France

Introduction

France has a universal healthcare system which is called PUMa (Protection Universelle Maladie). There are two main ways in which you can qualify for PUMa coverage:

• you are employed or self-employed, or
• you have been living in France for at least 3 months and are planning to stay for at least 6 months (183 days).

Being affiliated to the French healthcare system covers health expenses, i.e. reimbursement of healthcare costs, for the insured person, as well as for their minor dependents Adult family members (such as spouse or adult children) are insured in their own right – meaning that such family members should apply for the affiliation to French healthcare system individually.

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Am I Covered by the French Healthcare System?

Below, you will find more detailed information on the most common scenarios. 

I am employed by a French employer

As a worker employed by a French employer, you are going to be attached to the general social security system and affiliated to a health fund of your place of residence. 

As soon as you start working, your employer will have to give a declaration of your employment to the Urssaf (Union de recouvrement des cotisations de sécurité sociale et d’allocations familiales), and after that you will have to provide a set of documents to Ameli (French Health Insurance Institution).

To see which documents are required, visit this website, and select a drop-down section called “Your principal residence and your salaried work activities are in France”.

After fulfilling these steps, you will become associated with a health insurance fund (CPAM – caisse primaire d’assurance maladie) that will be responsible for the reimbursement of your expenses. 

I am self-employed:

As a self-employed, you are covered under the same general scheme as salaried workers, under the same conditions and using the same reimbursement rates.

Unlike salaried workers, you yourself are responsible for the payment of social security contributions to the Urssaf.

In order to see the contributions rates, as well as other useful information relating to your healthcare rights as a self-employed, visit this website. 

I am unemployed:

If you are unemployed, the way how you can be affiliated to the French healthcare system is through your residency in France. You will have to live in France for at least 3 months (and intend to stay in France for at least 6 months) before you can make an application.

In the meanwhile, if you are coming from another EU country, you can use your European Health Insurance Card (EHIC) for medically necessary treatments in public hospitals (note that you can’t access planned treatments through EHIC), and if you are coming from outside the EU, you will have to use your private health insurance.

You will not have to pay any contribution if you get affiliated in this way.

For more information (required documents, procedure) on how you can get affiliated to the French healthcare system through 3-months residence in the country, see this website.

Special case – capital income earners 

Normally, if you affiliate to the French healthcare system through 3 months residency in the country, you will not pay any contribution.

However, you may be liable to a 6.5% alternative healthcare contribution (cotisation subsidiaire maladie/ CSM) on your earned and asset income in the following cases:

1. Not having employment income or your employment income amounts to less than 25% of the annual Social Security ceiling (in 2023, less than €10,998 per year);
2. AND your investment or property income (e.g. real estate, and other property income) is more than 50% of the annual Social Security ceiling (in 2023, more than €21,996).

This contribution is capped at 8 times the annual Social Security ceiling – meaning that the maximum contribution that could be paid this way is €351,936 in 2023. 

I am a student:

If you are a foreign student moving to France, and you are not in employment, you will have to register for the French social security system on this website.

In order to see the required document to complete the procedure, as well as the steps of the procedure itself, visit this website. 

Further Info.

Please, note that there might be other possibilities for you to be covered under the French healthcare. In order to see more scenarios, as well as the documents that you have to provide in each of them, visit Ameli website. 

If you haven’t encountered there a scenario that fits your situation, or if you have any doubts regarding the affiliation to the French healthcare system, please, get in touch with our experts to find more information.

Last updated on 31 January 2025