Health insurance in France for foreign expats

From elegant cities to picturesque villages, France has something for everyone. With its world-famous cuisine and laid-back way of life, it’s not difficult to see why so many people choose to move there.

As if all that wasn’t enough, France also has one of the best healthcare services in the world1. And, with a thriving expat community throughout the nation, the good news is that it’s easily accessible and designed to look after everyone equally.

So, whether you’re moving to Paris to start a new job or retiring to the French riviera, you’ll be in safe hands if things don’t quite go to plan. Here’s a simple guide to help you understand the system a little better and understand what you’ll need to consider before you make your move.  


The French healthcare system is considered to be among the best in the world1. It offers low-cost, high-quality, accessible care to all its citizens and long-term residents. 

The French government dedicates over 10% of its GDP (Gross domestic product) to public healthcare2. This has helped the country improve its quality of care, medical innovation and the overall numbers of doctors, nurses, midwives and specialists.

Both public and private hospitals are usually well-equipped with modern facilities, and you shouldn’t have to wait too long for an appointment to see a doctor – often an appointment will be made that same day. France also offers free check-ups to citizens over the age of 16 with a view to catching issues early. And, because the country is at the forefront of medical research, there are often a wider range of treatment options and medications available compared to other countries.

France’s universal healthcare system is called Protection Universelle Maladie (PUMA). It ensures healthcare is available to all French citizens, regardless of age, wealth or status. 

If you’re moving to France, you’ll be eligible to register with PUMA and get healthcare cover through the state-run public health insurance scheme – L’Assurance Maladie. You’ll just need to have lived in the country for three consecutive months, with the intention of spending at least six months of the year there. 

It’s mandatory for all French residents to have some form of health insurance,  L’Assurance Maladie is the minimum requirement. If you’re going to be working in France, this will be paid for through automatic salary deductions, while low-income or unemployed workers can apply for free cover.

This state health insurance usually covers around 70% of GP costs, 80% of hospital visits and even the full cost of some medications. You’ll usually be asked to pay your medical bill up-front and then be reimbursed the appropriate amount through the state insurance scheme. Many French citizens then take out private health insurance to cover their remaining costs, while anyone not registered to the PUMA scheme needs to get a private healthcare policy instead.

Like a lot of other European nations, the French healthcare system is insurance-based. It’s a requirement for all French residents to have some form of health insurance, whether that be public, private or both. Expats who have lived in the country for more than three months are subject to the same requirements as the locals and the public healthcare system is accessible to all. There are different ways of accessing it, depending on your situation.

1. As a resident: 

Once you’ve been a resident in France for at least three consecutive months, you can register for public healthcare through your local Caisse Primaire Assurance Maladie (CPAM) office. Along with a passport, you’ll need to show proof of your address in France (such as a utility bill) as well as proof of residence.

2. As an employee: 

If you’re employed in France, you’ll have access to PUMA (Protection Universelle Maladie) through the French social security system (L’Assurance Maladie). The social security system will also cover things like maternity, paternity and disability. Contributions will be taken directly from your salary and your employer should organise this for you when you start in your role. They’ll also be able to advise whether there’s anything else you need to do once you’re registered, such as register separately for PUMA.

If you’re a freelancer, sole trader or you own a limited company, you’ll still need to make social security contributions in order to access the French public healthcare system. You can arrange this through your local CPAM office once you’ve registered as self-employed at the Centre de Formalités des Entreprises (CFE). You’re able to do this as soon as you arrive, rather than after three months and it can be a timely process so the sooner the better.

4. Children: 

Up until they’re 18, children are eligible for free healthcare in France through their parents or guardians. Children in France also have regular routine check-ups and screenings to monitor their general wellbeing and look for signs of various conditions or diseases.

5. Retirees: 

All retirees are eligible for L’Assurance Maladie, but you have to wait the full three months before you can register. In the meantime, you’ll need private health insurance to be covered for any consultation or treatment. It’s also important to remember that health insurance is mandatory for all French residents, so you’ll need private cover to get a visa within the first three months. Find out about our short-term healthcare plan, which can be taken out for between three and 11 months.

When you do come to register for L’Assurance Maladie, you’ll have to fill out a specific form called the ‘demande d’ouverture des droits’ and send it to your local CPAM office. This will enable you to set up social security contributions through your pension income or if you’re from another EU country, attribute your health insurance to the social security system of your home nation. 

The French healthcare system can seem quite complex to begin with and it might be very different to what you’re used to, but once you know a few key details you should find that it’s not too confusing. 

Carte vitale

When you’ve registered with the French healthcare system, PUMA (Protection Universelle Maladie), you’ll receive a carte vitale. This is the French health insurance card, also known as a ‘green card’. It’ll have your photograph on it and an electronic chip, which holds your insurance and social security details. You need to bring this card along to any appointments. The insurance system is highly computerised in France, so cards can usually be scanned at the point of treatment to make it easier for you to be reimbursed later.


Depending on what kind of consultation you’ve had, you’ll usually be asked to pay for your treatment at the end of your appointment. 

If they don’t have a card machine, they’ll give you a form (called the feuille de maladie), for you to complete and send off yourself. This makes the process of getting a reimbursement a bit longer, but forms are usually processed within around 10 working days and you’ll be reimbursed directly into your bank account.

There are set prices for most services, which have been put in place by the state. Most doctors, both public and private, adhere to these prices. Any additional charges won’t be included or considered during the reimbursement process, so make sure you’re clear on exactly what’s covered and if there are any extras to pay. A private healthcare policy can help to cover any excess costs, as well as the percentage that isn’t covered by the public healthcare scheme.

Dental cover

The cost of your dental care will also be covered by the public health service. This has its own set of fixed prices and separate reimbursement percentages depending on the type of treatment you have. Generally, more routine dental services like check-ups, fillings and extractions follow a similar process to what you might experience at a doctor’s office. Complex procedures, however, tend to have separate rates that offer a lower percentage of reimbursement. 

Pharmacies and medicine

You shouldn’t find it too difficult to spot a French pharmacy (or ‘pharmacie’) as they usually have a big neon green cross outside. They tend to be open for six days of the week (Monday to Saturday) from 8.30am to 7.30pm, though some close for a couple of hours around lunchtime and each region has one that stays open out-of-hours (including Sundays).

In a similar way to consultations and treatment, the French healthcare system covers a percentage of the cost of medications. This is usually around 65% but could be as little as 15% or as much as 100% (while certain medications for chronic conditions aren’t covered at all). When you take your prescription to the pharmacy, you’ll still present your insurance credentials, but you’ll find the payment system is slightly different. Instead of paying the full amount up-front and then seeking a reimbursement, you’ll only pay the amount that isn’t covered.

It’s worth remembering that healthcare in France is not free and that health insurance is mandatory. The public health insurance (L’Assurance Maladie) is available to all expats after their initial three months, so you can register for that without having to get private healthcare cover. 

The public system covers a significant percentage of your treatment costs, however there’s still a percentage that you’ll have to cover yourself. A popular option for many is to take out a supplementary private policy to cover the remaining costs.

The French state system doesn’t cover psychiatrists, chiropractors or osteopaths, while certain medications aren’t covered or have a low percentage of reimbursement So it might be worth considering private cover which will cover you if you develop a chronic illness or condition

Annual Cover

Long-term cover

There’s a lot to consider when moving to France, but with our annual healthcare plan, you’ll have one less thing to worry about. We’ll help you settle into your new life with the peace of mind that comes from knowing you’ve always got somewhere to turn for help.

Virtual doctor service

Virtual Doctor Service from AXA. See a real doctor, from anywhere in the world.

With the Virtual Doctor service, you can have a medical consultation with a real doctor wherever you are in the world – from the comfort of your home, hotel or office. Better still, there are doctors on call and available 24/7.3


With picturesque coastlines, mountain adventures and world-renowned cuisine, France is an unforgettable place to visit or call home. We want to make sure you enjoy every minute of it, with comprehensive healthcare cover that can supplement the public health insurance system or be taken out instead.

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Virtual Doctor

Our Virtual Doctor service lets you speak to a real doctor over the phone or by video from anywhere in the world.3 Consultations are available in a number of different languages, including English, Spanish and Mandarin, which could come in handy if you’re not quite au fait with the language just yet. 

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Mental health support

The French culture and way of life could seem very different to what you’re used to. It can take time to settle in and you may feel a long way from the comforts of home. Our Mind Health service is designed to help you when times get tough, wherever you are, by connecting you to qualified psychologists through video or telephone appointments. 5

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Emergency cover

From overnight hospital stays and medical scans to ambulance transport, our comprehensive cover plans offer emergency cover as standard. And with the option to include dental care and out-patient services, it’s easy for you to choose the right level of cover that suits your new life in France.

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Second Medical Opinion service

If you feel unsure about a diagnosis or treatment plan, want a better understanding of local healthcare practices, need details explained to you in another language, or you’d like to make sure you’ve explored every option – our Second Medical Opinion service can help bring you peace of mind.6

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Evacuation and repatriation

Whether you’re exploring the wine region or relaxing on the riviera, you don’t want to have to worry about what might happen in an emergency. Our team can arrange for your evacuation and repatriation if things don’t quite go to plan, so you can focus on enjoying la joie de vivre.

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Claims and compensation

We think compensation should be simple. Provided we have all the right information, over 80% of all eligible claims are paid within 48 hours.4

Who we help

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Whether you’re moving to work in the heart of Paris or teaching at an international school, we offer comprehensive expat health insurance, as well as optional benefits that you can tailor to your needs. From prescriptions to hospital visits, we can cover the percentage of fees that the PUMA system doesn’t include or provide full cover if you’re not registered to receive public healthcare.

Man playing with his son

France is a popular destination for families from all over the world. With so many safe, picturesque and exciting places to settle down, the last thing you want is to let a health worry interfere with your experience. Discover our long and short-term international health plans, which can cover you and your family’s general health as well as emergencies.

Man and woman by the sea

France is a great place to retire. From the Alps to the riviera, you’ll be spoilt for choice. But remember, when you retire to France, you’ll only be eligible for the state-run insurance after the first three consecutive months of your stay. So, in the meantime, you’ll need international private health insurance if you want to be covered and to apply for your visa (remember, health insurance in France is a requirement).

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*Lines are open Monday to Friday, 8am-5pm (GMT).

Calls may recorded and/or monitored for quality assurance, training and as a record of the conversation.

The Virtual Doctor, Mind Health and Second Medical Opinion services are provided by Teladoc Health.

The Virtual Care from AXA service is now available to all Individual and SME members (excluding those whose health plan is insured by AXA General Insurance Hong Kong Limited). 

All Information in this article was correct at the time of publishing

Local insights have been provided by Oban International’s LIME (Local In-Market Expert) network. - 



3 The Virtual Doctor service is part of our Virtual Care from AXA service. Appointments are subject to availability. You do not need to pay or claim for a consultation but you will be charged for the cost of the initial phone call when using the call back service. You won’t be charged if you request a call back using the app or online portal. Telephone appointments are available 24/7/365 and call-backs are typically within 24 hours. Video appointments in English, Spanish and Mandarin are available between 08.00 and 00.00 UK time, Monday to Friday. Video appointments in German are available between 08:00 -20:00 CET, Monday to Friday

4 80.6% of eligible claims submitted online between July 2022 and June 2023 were paid within two days.

5 Mind Health psychologist appointments are available in English and Spanish between Monday and Friday, 09.00 - 17.30 (UK time). If you are calling from the UAE, appointments are available between Saturday to Thursday, 09.00 – 20.00, and Friday 09.00 – 16.00 (UAE time). The service, provided in partnership with Teladoc Health, provides access to six sessions with a psychologist, per mind health concern, per policy year. The Mind Health service is part of our Virtual Care from AXA service.

6 Our Second Medical Opinion service is here for you anytime you’re unsure over a diagnosis or recommended course of treatment. It’s part of our Virtual Care offering, along with the Virtual Doctor and Mind Health services, so you might have already seen it on your plan or on the Virtual Care from AXA <app> or <portal>. Provided in partnership with Teladoc Health, the service unlocks access to a network of over 50,000 world-leading specialists and connects you to a doctor who will review your case alongside an expert. They’ll work with you to help you understand your diagnosis, make sure you know your options and support you throughout any treatment, wherever you are in the world.