Jeffrey Wade
France has a universal health insurance system that covers all residents. The system is financed through employee and employer contributions, taxes on revenue, and government funding. All working people are required to pay a portion of their income into a health insurance fund, which covers medical expenses at varying rates. The French government fixes the reimbursement rate for medical services, with doctors able to choose between adhering to negotiated fees or charging higher fees within reason. The social security system covers 70% of medical costs, with the remaining 30% covered by supplemental insurance or paid out-of-pocket. France also offers free or discounted health insurance for low-income individuals and families, and foreigners residing in France may be eligible for State medical assistance.
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What You'll Learn
- Foreigners in France have different rules for health insurance depending on their country of origin and status
- SHI schemes: the general scheme, the self-employed professionals' scheme, and the agricultural scheme
- Social security covers 70% of costs, unless the person has a long-term medical problem, in which case 100% is covered
- The social security system will only reimburse at pre-set rates
- Low-income individuals are entitled to free or discounted health insurance
Foreigners in France have different rules for health insurance depending on their country of origin and status
France has a universal healthcare system called Protection Universelle Maladie (PUMA). It ensures that healthcare is available to all French citizens, regardless of age, wealth, or status. Foreigners in France have different rules for health insurance depending on their country of origin and status.
If you are a foreigner planning to settle in France, health insurance rights differ depending on whether you are a citizen of a European Economic Area (EEA) country, Switzerland, the United Kingdom, or another country. For EEA citizens, the European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) entitles you to medical treatment in France under the same conditions as insured French nationals. If you are from Switzerland, you can choose between the French health insurance and the Swiss scheme for your healthcare. If you are a citizen of another country, you may need to inquire with your health insurance fund before your departure.
For foreigners residing in France for more than three months with the intention of staying for at least another three months, you can benefit from the PUMA system. This applies to all legal residents, including expats, and guarantees health coverage to those who live or work in France for at least three months per year. To qualify, you must demonstrate that you intend to reside in France permanently and legally, planning to stay for at least half of the year. Additionally, you must register with a primary care physician and provide proof of this registration when applying for public health care at your local CPAM (Caisse Primaire d’Assurance Maladie) office.
Employees working in France, both nationals and non-nationals, are eligible for state health insurance through their social security contributions, which are automatically deducted from their salaries. Freelance sole traders and limited company business owners can access medical insurance through the independent social security system. If you are on a work mission from a foreign company, your situation may be more complicated, and it is best to consult your employer or Cleiss for more information.
While France's public health insurance is universal, it typically covers only a percentage of the medical costs, with the patient responsible for the remaining amount. As a result, many French residents supplement their coverage with private health insurance, known as a "mutuelle," which covers additional health and medical costs. This includes expenses such as the co-pay for doctor visits, physiotherapy, and private hospital room accommodations.
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SHI schemes: the general scheme, the self-employed professionals' scheme, and the agricultural scheme
France runs a statutory health insurance (SHI) system that provides universal coverage for its residents. The system is financed through employee and employer contributions and, increasingly, by earmarked taxes on a broad range of revenues. There are three main SHI schemes: the general scheme, the self-employed professionals scheme, and the agricultural scheme. All SHI schemes provide the same coverage and benefit policies, and funds are pooled at the national level with the possibility of subsidies between schemes.
The general SHI scheme covers all working people, who are required to pay a portion of their income into a health insurance fund. This fund reimburses medical expenses at varying rates, and children and spouses of insured individuals are also eligible for benefits. The rate at which expenses are reimbursed is negotiated between the Ministry of Health and manufacturers, based on the average price of sale observed in neighbouring countries. A board of doctors and experts decides if a medicine provides a valuable enough medical benefit to be reimbursed. Most medicine is reimbursed, including homeopathy.
The self-employed professionals scheme is one of the smaller SHI schemes, covering a specific sector of the population. The agricultural scheme is another of the smaller SHI schemes, also covering a specific sector of the population.
In addition to the three main SHI schemes, there are a variety of other small special schemes that cater to specific sectors of the population. All citizens and legal foreign residents of France are covered by one of these mandatory programs, which are funded by worker contributions. The social security system covers 70% of the global cost, unless the person has a long-duration medical problem such as cancer or diabetes, in which case all expenses are covered.
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Social security covers 70% of costs, unless the person has a long-term medical problem, in which case 100% is covered
In France, the government has taken responsibility for the financial and operational management of health insurance. The French social security system covers 70% of most healthcare costs. This includes doctor's appointments, medications, examinations, procedures, hospitalizations, and treatment in heavy care facilities. For instance, a doctor's appointment within the coordinated healthcare pathway system is reimbursed at a rate of 70%. The social security system will only reimburse at the pre-set rate.
However, there are exceptions to this 70% coverage. For costly or long-term ailments, the government refunds patients 100% of the expenses. This includes cases where individuals have a long-term medical problem, also known as an "ALD" (long-duration medical problem) such as cancer, AIDS, or diabetes. In these situations, all expenses are covered. Additionally, in the Alsace-Moselle region, due to its unique history, the social security system covers 90% of the global cost.
It is important to note that the French social security system also provides coverage for specific situations, such as sickness, maternity, paternity, disability, and death. For example, in the event of sickness, health insurance provides daily allowances to the insured who are physically disabled and unable to work. The French social security system also contributes to hospital costs incurred by insured persons and their dependents, covering fees for medical and surgical procedures, medication, examinations, and more during the patient's hospital stay.
The French healthcare system is funded through a combination of employee and employer contributions, as well as taxes on various revenue streams. All working people are required to pay a portion of their income into a health insurance fund, and children and spouses of insured individuals are also eligible for benefits. The system aims to provide universal coverage for its residents, and all citizens and legal foreign residents of France are covered by one of these mandatory programs.
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The social security system will only reimburse at pre-set rates
France runs a statutory health insurance (SHI) system, which provides universal health coverage for its residents. The SHI system is financed through employee and employer contributions, with additional funding from earmarked taxes on a broad range of revenues. There are three main SHI schemes: the general scheme, the self-employed professionals' scheme, and the agricultural scheme. All SHI schemes provide the same coverage and benefit policies.
The social security system, which falls under the portfolio of the Minister of Health and Solidarity, covers 70% of the global cost. However, for individuals with long-duration medical problems (ALD) such as cancer or diabetes, the social security system covers 100% of the expenses. In the Alsace-Moselle region, due to its unique historical context, the social security system covers 90% of the global cost.
Doctors in France can choose to adhere to negotiated fees (Sector 1), charge higher fees within reason (Sector 2), or have no fee limits (Sector 3). The social security system will only reimburse at pre-set rates, which are negotiated annually with doctors' representative organisations. These pre-set rates are based on the average price of sale observed in neighbouring countries, and a board of doctors and experts decides on the reimbursement rate based on the medical benefit provided.
It's important to note that the social security system's finances have been under strain, leading to concerns about the growth of France's healthcare expenses. Experts have proposed various measures to address this issue, including reorganising access to healthcare providers and revising pertinent laws.
Regarding foreigners and expatriates, the rules for health insurance coverage depend on factors such as their country of origin, status (student, retired, worker, etc.), and whether they intend to reside in France permanently and legally. In some cases, foreigners may be eligible for State medical assistance (AME), which covers most medical and dental care expenses within the maximum rates set by the French Social Security system.
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Low-income individuals are entitled to free or discounted health insurance
In France, health insurance is mandatory for all residents, and everyone has the same access to medical services, regardless of their income. Low-income individuals are entitled to free or discounted health insurance, free vision care, and free dental care. This is available to those who make €8,723 ($11,040) or less per year, with the qualifying income level increasing for households with more members. Around 9% of the population are low-income beneficiaries, with 6% receiving means-tested vouchers for VHI and 3% receiving free state-sponsored coverage.
The French healthcare system is insurance-based, with three main SHI schemes: the general scheme, the self-employed professionals' scheme, and the agricultural scheme. All SHI schemes provide the same coverage and benefit policies, and funds are pooled at the national level. The system is financed through employee and employer contributions, with employers paying 80% of the tax, and employees making up the remaining 20%. Contributions are calculated from actual salaries, capped at €3,311 ($4,191) per month.
The government fixes the reimbursement rate for medical services, with doctors choosing to adhere to negotiated fees or charge higher fees within reason. The social security system will only reimburse at the pre-set rate, and these tariffs are set annually through negotiations with doctors' representative organisations. The Ministry of Health directly negotiates medicine prices with manufacturers, based on the average price of sale in neighbouring countries. A board of doctors and experts decides if the medicine provides a valuable enough medical benefit to be reimbursed.
The French system of health insurance ensures that low-income individuals have access to the same quality of healthcare as everyone else, with financial support to remove barriers to accessing medical services.
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Frequently asked questions
France runs a statutory health insurance (SHI) system, which provides universal coverage for its residents. The system is financed through employee and employer contributions and taxes on a broad range of revenues. There are three main SHI schemes: the general scheme, the self-employed professionals' scheme, and the agricultural scheme. All SHI schemes provide the same coverage and benefit policies.
The health insurance of a foreigner in France depends on your country of origin and your status (e.g. student, retired, worker). If you are an expat, you will need to demonstrate that you intend to reside in France permanently and legally, and have been doing so for at least three months. You will also need to register with a primary care physician and provide proof of this registration when applying for public health care at your local CPAM (Caisse Primaire d’Assurance Maladie) office.
The French health insurance system covers most of the expenses for medical or dental care provided at the practitioner's office or in a hospital. The social security system will cover 70% of the global cost unless the person has a long-duration medical problem such as cancer or diabetes, in which case all expenses are covered.
