We often get asked questions about healthcare for expats in France. This is especially true for our older audience — retirees hoping to move abroad, folks over 50 who decide to make a life for themselves in Paris or elsewhere — they want to make sure they’ll have coverage.

It’s no surprise that Americans are concerned about this as our healthcare system is one of the most complicated, expensive, and challenging ones in the world (I said what I said). For many, healthcare is one of the biggest unknowns when moving to France. 

The good news is that France consistently ranks among the best in the world for quality and accessibility of care. I have had nothing but good experiences with healthcare in France (okay, maybe I’ll admit the one dentist I saw wasn’t the best), and I found it easy to navigate once I got the hang of it. 

We’ve already written about our experiences with osteopaths and chiropractors, how to get a numéro provisoire to get your carte vitale and sign up for a mutuelle, and the differences between the CSS and top-up insurance, but I wanted to create a deep dive to hopefully help quell some of your worries.

While the system may seem intimidating at first, healthcare for expats in France is surprisingly affordable and reliable once you understand how it works.

The Basics of French Healthcare

France operates on a universal healthcare system called the PUMA (Protection Universelle Maladie). This means that every legal resident — yes, including legal expats — is entitled to coverage. When you go to the doctor or a hospital, the state pays a percentage of your medical costs and you’re responsible for the rest.

The golden ticket to benefiting from this system is the carte vitale. This small green health insurance card is tied to your French social security number, and when you hand it over at the end of appointments or at pharmacies your reimbursement is processed automatically. 

Once you arrive, securing this card is one of the first big steps toward fully integrating into life in France.

Who’s Eligible and When

Generally anyone with legal residence in France can access the system. Non-EU expats (like Americans) typically have to wait three months after their arrival before they can apply. 

Students, salaried workers, and retirees each have slightly different processes:

• Students are often enrolled through their university (this is how I first obtained mine way back when!).
• Employees are usually registered by their employer.
• Self-employed expats and folks on the visitor visa (including retirees) need to apply directly through their local CPAM (Caisse Primaire d’Assurance Maladie). We have a full article on this process!

While you wait for approval, we typically suggest you stick to the private health insurance you were required to have for your visa application. Cigna Global has great options for expats, as does AXA.

What’s Covered and What Isn’t

One of the best surprises about healthcare for expats in France in my opinion is just how much is included. Doctor’s visits, specialist appointments, hospital stays, prescriptions, and maternity care all fall under the state system. Most GP visits cost around 25 €, and the government reimburses about 70% of that (color me surprised at my first appointment when I only owed 7.50 €!). Hospital stays are reimbursed at 80%, and chronic conditions are covered 100%.

The biggest gap is in dental care, eye care (including glasses and contact lenses), and certain specialists. I personally found the cost to be nominal coming from the US, but after some encouragement from my mother-in-law, who was choquée that I didn’t have top-up insurance to cover it, I did end up signing up for a mutuelle to help cover the costs (more on that later).

One thing to note if you’re still waiting on your carte vitale — save your receipts. You’ll be required to pay up front, but as soon as you receive your card, you can submit your feuilles de soins for reimbursement later. And yes, I can confirm they actually do reimburse you.

The Role of the Mutuelle

A mutuelle is France’s version of supplemental private insurance, or “top-up” insurance. You can think of it as the add-on that fills any gaps left by the state. A typical mutuelle covers the remaining 30% of GP visits, plus higher percentages of dental and eye care.

Don’t let the word “private” fool you, it’s still very affordable especially coming from the US. You can expect to pay anywhere from 30 € to 100 € per month, depending on the coverage you choose. I wear glasses and contact lenses so I decided to get a plan somewhere in the middle and paid around 45 € per month. Most, if not all, of my appointments were covered and my glasses and lenses were very inexpensive.

For any of our salarié readers, if you’re employed in France your company is legally required to provide a mutuelle, and it’s usually one with very good coverage. Freelancers, students, visitors, and retirees need to shop around for themselves. I like Harmonie Mutuelle myself.

Tips for Using the System

Once you’re set up with your carte vitale and mutuelle (if you choose), daily life within the French healthcare system is very straightforward:

• Finding a doctor: USE DOCTOLIB. It’s the easiest way for expats to find a doctor, especially if you haven’t made French friends yet who can recommend one. You can even set filters for providers who speak English. If you’re in the Paris area, I loved my team at Ipso.
• Appointments: Remember to bring your carte vitale so you are reimbursed automatically. Otherwise, save your receipts to submit later.
• Pharmacies: You’ll also need your carte vitale to pick up prescriptions. Another thing to mention: don’t be afraid to ask your pharmacist for advice on medications. I’ve found that they are incredibly helpful and knowledgeable and they served as an invaluable resource for me.
• Emergencies: Don’t call 911 and expect to receive help. Instead, dial 15 for the SAMU (medical emergency line that can connect you to ambulances).

The one caveat about the French healthcare system that I feel called to share is that not all French doctors are well-trained in bedside manner. I do believe this is changing as more time goes on, but like many things, don’t expect to receive the same exact experience as you would in the US. 

The care is just as good, don’t get me wrong, but you likely won’t be coddled in the same way you would in America. Honestly, this is good advice to heed when it comes to adjusting to life in France as a whole (just saying).

Healthcare for expats in France may seem intimidating at first glance, but once you take care of the necessary paperwork, it will quickly become one of the more reassuring aspects of life there. With universal coverage, reasonable costs, and a mutuelle to handle all of the extras, feel confident that if something happens, you’ll be well cared for.

Photo by Annie Spratt on Unsplash

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