What Expats Need to Know About Healthcare in France
How much do expats love their life in France? A lot! A generous 78% report being satisfied with their new life and their new country. Considering that their top three reasons for relocating were for the quality of life, employment, and, of course, love, it’s no surprise that France agrees with expats. In fact, 40% of them have no plans of ever leaving. With this in mind, it’s crucial that expats have a thorough understanding of medical care and health insurance in France.
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An Overview of Healthcare and Insurance in France
France administers a universal health insurance system funded by taxation. The standard of care is considered superb.
In fact, France is listed among the healthiest countries in the world by the World Health Organization’s ranking of health provider efficiency. From preventive medicine to emergency surgery, France offers an excellent healthcare system.
In addition to having outstanding public health insurance in France, most people also pay for supplemental French health insurance.
This is known in France as “mutuelle,” and it’s designed to offset additional health and medical costs. One of the extra medical costs is doctor visits. Only 70% is covered by the state, leaving the patient to cover the remaining 30%.
Thankfully, that works out to around €7. But in a large family, these small costs can quickly add up, and it’s nice to have some extra coverage through the mutuelle. The mutuelle also covers much larger expenses, such as physiotherapy and private hospital room accommodations.
Accessing the Public Healthcare System
So where do expats fit in this French healthcare system? A significant regulatory change in 2016 brought welcome news to expats.
Since then, any expat who has lived in France for at least 3 months in a “stable and regular manner” and plans to remain in France permanently can apply for public health coverage.
Of course, “apply” is really a code word for paperwork! The new French health insurance system is known as Protection Universelle Maladie (PUMA), while the old medical insurance system was Couverture Maladie Universelle (CMU).
Of course, there is some fine print. Expats can apply to the PUMA program only if they’ve been in the country for less than 5 years, do not have paid employment, are under 65 years of age, and do not receive a pension from a European country.
Non-European students aged 28 or older with no income, as well as British early retirees who receive no compensation, are also eligible.
There is also a paperwork-heavy annual renewal process. No wonder expats are pleased with the new changes! However, when gathering documents, it’s essential that you follow the new PUMA regulations and requirements.
Many expat-focused websites still offer recommendations based on the CMU era. An international health plan would still be required if you need worldwide coverage.
Best Private Health Insurance Options for Expats in France
International private health insurance offers several additional benefits beyond local insurance plans. First, they are global and will cover you anywhere in the world.
Furthermore, they can be more comprehensive, giving you access to a wider range of French healthcare facilities and doctors.
Best Global Medical Insurance Plan for Expatriates Living in France
For expatriates moving to France, we would recommend two options. Cigna Global is a leading global insurer with excellent service and benefits.
Cigna Global offers a modular plan design, allowing you to select and customize different modules to tailor the plan to your specific needs and budget.
Cigna Global Insurance Plan
- Flexible plans tailored to your needs and budget
- 1.5M+ providers in 200+ countries
- 24/7 multilingual customer support
Best Health Insurance for US Citizens Living in France
The second suggested plan, primarily for U.S. citizens living abroad, would be the BCBS Global Solutions Worldwide Premier plan, which offers benefits and services similar to those of Cigna.
The plan is offered in association with Blue Cross and Blue Shield of America. It comes with an excellent BCBS network of doctors and hospitals, as well as access to the highest-quality doctors worldwide.
For other options, view our list of the best international health insurance companies.
BCBS Global Solutions Worldwide Premier
- Unlimited annual and lifetime coverage
- Pre-existing conditions covered with prior insurance
- For U.S. citizens abroad or foreign nationals in the U.S.
Understanding Insurance Paperwork Required of Expatriates in France
If you’re an expat, you’re going to need extra documents. You must demonstrate that you intend to reside in France permanently and legally.
You must prove that you intend to reside in the country for at least half the year (anything less means you are not a permanent resident).
As you settle into your new life in France, register for classes and sign up for volunteer work, and hold onto your receipts and application forms.
They will all help to support your claim. And, like with most government-based applications, you’ll need to provide proof of identification, address, and income.
The paperwork fun doesn’t stop there. All expats must register with a primary care physician. You’ll need proof of this registration when applying for public health care at your local CPAM (Caisse Primaire d’Assurance Maladie) office.
Once you’ve been approved, you can apply for your national health insurance card, the carte vitale (green card).
Since 2017, having your green card with you when you visit the doctor means that you’ll avoid paying upfront and in cash for services, and then going through a tedious paperwork process for reimbursement.
If you require global coverage, your application is rejected, or your time in France will amount to less than 50% of the year, you will need privately held international health insurance to cover your needs.
Mental and Social Well-being
While France’s healthcare has outstanding ratings, many expats report that it is challenging to break into French social circles.
Language barriers and the small, tight-knit nature of French friendships are primarily to blame. Nearly 60% of expats in France say it’s challenging to get used to the local culture, a figure that’s similar to what expats experience on average across the globe. This can take many by surprise.
They assume it will be easier to adapt to life in France than, say, China or Nigeria, but that’s not always the case. And language can be a big part of that. 76% of expats report that it’s hard to live in France if you don’t speak French.
In short, expat life can be isolating and lonely. And it doesn’t help when friends and family back home can’t appreciate that life in Paris is anything but perfect.
Enrolling in small group language classes is a great place to start. Joining more than one, perhaps with a focus on grammar or conversation, is even better.
Working in France as a volunteer with a cause that’s dear to your heart will help you meet locals who share your values and interests.
Making sure your friendship circle includes both expats and locals will help you expand your network of support.
Find the Best International Medical Insurance
- Compare multiple quotes from top insurers
- Get expert advice at no additional cost
- Find the right plan for your needs and budget
Joe Cronin, President of ICI, is a leading expert in international health, life, and travel insurance. An MBA and founder of multiple global businesses, he helps expatriates and travelers access trusted, comprehensive insurance solutions worldwide.
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