60 depending on specialty, 70% reimbursed. Sector 2 doctors can charge above standard rates
• Hospital care: 80% covered for most stays, 100% for serious conditions and long hospitalizations. Daily charge (forfait journalier) of ~€20/day for room and board
• Prescriptions: variable reimbursement from 15-100% depending on medication classification. Generic substitution is common
• Dental: basic care mostly covered, but prosthetics and orthodontics have significant out-of-pocket costs. Mutuelle coverage for dental is important
• Optical: minimal Sécurité Sociale coverage. Mutuelle typically provides a budget every 2 years for glasses
• Emergency care: covered, but urgences may have longer waits for non-emergencies. Clinics and SOS Médecins handle many urgent-but-not-emergency cases

Healthcare before registration

The gap between arriving and being registered in the French system requires planning.

• Private travel/expat insurance covers you initially. Required for many visas. Keep it active until Sécurité Sociale registration is confirmed
• EU citizens can use EHIC/GHIC for temporary coverage. This is meant for temporary stays, not permanent residence, but provides a safety net
• Paying out of pocket is expensive without insurance. A specialist visit might cost €50-80+, hospital stays run hundreds per day. Avoid being uninsured
• Keep all receipts and prescriptions. Once registered, you can often claim retroactive reimbursement for care received while your application was pending
• Some employers provide private insurance during the transition. If employed, check what coverage your contract includes
• Registration delays are normal. Plan for 2-4 months before you have full access to the system. Don't let insurance lapse during this period

Next steps

Continue your research with these related guides.