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The French public health system is rated highly throughout the world.  First established in 1945, it is  now accessible to all legal residents, those who contribute to the social security system.  Affiliating to  the system depends on your nationality (EU or non-EU) and your status – employed, self-employed, retired, second homeowner etc.  You need to talk to your local Caisse primaire d’assurance maladie (CPAM) office.  The website for the administrative arm of the Sécurité Sociale Assurance Maladie – - has a list of CPAM offices.  Generally, 70 per cent of an individual’s health costs are paid for by the system, with the remainder either coming out of your pocket or being covered by a mutuelle supplementary personal health insurance policy (complémentaire santé) which you pay for  (rates depend on age, health, etc.).

Those who become affiliated*, provided their GP (médecin traitant) has the machine to process it, will be given a carte vitale. First introduced in 1998, this credit cardsized piece of plastic has revolutionised administration of the system as it cuts out all the paper work.  Generally, the patient pays for their  treatment, the doctor swipes the card and they are automatically reimbursed – direct into their bank  account - by their local CPAM office.  Since 2007, carte vitale 2 made its appearance, the main  difference being the inclusion of a photo graph of the cardholder.  It also contains the holder’s medical files (blood group, medication etc); contact details of the person to call in an emergency; GP’s name;  and health insurance details. In the event of a serious accident, medical personnel are able to rapidly  access vital data on the patient.

*Note that under 16 year olds are covered on both parents’ cards.

In accordance with changes in EU residency rights of Community citizens (Directive no.2004/38/EC) rights to health cover have changed in France.  As a result some expatriates will lose their health  coverage under the French system, while others will continue to benefit.  The reality in simple terms is  that those inactive (not working) EU citizens residing in France must have alternative private insurance; however, those who were already in the French Sécurité Sociale system before 23/11/07 have not lose  their coverage from the Couverture Maladie Universelle (CMU).  Worth noting: holders of form E106 are  not entitled to the CMU system and must obtain health insurance. In summary any EU citizen wishing  to reside in France without a job (students, jobseekers, retired and inactive persons) must satisfy two  criteria: they must hold comprehensive health insurance; and have sufficient resources not to become  an unreasonable burden on the social system.  Once EU citizens have lawfully resided for five years  they obtain a permanent right of residency entitling them to CMU cover.

EU citizens are automatically entitled to have access to basic health care if travelling in or visiting  France on a temporary basis. Since 2004, the European Health Insurance Card (EHIC) has replaced all the previous forms, such as the E111, and you should apply in your home country for this at least two weeks before leaving. The same applies for those affiliated to the French system if they go abroad within the EU. 

If visiting France on a temporary basis, you will need private health insurance.  Otherwise you are able to affiliate by becoming a resident.