How the healthcare system works
Healthcare in France is not free. GPs and many specialists are paid upfront.
This money is then reimbursed through two different systems, the state and an optional private health insurer or mutuelle.
The state will reimburse money at a certain percentage of a pre-arranged fee. Your top-up insurer, depending on the contract, will then pay some – but not necessarily all – of the rest.
The way in which your healthcare is covered in France will vary according to whether you are an early retiree, state pensioner, coming over to work or start a business.
Your European Health Insurance Card should cover you for any health problems you encounter during the short initial transition period.
Useful tip:
- You must choose and register with a GP (médecin traitant) if you want to get the full levels of reimbursement available. If you do not follow the normal procedure and go straight to a specialist, you will be liable to pay more.
In the full Moving to France helpguide, we explain:
- Finding doctors and choosing a GP
- Documents you might need to provide
- Fees charged by GPs and specialists
- How state and private health refunds work
- Getting and using a Carte Vitale
- Getting top-up insurance
- How a mutuelle works
- Health cover for state pensioners
- The situation for early retirees
- How the self-employed are covered
- Basic medical rights: the CMU
Download the guide as a PDF now from this link
…or ask a question about this topic in the comment box below.
I am Canadian if I apply for permanent residency from Canada via French consulate if and when I arrive in France I understand I need to purchase private health insurance. However, how long after can I apply for French health care system?
Thank you
Wally
[Reply]
Moving to France editor Reply:
January 18th, 2012 at 9:14 am
Exclusive Healthcare respond:
“Dear Wally, if you wish to reside in France for more than 90 days, before you leave Canada you must apply for a long stay visa in person from the French Consulate which serves the area where you live. One of the visa’s conditions is to have health cover. Please note that all private health insurances can have exclusions for pre-existing medical conditions.
As regards applying for the French health system, you would need to discuss this with the French health authorities when you are resident in France.
This reply is solely confined to the question you have asked. It is preliminary in nature and may contain references for you to research your personal circumstances to greater degree. It does not and cannot replace any professional advice you may need. As regards public bodies charged with implementing the law, only such official bodies are empowered to give you an official answer.
[Reply]
I am a UK citizen moving to France and wont be working, my husband will be working abroad(not France). Am I entitled to free health care in France? Do I need to register? Or can I as in UK make a NI contribution to cover me? Plan is to have a baby in the future. Will my huband be covered?
Thanks
[Reply]
My husband and I are looking to permanently settle in France. We are early, self funded retirees (58yrs and 62yrs) and have been renting in Switzerland for the past year . I hold dual citizenship , swiss/australian, and my husband is australian. Would we be able to enter the french state health system at 60yrs and 65 yrs respectively or must we wait till we have been residents for 5 years.?
Where could I find more information/quotes on private health care as i am having trouble getting an idea of annual costs.
My husband has his swiss residency permit B ,does this have any significance in obtaining a visa to reside in France?
Thanking you in advance for your help.
Nicole
[Reply]
We have lived in Australia for 31 years, we both hold dual citizenships – my husband is originally from UK, I am from Poland. We’d like to move from Australia to France for retirement. My husband is 66 and receives full UK State pension.
Can he obtain S1 form so that he has full healthcare cover in France? Would I be covered under his S1 as his dependant? (we’ve been married for 25 years)
[Reply]
Hi, after taking early retirement my wife and I moved to France in 2006. We applied to join the French health system but were refused on the grounds that I was “inactif” i.e. not working and too young to retire.
It is not clear to me if I can re-apply after a certain number of years or if I reach a certain age (I will be 60 in November). Can you help with this information?
I have private medical insurance (UK based but covers all the Eurozone) which is becoming increasingly expensive. A second question for you is what percentage of my pension would I have to pay to join the French system?
Thank you for your help with this.
Terry Blom
[Reply]
Moving to France editor Reply:
November 21st, 2011 at 12:06 pm
Hi Terry,
It is surprising you were refused access on grounds of being “inactif” in 2006. Until autumn 2007 most early-retirees coming to France joined the “CMU” system, a way of joining the French national health system without having paid into the French social security system. At that point, however, France tightened the rules and said such people needed to take out private insurance instead. However after an initially draconian attitude they agreed people who were already in the CMU, or who were getting healthcare via European E106 forms on the expectation of joining the CMU when they expired, could stay in it/join.
Under the latest rules “inactive” newcomers can apply only if their circumstances change in some unexpected way after they came to France – that is unless they have been here five years, as you have. In your case you can apply to your prefecture for a “permanent” residents’ card, entitling you to join the CMU.
The CMU is free for those under €9,164 income per year (revenu fiscal de référence, as shown on your income tax demand) or otherwise at 8% of income above this.
[Reply]
Complicated question…. married US citizen is pregnant with French resident’s (not her husband) child. If she joins him in France before the baby is born, does she qualify for healthcare that would cover the cost of prenatal care, delivering the baby, and after care for both?
[Reply]
Moving to France editor Reply:
August 23rd, 2011 at 9:48 am
Exclusive Healthcare reply:
US citizens need a visa to enter France and, for a stay of more than 90 days, a long stay visa would be required. Only this lady’s French Consulate serving the area where she lives in the US is empowered to grant this visa and personal appearance at the Consulate is mandatory. The visa must be obtained before arrival in France. One of the visa conditions is to furnish an attestation from an insurance company stating that she will have medical coverage valid in France. Pregnancy is a pre-existing medical condition and would normally be excluded from a health insurer’s policy.
She is pregnant with a French resident’s (not her husband) child and he may wish to contact his CPAM to see whether there exist any extenuating grounds in her case concerning the granting of a visa. In this context, the following factors are important:
(a)the formal recognition of the baby by the father
(b)the rules concerning a ‘Union Libre: protection sociale’ as fully set out on http://www.service-public.fr
This states that if he lives maritally* with his concubine and that if he is an ‘assuré sociale du régime général” and that if she is effectively, totally and permanently dependent on him (‘à sa charge’), then she may be his health beneficiary (‘ayant droit’) and be covered for ‘ l’assurance maladie-maternité’
*”Living maritally” is intended for situations which are commonly regarded as a marriage but which do not constitute a marriage.
The above reply implies that liaison between the French Consulate and CPAM would be necessary.
[Reply]
I have a small business in France, which is under the regime Micro entreprise. I have been doing business and paying RSI cotisations since 2003. I have also got private health insurance, which covers both the obligatory 70% and a mutuelle of 30%. A neighbour has recently told me that because I pay RSI cotisations, I have no need to pay the 70% health cover, as I automatically qualify for health cover with my RSI cotisations. Can you confirm if this is the case? If so, should I be reimbursed by my private health insurance?
[Reply]
Moving to France editor Reply:
July 18th, 2011 at 9:33 am
Exclusive Healthcare recommend that you check this with your French accountant. They should be able to explain why they advised the business set-up you are under, and what your regime means.
[Reply]
As an “early retiree” I understand that there is a transition period where you would be covered by form E106 (now S1) for entry into the French health-care system, but that this depends upon recent National Insurance contributions in the UK. Both I and my wife have made sufficient contributions over the years to qualify for a full UK pension, but neither of us have worked for the past 2 years and will not reach UK retirement age for a few more years. Does this mean that we would not qualify for any period of French health-care were we to move to France next year? Would it be worth-while making voluntary NI contributions for a year?
[Reply]
Moving to France editor Reply:
June 22nd, 2011 at 10:28 am
The Exclusive Healthcare team respond:
Dear Tim, it is true that an S1(former E106) may be able to be issued
by the Dept of Work & Pensions(DWP) in respect of inactive (i.e.
non-working) UK people who wish to reside permanently in France. This
DWP/S1 is only valid for a limited period, which period depends on your
UK/ NIC record in the last two to three years. If granted, this S1 gives
basic French State healthcover at UK expense during the period of its
validity. Only DWP is empowered to give you an official answer, so please
contact them at : Overseas Medical Benefits , Benton Park View, Newcastle
upon Tyne, NE98 1BA ENGLAND Tel 0044 191 2181999
If you take up work (either employed or self-employed) in France during
this period this would invalidate this S1 and you are then legally required
to affiliate to French Social Security which covers for basic French State
healthcare (and other aspects).
Turning now to your last sentence, it may be worthwhile making voluntary
UK/NIC’s in respect of your UK State Retirement Pension , but this does not
give you any rights to basic French State health cover. Again, please
contact DWP to see whether you need to make voluntary NIC’s. When you are
in receipt of a UK State Retirement Pension, you then become entitled to
an S1(former E121) which covers you for basic French State Health cover at
UK expense.
[Reply]
I am a british citizen and have been living South Africa. I married a South African girl ( SA Citizen ) in 2009. I am an early retiree aged 64. We will be moving to France at the end of April this year. I have been paying National Insurance and have applied for an E106 health card. I would like to ask, assuming I am granted an E106, will my wife be covered in anyway on my E 106. If not what medical insurance options exist to cover her medical expenses should they arise. Thanking you for your assistance, look forward to hearing from you soon. Regards. Malcolm
[Reply]
Moving to France editor Reply:
February 23rd, 2011 at 3:54 pm
Exclusive Healthcare replies:
Dear Malcolm,
Assuming the Dept of Work and Pensions grants you health form S1(exE106) as an inactive early British retiree, then your French health office(CPAM) can decide to add your wife to your S1 as your health beneficiary, but you cannot do this until you are both resident in France.
However, in this context your wife’s country of residence is important. You do not say whether you and your wife are presently resident in SA or resident in the UK. Assuming your wife only has SA nationality and is currently resident in SA, she would need to apply for a visa to a French Consulate in SA beforehand in order to enter France. One of the visa conditions is to be covered for health, and Exclusive Healthcare can provide a health policy and attestation needed for the visa.
On the other hand, if you are both in the UK and your wife has been accepted as legally resident there, she would be coming from one EU Member State to another. In view of this, whether she would still require a visa to enter France only the Consulate-General of France in London can advise you – and in particular you should bring to their attention the fact that she would be your S1 health beneficiary once registration is effected at CPAM.
[Reply]
Exclusive Healthcare responds:
Dear Tim, you ask what “being employed” means and how to fit in the French healthcare system. In general you can either work as an employee or as a self-employed person. To receive basic State health cover for one year you must have worked in salaried employment in France for at least 60 hours during one month or at least 120 hours during three months. The “chèque emploi service universel” is one way achieving this and provides legal protection for both employee and employer.
Turning now to working in a self employed capacity, as an auto-entrepreneur: to the best of my knowledge there is no minimum sales or services requirement for up to two years. You ask whether it would be worth it instead of buying insurance. The answer has to depend on the success or not of your business, and you may consider it prudent to seek advice from a business professional concerning your particular venture. Meanwhile, you can of course buy the Connexion Helpsheet entitled ‘Auto-Entrepreneur” to inform yourself further.
[Reply]
Tim Blakemore Reply:
June 17th, 2011 at 11:47 am
Thanks for the prompt reply. I’ve obtained and read through the Connexion Helpsheet and it is very informative. However the relevant section says, in connection to Social Charges which are based on turn-over : “state health insurance cover (nb. You are not entitled to any cover if you make no money from the business)”. Ok – but HOW MUCH does your turnover have to be in order to obtain health-care cover!?
As far as I can see, the costs of setting up an auto-entrepreneur business are minimal (assuming you can meet the qualification requirements), and so the success of the business is not relevant UNLESS there is a minimum turn-over requirement for health-care purposes. I’m not seeking to get something for nothing, by the way, but it would be a great incentive to start a auto-entrepreneur business if it also got you into the health-care system.
[Reply]
Moving to France editor Reply:
June 22nd, 2011 at 10:30 am
The Exclusive Healthcare team respond:
Dear Tim, o
the best of my knowledge there is no minimum turn-over requirement for up to
two years. Quarterly returns have to be made even if there is no turn-over.
Auto-entrepreneurs must affiliate to the RSI (‘Regime Social des
Indépendants’), whose web site http://www.le-rsi.fr
contains a considerable amount of detailed information concerning
self-employed people (including auto-entrepreneurs). Only your local or
regional RSI is empowered to give you an official answer to your question.
[Reply]
Exclusive Healthcare responds:
Dear Jacqueline, you ask about the need to have top up health insurance because you are covered at the 100 per cent reimbursement rate for your listed serious illness. The confirmation letter from your health office has no doubt made clear that this rate applies only to that illness.
Because another illness or medical problem could arise, it seems prudent to cover this risk, particularly in the case of hospitalization where the normal reimbursement rate is 80 per cent and the remaining 20 per cent may turn out to be significant in some cases. As an insurer, our policy is to leave this question to the judgment our clients.
[Reply]
An early retiree moving to France will only have a limited period of “free” health care, I know. It is said that if you are employed, you can fit into the French health-care system, however. But what does “being employed” mean? If I was a properly registered auto-entrepreneur, would I have to earn a minimum amount in order to qualify? If so, would it be worth it (ie, paying social charges) rather than buying insurance?
[Reply]
With a poly-arthritic condition I qualify for 100% cover under the french medical system. Do I then need to have top up medical insurance?
[Reply]
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