How to get Healthcare in France as an Expat

Last updated on August 10th, 2023 at 08:11 am

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Wondering how you get Healthcare in France as an Expat? We’ve got you covered.

When you first move to France, there are many things you need to think about and one of those is medical insurance.

The big question on most people’s lips is, ‘How do I get healthcare in France as an Expat?’

How does it work, and what hoops do I have to jump through?

Well, as you’d expect, every country has a different system in place, and if you don’t want to get caught out, it’s best to have all the facts.

Luckily for you, here at Life in Rural France, we’ve partnered with the fantastic team at FAB Insurance to help make sense of it all.

Fabien has years of experience and has helped many Expats not only get the right insurance but also get their visa, allowing them to live in France.

Quality of Healthcare in France as an Expat

France’s healthcare system is generally recognised as one of the best in the world. In surveys rating healthcare across different countries, France is always near the top.

The quality and speed of service is excellent, and I’ve never heard anyone complain.

In fact, it’s quite the opposite, and most expats sing the praises of the French healthcare system, compared to where they’ve come from.

There are no lengthy waiting lists for operations compared to other countries, and it isn’t hard to get an appointment with the doctor.

Cost of Healthcare in France

Unlike in the US, where healthcare costs are extremely high, and there is no universal healthcare system, France isn’t expensive.

And the slightly higher tax rates paid actually come with higher levels of public services, including heavily subsidised healthcare.

However, for those expats coming from the UK, it’s slightly different. We’re used to the NHS, where we don’t pay directly from our own pockets it’s all done through our national insurance contributions. Doctor’s appointments are free, as are all operations, hospital visits, ambulances etc.

Overview of Healthcare in France as an Expat

Caisse Primaire d’Assurance Maladie (CPAM), is the bedrock of French medical coverage (equivalent of the British NHS).

It’s available to all legal residents, even migrants although they need to apply for it manually, but every French resident is covered by CPAM eventually.

Just like numerous other countries, France offers both private and public healthcare.

Patients have the liberty to opt for either route, but the beauty of the French healthcare system, or the Caisse Primaire d’Assurance Maladie (CPAM), is that it provides consistent coverage regardless of whether you seek public or private treatment.

A banner advertising medical insurance in France

While the National Health Insurance pays for a significant chunk of your healthcare costs, it doesn’t foot the entire bill. For instance, a visit to the doctor costs €25, CPAM only covers 70% of it, leaving you with a balance of around €6.50.

But it’s not all doom and gloom because there is a wonderful little thing called top-up insurance, or La Mutuelle, which we’ll talk about in a minute.

La Mutuelle together with CPAM, gives you full medical coverage in France.

Need help with your healthca r e?

Our trusted expert, Fabien Pelissier, and his consultants make the process easy. Get their help with top-up insurance, carte de séjour application and more.

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Fabien Pellesier a French Expert in applying for French visas

How much of your French Healthcare do you get reimbursed and how?

In the labyrinth of French healthcare, an important element is what’s referred to as an index, officially termed “BRSS – Base de remboursement de la sécurité sociale”.

Crafted directly by the CPAM, this index is a guideline specifying the reimbursement amounts for various treatments.

Crucially, this index remains uniform irrespective of whether you’re treated at a public hospital or a private clinic, ensuring equivalent reimbursements across the board.

The worst-case scenario is paying the discrepancy between the indexed rate and the actual expenses incurred.

However, the rates charged in the private sector are under the watchful eye of French regulators, making it unlikely for you to face charges exceeding multiple times the indexed rate.

In the event of such a discrepancy, particularly in cases like dental care, the law obligates service providers to present you with a quote that’s entirely free of charge.

This way, the French healthcare system ensures you’re never left in the lurch, financially or health-wise.

Maximising your coverage in the French Healthcare System

The pivotal guideline to bear in mind within the French healthcare system is the “parcours de soins“. Essentially, it outlines the protocol you need to adhere to whenever you require medical attention.

Everything starts with a visit to the General Practitioner (GP), who then refers you to specialists, clinics, or public hospitals as required.

Adhering to this ensures maximum refunds from the system.

And this applies to even minor purchases like aspirin. For instance, if you visit your GP to get a prescription for aspirin instead of going into the pharmacy and buying it without a prescription, you then get both the GP’s consultation fee and the few euros spent on aspirin fully reimbursed.

As you can imagine, this leaves the system open to misuse, so to prevent problems regarding refunds, a 1€ deduction is applied to each claim and is not refundable.

But don’t worry, it’s the only charge you get when going through the reimbursement process.

In the event of a discrepancy, particularly in cases like dental care, the law obligates service providers to present you with a quote that’s entirely free of charge. This way, the French healthcare system ensures you’re never left in the lurch, financially or health-wise.

La Mutuelle – Top-Up Insurance in France

Acting as top-up insurance, Mutuelle is the aromatic truffle oil drizzled over your health coverage pizza.

It seals the gaps left by national health insurance, taking care of those out-of-pocket expenses, so you’re free to spend your savings on wine instead of medical care.

How do you get a Mutuelle?

Anyone that has an active French social security number (even if it’s a temporary one), can get a Mutuelle.

All you need is your “Attestation de Droit,” a certificate that proves your inclusion in the French system.

You can download this document from your online CPAM account at ameli.fr.

And the best part, pre-existing health conditions won’t hamper your coverage or cause your premiums to skyrocket.

Why the crazy percentages on a Mutuelle policy?

The state offers reimbursements based on the standard index, but many doctors and private clinics have the liberty to set their own charges.

For consultations, tests, and specialist visits, it’s rare for the costs to exceed twice the index.

However, in private hospitals, costs may climb to three times the index, and with dental care, it could be significantly more.

For this reason, you might choose to supplement your CPAM refund with a mutuelle that tops up to the indexed rate.

Alternatively, you might consider plans that cover two to three times the index, or even more.

As these are represented in percentages, this is why you can find mutuelles claiming to cover up to 300% for hospitalization, for example.

How are medical claims refunded in France?

France essentially has three distinct procedures for handling healthcare payments, which are as follows:

Tiers payant

The most straightforward method is known as “Tiers payant.” This is the system you typically encounter in hospitals, many pharmacies, and some labs.

All it requires is presenting your Carte Vitale (CPAM card) and your mutuelle card, with no upfront payment necessary.

If there’s any remaining balance after all parties have paid their portions towards the medical expenses, you’ll simply be billed the difference.

Teletransmission

The second most common process is called “Teletransmission.” This is often used during consultations or when the “Tiers payant” system is unavailable.

In this case, you pay upfront, but the claim is automatically sent to the CPAM, which reimburses you.

Subsequently, the claim is forwarded to the Mutuelle for an automatic refund as well.

Feuille de soin

The third option is known as “Feuille de soin.” This is a manual claim process and essentially the last resort when the first two options aren’t available.

With this process, you must send a brown form to manually claim a refund from the CPAM.

Once that’s done (usually within one or two months), you have to send it manually to your mutuelle for the top-up. It goes without saying, but we aim to avoid this process as much as we can.

FAQS: Fabien answers your questions about healthcare in France as an ex-pat

How do expats get health insurance in France?

It depends on the goal you’re trying to achieve. For visa applications, the best is to use the services of a company or a broker that already deals with medical insurance in the context of a French visa application. We partner with Fabien from Fab Insurance but plenty of fish in the sea.

For residency applications or visa renewal (carte de séjour) you can either use private medical insurance or top-up health insurance (they call that Mutuelle in France) if you already have a French social security number.

For Mutuelles, you’ll find plenty of online aggregators although it may be best to stick with an English-speaking broker such as Fab French Insurance.

Is healthcare free for foreigners in France?

It is although you need to apply manually into CPAM.

How much is health insurance for expats in France?

Depending on the age band, someone in his/her early 50s would be a couple of thousand euros a year for example.

What healthcare will expats get in France after Brexit?

It depends on the context. As a tourist or with a temporary visa (VLS-T) British expats can use the GHIC and the GHIC can be secured for free with the NHS.

For long term expats, they would have nothing at first and that’s why they need private medical insurance in the first place, but eventually, they’ll get into the French social security system and therefore will be covered as if they were French no matter the medical history, conditions, age or resources.
ex-pats

It takes roughly 9-10 months to get into the French system although this can vary massively so take the information with a pinch of salt (and not that you can only apply once you’ve been around for more than 3 months).

What is a Carte Vitale and how do I get one?

A Carte Vitale is proof that you’re part of the French social security system (CPAM) and that card also allows doctors, pharmacists, labs, etc. to scan your details and process your claim automatically so that out-of-pocket expenses are refunded automatically.

What are the challenges of healthcare in France?

The system works quite well actually. Understanding how it works is the challenge but let’s be honest, even French natives usually don’t get it so in a way, that’s even more proof that the system is working well, as even the French don’t care about how it works, it just does.
You just need to make sure you keep your receipts just in case you need to file a claim manually.

The main difference is that everything starts with a GP, even buying aspirin should go through the GP, (in theory) so that he refers you to someone or something in particular.

It’s called the “parcours de soin” in France and that allows doctors to dispatch users so that the system runs more smoothly.

Is health care good in France?

Yes, healthcare is good in France. Nothing is perfect but the system works quite well. Waiting lists are almost non-existent for critical care and you will be covered no matter if you go public or private.

Even in the private sector prices are monitored so that the out-of-pocket expense is always reasonable (exception made for dental care although you’ll always have an option that’s 100% covered).

What health insurance do I need when I come to live in France?

Actually, it’s easier to say what doesn’t work. Travel insurance doesn’t work, Schengen policies don’t work and any policy with an excess would be rejected.

Emergency-only plans are also automatically denied.
Basically, you have to go with private medical insurance with no co-pay or co-insurance and one that’s comprehensive (in and outpatient benefits).

There are other requirements but it’s best to go with insurers that have a track record history of dealing with visa applications to make sure you’ll get the right plan.

Also, remember that you probably won’t need that policy for more than 12 months as you should be part of the French system within 12 months which means you can then switch to the holy Mutuelle.

GET ADVICE ON INSURANCE WITH FABIEN >>>

Final Thoughts: Getting Healthcare as an Expat in France

As with most things, healthcare in France is about proper planning and advice. When I first moved over I got advice on everything, including healthcare.

It can be so disheartening to receive all your paperwork back because you missed one thing or answered something incorrectly. This means starting again which is frustrating, not. to mention adding quite a delay. to you receiving everything you need.

Bottom line having the proper healthcare in place in France is a non-negotiable so if in doubt ask someone for help.