Health Insurance in France

The French healthcare system is based on two main components:

- the basic state health insurance

- and supplementary health insurance (¨Mutuelle¨), a blend of public and private services. 

The basic state health insurance: Sécurité Sociale

The French social security system is based on the principle of ‘solidarity contributions’. Persons exercising a professional activity (employed or self-employed), or those resident on French territory on a continuous and legal basis, and their dependents, are entitled to healthcare, both in private practices and in hospitals, while benefiting from partial coverage of healthcare costs by France’s Social Security system (topped up with supplementary cover). Contributions are made through social security deductions from each person’s income.

3 minutes to understand the French Social Security system, an official video from Sécurité sociale.

  • What health insurance rights do foreign nationals have? 

Whether they work in France or reside in France on a regular basis, expats are covered via the Universal Health Protection scheme as long as they are not covered by the social protection system of another country. French Social Security system allows foreign citizens living in France to obtain a social security number and a carte Vitale.

  • The carte Vitale 

"The carte Vitale (which color is green) allows you to benefit from the French health insurance system. How does it work: All you have to do is to present your card (Carte Vitale) to your doctor if you take a medic visit or the pharmacist if you take the medicaments and the French Social Security fund will be notified of the costs of your treatment or services. The fund (‘caisse’) then processes your reimbursement automatically, without any other procedure being required. The carte Vitale is a card with a chip in it which proves your entitlement to benefit. It is issued to everyone over 16 years of age and contains all administrative information necessary for the reimbursement of treatment costs. Depending on personal circumstances, it also contains the information needed to use the third-party payment system (meaning that the patient does not pay amounts upfront that will later be reimbursed either by the health insurance system or by his/her supplementary insurance, which kicks in once the patient has been reimbursed by the national system).

Parents can apply for a separate carte Vitale for children ages 12 and up.

NB: these reimbursements are generally partial (except in some cases), and are usually capped. Obtaining complementary cover is therefore essential in order to guarantee full reimbursement of your medical costs which can, sometimes, be considerable.

Some important information on health services

  • Doctor’s Fees 

You will be usually asked to pay the fees at the end of your consultation. Your doctor may have a terminal which reads your Carte Vitale and transmits the information directly to the Social Security office for reimbursement. If not, you have to fill in the form “feuille de soins” and send it to the Social security yourself. Many doctors charge for their services according to the Social Security approved rates but it is always helpful to confirm this before your consultation. Doctors don’t always accept card as means of payment, so ensure you take cash or cheque with you to the appointment.

  • Pharmaceutical products 

Pharmaceutical products must be prescribed by the doctor to be reimbursed. It is also possible to have part of the cost (pharmaceutical direct settlement) paid directly by the fund by presenting your card. In that case, all you pay to the dispensing chemist is that part of the cost not covered by your sickness insurance fund.

  • Non-hospital medical care in France: operations and repayments

In France, everyone covered under state Social Security is free to choose their own General practitioner (GP), provided they declare them to the Social Security as their "treating doctor" (‘médecin traitant’). By declaring your GP, you have the right to the maximum repayment rate: 70% of the basic fee, currently set at €25. If you do not do this your GP consultations will be repaid at 30% of the basic fee. However, in no case are you obliged to stay with the same doctor from year to year. You can change your doctor at any time - just don't forget to inform your Health Insurance Fund.

Your treating doctor is responsible for coordinating your treatment, meaning they’re responsible for recommending any extra consultations or referrals to a specialist (rheumatologist, cardiologist, dermatologist, etc.). Again, you’re entitled to select the doctor or specialist of your choice. By going through your treating doctor, you’re guaranteed to receive a 70% repayment of the basic fee. However, you can consult specialist such as gynecologists, ophthalmologists, psychiatrists, dentists…, without any prior referral from your treating doctor.

There are a lot of useful web platforms for making un medical online appointement. You can choose the availability of specialist, check their expertises, spoken lanquages, method of payment acceptable and other useful information before to decide to make medical appointement.

  • Hospitalisation

which hospital they’re treated in, whether public or private. The cost of healthcare is divided into several categories:
• Accommodation costs: 80% repaid by Social Security;
• Supplements for personal comfort (individual room, television, etc.): payable by the insured;
• Additional fees which may be charged by some hospital doctors, also payable by the insured;
• The "daily flat-rate charge": a financial contribution by the insured of €20 per day.
The remainder of the fees, called the "ticket modérateur" [deterrent fee], is not repaid by Social Security, but can be covered by a top-up health insurance policy.

  • Additional medical fees

Whether they work in a private practice or a public hospital, French doctors (GPs and specialists) can choose from several pricing structures:
• They can opt for rates based on French Social Security's repayment scheme (BRSS), for example €25 for a GP consultation. These doctors are part of what’s known as the "Sector 1" category;
• They can charge (limited) additional fees, as a member of a DPTAM (Controlled Pricing Practice System – ‘Dispositif de Pratique Tarifaire Maîtrisée’);
• They can charge unrestricted additional fees, and as such are not associated with a DPTAM.
Social Security reimbursements are restricted to the BRSS rates and prices, and don’t take into account any extra charges as a result of visiting DPTAM or non-DPTAM doctors. These supplementary charges will affect the remainder you’ll have to pay after any course of treatment, as well as the amount of the repayment guaranteed by your top-up health cover. As a result of regulations affecting "responsible contracts" (which must comply with the repayment caps imposed by French law), services offered by non-DPTAM doctors are reimbursed at a much lower level than BRSS- or DPTAM-affiliated doctors.

  • Sickness leave

If you are employed and your doctor signs you off work for medical reasons, you will continue to receive your salary. The Social Security and your complementary health insurance scheme will cover the cost and repay your salary to your employer. The French government also guarantees maternity / paternity / adoption leave, that is much longer for women than men and is variable according to sectoral agreements.

How to proceed to be covered by the French Social Security?

  • For the student-citizen belonging to the EEA (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden)

If you come to study in France, you are considered a temporary resident and must be affiliated with the health insurance plan of your country of origin. However, before your departure, you must verify that this plan will cover your medical expenses for the duration of your stay in France. If this is the case, you can use your European Health Insurance Card in France.

Before your departure, check with your affiliation organization and the French health insurance company.

  • For the student-citizen non belonging to the EEA

 You must register on the website dedicated to the reception of students, in order to benefit from the coverage of your health expenses upon your arrival in France:

https://etudiant-etranger.ameli.fr/

More explanation for student, you can find here: https://access.ciup.fr/en/steps-in-your-administrative-process/health-insurance/students-and-social-security/

  • You’re a PhD student:

- You are a PhD student enrolled in a PhD program in a French establishment, you have a student card, and are not a paid employee (doctoral contract, CIFRE contract…): you can benefit from social security for free. To find out how to register, please consult the following rubric: https://access.ciup.fr/en/steps-in-your-administrative-process/health-insurance/students-and-social-security/.

- You are a PhD student in an international joint thesis program: this will depend on your program contract and how long you will stay in France. If you will be staying in France for fewer than three months, you are not eligible for social security.

- You are a PhD student and employed in France (you have a doctoral contract, a CIFRE agreement…): you will be registered for social security based on professional criteria. For the appropriate steps to take, consult https://access.ciup.fr/en/steps-in-your-administrative-process/health-insurance/researchers-and-social-security/ and begin your registration application process as soon as possible.

- If you are a non-European PhD student and have a visa/residence permit « researcher – talent passport » because you have a contract in France (doctoral contract, CIFRE…), please refer to https://access.ciup.fr/en/steps-in-your-administrative-process/health-insurance/researchers-and-social-security/#1522848866725-c2b8a6ed-5b79.

  • You’re a researcher

https://access.ciup.fr/en/steps-in-your-administrative-process/health-insurance/researchers-and-social-security/

For your family: https://access.ciup.fr/en/steps-in-your-administrative-process/health-insurance/#1522950665248-64439819-cfad

The Supplementary Health Insurance: la mutuelle

  • What is the French supplementary health insurance?

A supplementary health insurance or so-called ¨mutuelle¨ is a policy which reimburses medical costs not covered by the Social Security. Depending on the policy chosen, it will cover some or all of the remaining percentage NOT reimbursed by the state. This can be substantial if you need hospital or emergency treatment as hospitalization, a private room, ambulance costs, all of which can be expensive and refunded only minimally or not at all by the Sécurité Sociale (la Sécu). However, unlike health insurance in some other European countries, the French private cover does not guarantee faster treatment nor is it associated with private practitioners. It simply acts as a way of bridging the 30 per cent gap left by the state cover.

  • How to subscribe to a supplementary health insurance?

The choice to subscribe to a supplementary health insurance to top up the reimbursements of your medical expense is entirely up to you. It is not mandatory, but we do recommend it strongly. If you decide to have Mutuelle, you should to complete the subscription process. We advise you to start by asking for quotes and compare the offers. You can do so with: traditional healthcare mutuals, insurance companies or banks.

If you're a researcher or a professor: your employer may have a deal with a particular healthcare mutual and pay a part of your insurance.

If you are a student or a PhD student: you can choose a traditional student healthcare mutual. Check that health insurance you decide to choose offers a civil liability valid for both your private and employee/student life. That way, you'll be covered on your place of study and the place of your internship.

Useful information on Health insurance

- AMELI (Assurance Maladie en Ligne), the French Health Service web portal. Almost everything can be done online. This is a very usefull website.

- French Health Service English-language service. Tél. : 36 46

- CLEISS: Helpdesk for international mobility and social security. Address : 11 rue de la tour des Dames, 75436 Paris cedex 09. Tel : 01 45 26 33 41

 

×
Stay Informed

When you subscribe to the blog, we will send you an e-mail when there are new updates on the site so you wouldn't miss them.

Paris public transportation
Eligible masters