Health care in France through France Today we will learn everything you need to know about health insurance in France
France’s healthcare system offers some of the best standards in the world, although private health insurance is necessary in certain circumstances. Medical insurance in France has been a hot topic since the French healthcare system reform in 2016.
This guide explains the public and private health insurance offered in France, and how you can access treatment. It includes information on the following topics:
The health care and health insurance system in France
French law states that all residents of France must have health insurance. This could be through the public health care system or a private scheme.
In 2016, the government introduced a new and universal public health care system – Protection Maladie Universelle (PUMA). The introduction of the scheme means that most arrivals are now eligible for French state health insurance (l’assurance maladie ).
Individuals who are not covered by PUMA or who wish to increase their health coverage may choose private health insurance policies instead.
Who needs health insurance in France?
Under the PUMA system, permanent residents receive state health insurance if they have lived in France for three consecutive months.
Major healthcare reforms have simplified the requirements for workers and residents in France, which means that unlimited access to healthcare is now a right for all residents.
This applies regardless of age, medical history, and record of social security contributions ( social cotisations) .
Who covers public health insurance in France?
- Residents: Anyone who has a fixed and regular residence in France for at least three consecutive months per year can register for health insurance. Your family or main home must be in France, and you must intend to live there for at least six months (183 days) per year.
- Employees: Employees working in France are entitled to health insurance through social security contributions (cotisations sociales).
- Self-employed and self-employed: Solo traders (small entrepreneurs) and limited business owners (Société à Responsibilité Limitée) can access medical insurance in France through the Régime Social des Indépendants (RSI ) system.
- Children: Children are automatically entitled to health insurance in France regardless of their nationality.
- Students: Foreign students are not usually recognized as residents, so most students must have the required Student Social Security (Sécurité Sociale Etudiante) , which covers health expenses while in France. Exceptions are available to EU/EEA citizens holding EHIC cards, scholarship recipients, unemployed non-EEA nationals over 28 years of age, and students studying in France for less than three months.
- EU, EEA and Swiss citizens: These citizens can usually use an EU Health Insurance Card (EHIC) if they are staying temporarily. However, health insurance is necessary for legal residents.
- EEA and British pensioners: Those retirees who receive pensions from their home countries and reside in France can apply for French health insurance with a valid S1 form.
- Unemployed/low-income workers: Unemployed or low-income legal residents are eligible for French health insurance and can receive benefits through the CMU-C.
What does public health insurance cover in France?
- Doctors: Under the state system, you will usually need to pay a flat fee of €25 when you see a doctor. Insurance providers partially reimburse the costs thereafter.
- Emergency Care: A&E services are part of the state’s health care system, and all large cities and towns have an emergency ambulance service.
- Specialized care: Specialists in France may charge higher fees than GPs, but this will be set within the parameters of standard government healthcare costs. In order to be compensated for a visit to a specialist, you will need to be referred by your GP.
- Medicines: Pharmacies work a little differently than other items in the health care system. Instead of paying the full amount and then asking for a portion of your costs to be reimbursed, you will only pay the amount that is not covered by the state when you buy the drug at the pharmacy.
- Dental care: The French government health care system covers visits to the dentist. However, dental care comes with its own tariffs and reimbursement rates. General dental treatments are reimbursed in the same way as other specialized care, but reimbursement for advanced procedures are usually lower due to the higher cost.
- Maternity care: The majority of costs associated with pregnancy and childbirth are covered by public health care. 70% of the costs of the first two surveys are covered, then after six months all costs are covered in full.
How does private health insurance work?
Health insurance fees and reimbursements
Anyone working in France whose social contributions (cotisations sociales) will be automatically deducted from their salaries. This is covered by state health insurance in France.
There are a number of factors that affect costs, such as income and family. It averages about 8% of your net income above the minimum set by the state.
Visit CLEISS (Centre des liaisons Européennes et internationales de sécurité sociale) for the full list of French health insurance contribution rates as of January 1, 2019. The government adjusts the percentage of social contribution deductions annually.
Health insurance for the unemployed and low-income
Unemployed and low-income workers are entitled to free state-funded supplemental health care, known as the CMU-Complémentaire (CMU-C).
The current income thresholds per household for 2019 are set at the following levels:
- House for one person: 8,951 euros
- Family of two: 13,426 EUR
- Family of three: €16,112
- Family of four: €18,129
Each additional person in a household of more than four people: 3,580 euros per person.
Arrivals must first activate PUMA before qualifying for CMU-C. After that, all medical and dental costs are covered by state health insurance.
You will not be charged for advance payments after the Services have been rendered. You can apply for a CMU-C by filling out this form and sending it to your local CPAM.