Health Insurance in France

Here is a helpful article on getting into the French Health Insurance system

Already resident in France

If you have lived in France for more than three months then you are entitled to register within the French State health insurance system, known as Assurance maladie.

If you’re working in France your healthcare will be paid for by the French State, while if you receive a state pension from another country your home nation may pay for your healthcare, depending on bilateral agreements. If you’re not working and have not yet reached pension age, you can register through the PUMa system – but in all of the above cases you will receive a carte vitale, the card that entitles you to reimbursed healthcare.

Below are full details on how to register in the system.

Mutuelle –

the French system is a reimbursement one – you pay upfront for a medical appointment, procedure or prescription and then swipe your carte vitale. A percentage of the money is then reimbursed straight into your bank account.

Most procedures are reimbursed at around 80-90 percent, while some such as cancer treatments are reimbursed at 100 percent. You can either pay the remaining costs yourself, or take out a mutuelle – a top-up insurance policy – to cover the rest.

These are cheaper than standard private health insurance policies and if you are working, your employer is obliged to pay at least half of the cost of this – full details here.

Private health insurance

– if you are a resident it’s not compulsory to be registered within the state health system and you can if you prefer carry on paying for private health insurance.

The French health system is generally pretty good, so you are unlikely to get significantly better care if you go private, but it’s an option.

If you’re not registered in the state system you are unlikely to be called for things like routine breast cancer screening or a flu shot, so you will have to make your own arrangements.

Moving to France

If you move to France as an EU citizen you can move to France without the need for a visa and register within the state health system once you have been here for three months.

For any healthcare needs in the interim period, you can use the European health insurance card from your home country if you were previously resident in an EU country. If you are an EU citizen but not an EU resident (eg a dual British and Irish national who lived in the UK) you may need private insurance to cover you in the interim period.

If you move from a non-EU country you may need a visa and certain types of visa – primarily those for retirees or people who are not working in France – require proof of private health cover, usually for one year.

Find out more about how visas work here.

Once you have registered for the carte de séjour residency permit after arrival in France, you can then apply for the carte vitale, as detailed above.

Waiting for the carte vitale –

getting a carte vitale is not always the swiftest process. Times vary between areas, but a wait of six months is not uncommon. While you are waiting you can still access healthcare if you need it.

You pay upfront and ask the doctor or pharmacist for a feuille de soin – this is essentially a receipt and once you have your card you can use the feuille de soin to claim back the cost of any procedures that you had while waiting for the card to arrive. You can also request a feuille de soin if you have lost your card or just forgotten to take it with you to the doctor/hospital/pharmacy.

Second-home owners or regular visitors to France

Registration within the French health system is restricted to people who live here, so if you are just visiting France you will need to look at alternatives.

If you are visiting from an EU country you can use the European health insurance card to access healthcare – countries within the EU have agreements that they will pay for emergency healthcare needed by one of their citizens visiting another EU or Schengen zone country.

British visitors can no longer use the EHIC, but can use the new GHIC card, which France has agreed to recognise.

However, both the EHIC and GHIC cards will only pay for emergency or unplanned treatments and almost never cover the cost of repatriation, so travellers are always advised to have travel insurance with health cover as well.

Visitors from outside the EU cannot benefit from the EU health agreement so will need to have either health insurance or travel insurance in order to cover the cost of any treatment needed in France.

French hospitals are legally obliged to treat you if it is an emergency, so you won’t be turned away, but you could end up with a hefty bill for treatment if you are not insured.

https://www.thelocal.fr/20190418/how-to-get-a-carte-vitale-and-why-you-need-one-in-france/

How to get a carte vitale in France and why you need one

Applying for the health card carte vitale will get you free or discounted healthcare, but it will also make sure you are in the French social security system.

The carte vitale grants you a refund on the cost of healthcare.

The carte vitale is the national French health insurance card that allows those who have one to have most or all of their health costs either covered or reimbursed by the state.

The cards work mainly as a reimbursement system – when you have a doctor’s appointment or are prescribed medication, you pay upfront to the doctor or pharmacist.

They then swipe your carte vitale and the government reimburses some or all of the cost directly back into your bank account.

The card doesn’t pay for all of your medical costs unless in serious cases like cancer or heart disease.

How much is covered by the state depends on the treatment or action taken by the doctor. For example the rates of reimbursement depend on the specialist you see or the type of scan you get.

In general for dental treatment the rates are much lower.`

Carte Vitale: How It Works And How to Apply As An Expat

So who pays the rest of the bill?

Most people have top up health insurance – known as a mutuelle – to cover the difference (or most of it) between what the state pays via the carte vitale and the total fee.

Anyone who is working in France or who has been legally resident for more than three months is entitled to the carte vitale and it is not means tested.

Until now, many British people living in France have relied on the European health insurance card, what used to be called the E111.

However it is advised that these people now get a carte vitale, firstly because the European health insurance card won’t work after Brexit, and second because it is another way of ensuring that you are “in the system” in France.

So how to go about it?

Like most things in France, it will probably involve a lot of paperwork, but the system itself is relatively simple.