Healthcare in France

10 important things expats need to know

Healthcare in France

If you are thinking of relocating to France to live or work, then you are not alone: in July 2015, 185,344 British expats and 53,906 American expats were living in France. From big cities like Paris to idyllic rural regions like Provence, the country has plenty to offer.

However, it can be useful to understand how the French healthcare system works before you move. Knowing that you have healthcare in place and understanding the system it is a great way to give you peace of mind as you settle into your new home. With that in mind, here are 10 things to note about French healthcare services.

1. Public healthcare

France’s healthcare system is made up of more than 1,000 hospitals (regional, university, local and general) and about 23,000 general practitioners (GPs) or doctors. Public healthcare is 70 percent funded by the state and 30 percent by the taxpayer (through ‘la sécurité sociale’).

Expats from the EU, EEA and Switzerland who are only staying in the country for a short time can apply for a European Health Insurance Card  (EHIC). It provides temporary access to certain types of healthcare, including treatment for long-term and pre-existing conditions, as well as routine maternity care. However, it is not a long-term solution and it does not replace travel insurance or cover private healthcare costs.

2. Public health insurance for expats

By law, French residents must have health insurance in place, and this can be either private or state-funded. In 2016, the French government introduced Protection Universelle Maladie  (PUMA), a new health insurance scheme, funded by deductions from income tax returns, to help foreign residents access healthcare

The system has significantly simplified the process of applying for healthcare as an expat, and guarantees access to healthcare and state-funded reimbursements for anybody who has lived in France for more than three months, and who intends to live in the country for at least 183 days per year.

3. Private health insurance

Though France’s public health system is excellent, private international health insurance such as Aetna  can still play an important role. As the state only refunds about 70 percent of a patient’s medical costs, most people are signed up to a ”mutuelle” - a semi-private insurance body - often through their employer, which tops up the remaining amount to be paid.

If an expat chooses to take out a full private healthcare policy, instead of relying on state-funded healthcare, then they can probably expect to spend about EUR 2,000 per year – depending on the individual’s age and health.

4. Registering for public healthcare

If expats have lived in France for at least three months, they can register for healthcare via their local Caisse Primaire Assurance Maladie (CPAM) office. When doing so, they will need to present documents such as a valid passport, proof of long-term residence, birth certificate, proof of address and evidence of income.

Expats from the UK and the US will also need to gain a long-stay visa  to live in France permanently, and must register with the Office of Immigration and Integration (OFII)  within three months of arriving. Once successfully registered, patients can ask for a Carte Vitale (France’s health insurance card), which explains their rights and entitlement to automatic reimbursement for medical costs.

5. Costs

Taxpayers who receive public healthcare under the PUMA scheme have small tax contributions deducted from their salaries. In 2016, employees that earned more than EUR 9,654 per year had about eight percent deducted for healthcare costs. People that earn less than this are entitled to free healthcare under the CMU-C scheme.

Currently, patients pay for treatment upfront (unless they have gone to hospital), and are then reimbursed by the state. However, by the end of 2017, these upfront costs are due to be abolished. Other charges that patients might encounter include ‘dépassements’ (excess charges) and the cost of purchasing prescribed medication at a pharmacy (though they only pay the nonrefundable part of a prescription).

6. Standard of care

The French health system was ranked number one by the World Health Organization  in its World Health Report 2000. While the WHO doesn’t publish such rankings any longer, the standard of healthcare in France is still very high today. Patients enjoy short waiting times, high standards of hygiene and excellent levels of care.

7. General Practitioners (GPs) and specialists

Virtually every town has a ‘cabinet’ (GP practice / doctor’s surgery). Many operate as private surgeries or offices, though joint practices are common. It is possible to get state funding for specialist appointments e.g. optometry and physiotherapy, but patients must have been referred by their doctor first. Patients can generally see psychiatrists and dentists without a GP referral.

8. Medicine and pharmacies

If you receive a prescription for an ailment or condition, then these medicines can be obtained from the pharmacy (‘la pharmacie’). Pharmacies are common in France and for the majority of drugs – even over-the-counter drugs – this is the only place to find them. French pharmacies are usually open from 9am-6pm Monday to Saturday, but ‘pharmacies de garde’ (late-night pharmacies) are also common in major French cities: some are open seven days a week and until midnight or even one or two a.m.

9. Hospitals

There are two main types of hospital in France: ‘les hôpitaux’, which are public hospitals, and ‘cliniques’, which are private. Doctors can refer patients to either of these facilities. At most, patients might have to pay up to EUR 18 to cover their board and lodging costs at a public hospital, as 80 percent of hospital charges are paid for by the state.

10. Emergencies

In serious medical emergencies, expats can contact the Service d’Aide Médicale d’Urgence (SAMU) – a publicly run service that provides ambulances and specialist medical care across France. The free number to call is 15 from a landline, and 112 from a mobile.

In summary

The French medical system is efficiently designed to ensure that expats can access good and affordable healthcare while they are living and working in France – either by registering under PUMA or taking out private healthcare insurance.

Disclaimer: The information included in this article is provided for information purposes only and is not intended to constitute professional advice or replace consultation with a qualified medical practitioner. All information contained herein is subject to change.

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