Health Insurance in France: An Expat’s Guide for 2019

If you’re moving to France, you will want to ensure you have access to an incredible healthcare system. You’re in safe hands as France was ranked in position 1 by WHO as having one of the best healthcare systems in the world.
Allow us to walk you through what you can expect & how health insurance works when moving to France.

Health Insurance in France

French health insurance is funded by the government through its taxes. With this, public health insurance shoulders 70% – 80% of the medical fees and lets the patient pay for the rest. Thus, alleviating the financial burden associated with providing high quality state medical services.
The French state health insurance system works through reimbursements, resulting in lower medical fees. And since France has both public and private healthcare, most residents can also utilise a private insurance provider to shoulder the remaining fees. The French healthcare system also covers 100% of medical expense for residents with serious illnesses like cancer. This ensures that the sickest pay the least medical fees.
In 2016 a new healthcare system called PUMA or Protection Universelle Maladie granted expats access to the country’s health insurance system with lighter conditions. As opposed to the older healthcare system, CMU or Couverture Maladie Universelle. Expats are now eligible for health insurance if:

  • They are living in France for three consecutive months
  • They remain legal residents regardless of changes in their financial stability and personal circumstances

Upcoming Healthcare System changes in France for 2019 In September 2018, French President Emmanuel Macron announced new strategies for the French healthcare system for the coming years.
The new strategy aims to:

  1. Save time – This aims to remove numerus clausus – a method to limit the number of medical students
  2. Set up a community of healthcare professionals that will address the medical needs of the population in a certain area
  3. Quality health system – Prioritising patient experience as the basis of the quality of care

This new strategy will be invested with an additional 400 million euros for 2019 National Health Insurance Spending Target.
Eligibility for state health insurance in France
As much as the French government wants healthcare for everyone, certain conditions must be met to benefit from state health insurance. These include:

Legal French Residents

For expats living in France, French residents are defined by the new healthcare system as:

  • Expats who have lived for three consecutive months in France.
  • Undocumented immigrants that have residency.

Members of the French Workforce

Health insurance for expats who are working in France is obtained through the French social security system contributions. For detailed information on contributions consult Unions de Recouvrement des Cotisations de Sécurité Sociale et d’Allocations Familiales (URSSAF).


Any citizen of the EU and EEA (European Economic Area) visiting France as tourists can gain healthcare through their EHIC or European Union Health Insurance. As for other nationalities, the state covers their emergency medical care.

European Economic Area and British Retirees

Retirees who live in France and are committed in staying long term.

Minor Residents 16 years old and below

All minors regardless of nationality that are 16 and below are automatically under the state health insurance.

State Healthcare Coverage in France

The Ministry of Health manages the state healthcare and classifies citizens into categories as mentioned above. But generally, state health insurance covers around 70% of the costs for seeing a doctor, dentist or specialist, 80% for hospital fees and up to 100% of prescribed medication. A full list is detailed below:

  • Hospital care and treatment in public or private rehabilitation or physiotherapy clinics
  • Outpatient care by general practitioners (specialists, dentists and midwives)
  • Diagnostic services
  • Prescription drugs
  • Medical appliances
  • Prostheses (for approval)
  • Health care–related transportation
  • Home care
  • Long-term hospice (partial coverage)
  • Mental health care
  • Vision and dental care(Co-insurance)
  • Immunization
  • Mammography
  • Colorectal cancer screening

Dental care is covered under state health insurance but comes with separate repayment rates. Standard treatment is typically reimbursed the same way as care falling under specialist category, whilst advanced treatment will cost you more.

Free health insurance for unemployed & low-income workers

With PUMA still in place, CMU–complémentaire (CMU-C) is available and provides free health insurance for low income or unemployed citizens. ‘Inactive’ expats under the age of retirement are entitled to access the CMU-C, as long as they have registered under PUMA.
To be entitled for the CMU-C programme household income must be below the income threshold, the figures for April 2019 – April 2020 are provided below:

No. of Family Members
One Person
Income €8,951
Two People
Income €13,427
Three People
Income €16,112
Four People
Income €18,797
No. of Family Members Income
One Person €8,951
Two People €13,427
Three People €16,112
Four People €18,797

State Health insurance rates of contribution

The current standard contribution to PUMA is 8% of eligible income above the minimum threshold.
If your earnings are below the minimum thresholds you may not need to make health care contributions. It is best to research this further to understand the details as they apply to your specific situation.

How to apply for French health insurance

Applying for the French health insurance can be achieved in a few simple steps. You need to register with your local health authority (Caisse Primaire d’Assurance Maladie – CPAM), that includes an application form, that you provide along with your legal documents and proof of income so that your contribution level can be evaluated.
For more details on how to start your application, click here.
It can take time for your application to be reviewed, so please allow for this when planning your move.

Private health insurance in France: Why consider it?

Private health insurance takes care of the excess amount that’s not covered by the state. It bridges the 30% gap left by the state healthcare insurance cover, however it doesn’t guarantee you’ll get quicker treatment by private practitioners.
Private insurance will cover you for more specialist consultations that the state won’t including chiropractors, osteopaths, psychologists and other specialists. Additionally, if you have a pre-existing illness private insurance will ensure you receive the same treatment as you would at home.
The cost depends on the type of cover you require and other factors such as age. Basic packages usually focus on hospital care and medication but may have limited cover for things like dental treatment.
State health insurance doesn’t cover a citizen whenever he/she travels internationally. This is something you may want to look for with a private insurer if you travel a lot for business or leisure.
It’s wise to do your research into various companies and policies to find the best cover for you. It’s also a great idea to check whether your employer offers private cover as a benefit, which could save you money.
As part of your planning it’s important to check and understand that you have adequate health care cover at all times. If you are planning to make the most of the excellent public healthcare in France, make allowances for the time that the application process can take and research the application process in detail, to ensure that you will receive the cover you want.
We hope this article helped to answer any questions you have on health insurance for expats in France. If you need any help planning a move get in touch and let our international moving team help.