Expats in France can expect to benefit from a high-quality universal healthcare system. Many expats also choose to “top up” their state coverage with private insurance, so they can enjoy full coverage for their medical needs, including specialist treatments and dental care.
Health insurance for expats in France
How does the healthcare system work in France?
Expats who work in France, or have resided there for at least three months, can access France’s Social Security through the Protection Universelle Maladie (PUMa) system.
Through PUMa, foreign nationals living in France can obtain a Social Security number and a "Carte Vitale" (health insurance card). Then, they can benefit from the reimbursement of their health costs. However, the French healthcare system generally only covers a certain percentage of the expenses incurred.
When residents choose a GP and declare this choice to Social Security, they are usually reimbursed for 70% of the cost of their medical consultations, both in the public and private sectors. This also applies to specialists if the patient is referred by their GP. However, if the patient does not choose a GP or goes to specialists without a referral, they will be reimbursed at a much lower rate. Hospitalisation costs are covered at around 80% (excluding comfort costs such as single rooms).
In addition, doctors, whether in private practice or in hospital, can charge different rates depending on the category in which they practise: Sector 1, Sector 2, or Sector 3. Sector 2 and 3 doctors can charge extra fees, which are not covered by Social Security.
How to choose health insurance in France: local or international?
Given the complexity of French healthcare and the fact that most treatments are not fully covered by the public system, many policyholders opt for complementary private health insurance. This will allow for peace of mind and flexibility when selecting a doctor, and provide coverage for important healthcare services, such as dental care, and more comfortable care in hospitals (such as a private room), without having to worry about additional fees.
French employers are required to offer complementary French health insurance to their employees, which they must finance at least up to 50% (and which sometimes covers dependants as well). But these insurance packages are often basic and thus insufficient. As a result, employees often seek out a second insurance provider to ensure they are fully covered.
For foreign residents, choosing international health insurance also offers more advantages than local health insurance. International health insurance providers understand the unique needs of expats, offer more robust coverage, and may also cover you outside of France.