Don’t miss Part 1 of this series on Living in France as a Retiree

Health Insurance

When you first apply for your long-stay visa for your first year in France, you are required to prove that you have health insurance. The less expensive way of getting it, for me, was via the visa website; it cost about $500 for the entire year, but it was not comprehensive, i.e., not for preventive healthcare, but rather for emergency situations.

Be aware that basic Medicare covers nothing outside of the United States. Some supplemental plans may cover expenses in other countries after a deductible is met.

After you have been residing in France for three months, you can apply for a numéro de sécurité sociale (social security number, which is not the same as Social Security in the United States). You’ll need proof of residence, a birth certificate, and your passport/visa. Usually the application is mailed to the local CPAM office. CPAM (Caisse Primaire d’Assurance Maladie: national health insurance) will probably request additional information by mail or have you fill in a questionnaire. 

The process can be quite daunting and appear illogical. You may be asked for the same document again and again, and then suddenly discover that you’ve been covered for a year! (You can request reimbursement for expenses incurred in the meantime.)

To apply:

• Your name must be the same on your birth certificate and your passport. If not, you will need to prove that you are the same person through your consulate, and if there’s no consulate only an embassy.
• If you live with someone without being married or “PACS‘ed” (officially partnered) you may be considered a concubine. It doesn’t have the same connotations as in English, or at least it’s not limited to those connotations. 
• The CPAM agents usually answer any questions you may have on the phone, and while they are very polite they have little time to speak at length. Telephone number: 3646 (within France). You can request an English speaking agent when you call.
• You’ll need a French RIB (Relevé d’Identité Bancaire, or bank identity) in order to be reimbursed.
• To find your local branch, use the Adresses et Contacts (addresses and contacts) section on the Ameli website.
• More information on French healthcare in English.

Once you have your French social security number, you must request the carte vitale, the health insurance card, which will then be mailed to you. The card is used by medical providers to enter your information, when you fill a prescription or visit a doctor.

Some areas of France are medical deserts, with few medical facilities. In larger towns, you’ll find many hospitals and medical practices, but wait times for specialists can be long and some don’t accept new patients. In Nice, where I live, it’s hard to find a dermatologist — they are often busy with cosmetic procedures!

There are different tiers of medical practices; for some, you don’t need to pay anything over the basic reimbursement offered by health insurance; for others, you’ll pay more. For tier 1 medical practices, you will often pay nothing out of pocket; the national health insurance will handle it.

You can also buy supplemental insurance, through a mutuelle, in a dizzying array of levels. A basic mutuelle subscription might cost €40 a month, and help pay for hospital stays, which can be very expensive. Higher premiums will help pay for hearing aids, glasses, higher-tier medical practice fees… the second year, I used a broker to help me choose.

Nursing Homes and Assistance for the Elderly

In the US, nursing homes often cost much more than many of us can afford, especially in larger cities on the coasts. In France, they are not inexpensive, but appear to be more affordable. There are a variety of systems.

There are senior living facilities for seniors who are well enough not to need assistance, mainly for people who would like to have a community, and in-house facilities.

EHPADs (Établissements d’Hébergement pour Personnes Âgées Dépendantes) are like our medicalized nursing homes. They are meant for people over 60 who need daily assistance. As far as I know, in 2025 they cost about €4,000 a month, but it varies. If you don’t have enough income, you may be able to stay at a lower cost, but when you pass, the difference will be taken out of your estate.

• Public (government-run) homes cost less than privately-owned homes (nonprofit or for profit).
• For more information (in French)
• For a list of locations separated by area: Assistance Retraite (in French)

There are also agencies offering in-house care for a fee. I’m not sure, but if your income is below a certain level, and you are disabled or recovering from a hospital stay, you may be eligible for help paying for a nurse or a cleaning person.

In general, France is a good country to age in, once you have surmounted the bureaucratic hurdles! In my personal view, single-payer insurance is much better than the US system of many disparate for-profit insurance companies, especially as so many get left behind.

Some additional informational websites:

• Welcome to France: Registering for Social Security (not just for retirees)

Photo of Mont Boron in Nice

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