France’s healthcare system is renowned for its accessibility and quality of care. At the heart of this system lies the Carte Vitale, a crucial card that grants you access to the country’s extensive healthcare services. For expatriates, understanding and obtaining a Carte Vitale is an essential step towards seamless integration into the French healthcare framework. This guide outlines what a Carte Vitale is, who needs one, what it covers, and provides a comprehensive step-by-step process for application.
Table of contents
What is the Carte Vitale?
Definition and purpose
The Carte Vitale is a vital component of the French healthcare system. It is a green, chip-enabled card issued to individuals enrolled in the sécurité sociale (French national health insurance). The card holds essential information about your social security status, including your French health insurance number and details about your healthcare coverage.
The Carte Vitale streamlines the reimbursement process when visiting doctors, pharmacies, or healthcare providers in France. Instead of dealing with lengthy paperwork, patients simply present their card, and their healthcare expenses are automatically recorded and processed by the French social security system.
Who issues the Carte Vitale?
The Carte Vitale is issued by your local CPAM (Caisse Primaire d’Assurance Maladie), which is the regional health insurance office responsible for managing healthcare entitlements in your area. Each département has its own CPAM, and once your application has been accepted, the card will be sent by post to your registered address.
> You might be interested in this article: What is the CPAM in France?
Why it matters for healthcare access
Holding a Carte Vitale is crucial if you live in France and wish to access public healthcare. With it, you benefit from automatic reimbursements for medical expenses—typically around 70% of standard healthcare costs—with the remaining portion often covered by a mutuelle (private complementary insurance).
Without a Carte Vitale, you may still access healthcare services, but you’ll need to pay upfront and submit reimbursement claims manually, which can delay refunds and complicate the process. For this reason, applying for and obtaining a Carte Vitale as soon as you’re eligible is one of the most important administrative steps when settling in France.
Who can apply for a Carte Vitale?
Eligibility for foreign residents and expats
Foreign residents living in France long-term are generally eligible to apply for a Carte Vitale once they are affiliated with the French social security system. Whether you’re employed, self-employed, retired, or a student, the key requirement is that you are legally residing in France and contributing to or covered by the French healthcare system.
Expats must usually have been living in France for at least three consecutive months before they can register for health coverage under PUMA (Protection Universelle Maladie), unless they qualify through employment or another fast-track route.
Requirements for students, workers and retirees
Students enrolled in a recognised French educational institution can register for health insurance through the student system or via PUMA, depending on their age and situation. They will need to provide proof of enrolment and residency.
Workers—whether salaried or self-employed—are typically covered by the general social security regime and can apply for a Carte Vitale shortly after starting employment. Employers usually assist with registration for social security contributions.
Retirees from abroad, particularly non-EU citizens, must apply for coverage under PUMA and often need to provide documentation showing they are not eligible for coverage in their home country. Pensioners may also be asked to show proof of income and stable residence.
Non-EU vs. EU citizens: What’s the difference?
EU/EEA/Swiss citizens benefit from more streamlined access to French healthcare. They can typically use their European Health Insurance Card (EHIC) for temporary stays and then apply for the Carte Vitale if moving to France permanently. EU nationals may also be covered through their country’s social system for a limited time before enrolling in PUMA.
Non-EU citizens, including British and American nationals, often face stricter requirements. They must provide a valid long-stay visa or residence permit, proof of address, proof of income, and documentation demonstrating their legal stay in France. Many non-EU applicants are initially covered under private health insurance before becoming eligible to join the public healthcare system.
Regardless of nationality, the process can take several months, so early preparation is essential for ensuring access to affordable healthcare in France.
How to apply for a Carte Vitale in 2025?
Step-by-step application process
Applying for a Carte Vitale in 2025 remains a crucial step for anyone intending to access the French public healthcare system. While the process is largely the same as in previous years, it’s always good to follow the latest official guidance and prepare thoroughly.
Here’s how the application typically works:
- Register with French Social Security (Assurance Maladie): You must first register with the French social security system to obtain a numéro de sécurité sociale (social security number). This is often done via your employer, or you can apply directly through your local CPAM (Caisse Primaire d’Assurance Maladie) if you’re self-employed, a student, or not working.
- Wait for Your Social: Security Number
Once registered, you’ll receive a temporary number while your permanent one is being processed. You must wait until you receive your definitive number before applying for your Carte Vitale. - Create an Account on Ameli.fr: Once you have your number, set up an account on www.ameli.fr, the official health insurance website. This platform is essential for managing your health cover, submitting documents, and tracking your Carte Vitale request.
- Request Your Carte Vitale: Log into your Ameli account and complete the Carte Vitale request. You’ll be prompted to upload a passport-style photograph and a copy of your valid ID.
- Receive Your Carte Vitale by Post: Once approved, your physical Carte Vitale will be sent to your registered French address.
Required documents
To complete the application, you will generally need the following:
- Proof of identity (passport or national ID)
- Proof of address in France (utility bill, rental contract, or attestation d’hébergement)
- French birth certificate or a translated version of your foreign birth certificate
- Residency permit or visa (for non-EU nationals)
- French bank details (RIB – Relevé d’Identité Bancaire)
- Passport-style photo (digital format if applying online)
- Social security number (once issued)
Additional documents may be required depending on your status (e.g., employment contract for workers, proof of school enrolment for students).
Where to submit your application
Applications for your Carte Vitale are submitted through your Ameli.fr account once your social security number has been assigned. If you are not yet registered with social security, you must submit your application to your local CPAM office.
Each département in France has its own CPAM office. You can find the correct contact information and postal address via the Ameli website or by visiting a local health insurance office.
If applying by post, be sure to send certified or officially translated documents when necessary.
How long it takes to receive the card
Once your Carte Vitale has been requested through Ameli and your documents approved, you can typically expect to receive the card within 2 to 4 weeks by post.
However, the entire process—from registering for a social security number to receiving the Carte Vitale—can take 2 to 6 months, especially for first-time applicants. Delays may occur if documentation is missing or if translation is required, so it’s best to apply as early as possible after moving to France.
In the meantime, you may receive a temporary certificate of rights (attestation de droits), which allows you to start accessing public healthcare services before your card arrives.
> You might be interested in this article: Health insurance in France as an expat
What happens after you apply?
Once you’ve submitted your application for the Carte Vitale and completed your registration with the French social security system, there are a few important next steps to be aware of while you wait for your permanent card.
Receiving your temporary social security number
If you’re applying for French health cover for the first time, you will initially be issued a temporary social security number. This is typically provided once your registration with l’Assurance Maladie is underway and your documents have been reviewed.
This temporary number allows you to begin accessing healthcare services and is later replaced by a permanent number once your application is fully processed. It’s important to keep a record of this number, as it will be required when contacting CPAM or setting up your Ameli.fr account.
Using your attestation in the meantime
Before your Carte Vitale arrives, you’ll receive an attestation de droits—a temporary certificate that proves your entitlement to French healthcare coverage.
This document allows you to:
- Visit GPs and specialists
- Receive reimbursements for medical expenses
- Register with a mutuelle (top-up insurance)
- Prove your affiliation to the French healthcare system
Be sure to keep a printed copy with you, as you may need to present it at medical appointments, pharmacies, or when completing other administrative tasks related to your healthcare.
If you receive medical treatment before your Carte Vitale is issued, you’ll still be reimbursed as long as you provide your attestation and bank details (RIB). Any reimbursements will be sent directly to your French bank account.
Delays and what to do if you don't hear back
Processing times for social security registration and Carte Vitale issuance can vary widely, particularly if:
- You’ve recently arrived in France
- Your documents require official translation
- There are missing or incorrect details in your application
If you haven’t heard back within two months, or if you’re concerned about the progress of your application, here’s what you can do:
- Contact your local CPAM: Visit or phone your regional Caisse Primaire d’Assurance Maladie to check your file status.
- Log into your Ameli.fr account: Check for messages or document requests, and ensure your contact information is up to date.
- Send a follow-up letter or email: Include your temporary social security number (if you have one), a brief explanation of your situation, and a request for an update.
Delays are common, but keeping copies of all correspondence and being proactive with follow-ups can help prevent your application from stalling.
If you need help navigating the process, some applicants choose to work with a relocation advisor or language support service to ensure everything is submitted correctly and communication with authorities goes smoothly.
How to use your Carte Vitale
Once you’ve received your Carte Vitale, navigating the French healthcare system becomes far more streamlined. The card acts as your official proof of registration with the national health insurance system (l’Assurance Maladie) and is essential for accessing reimbursed healthcare services throughout France.
At the doctor's office or pharmacy
Using your Carte Vitale is straightforward. When you visit a general practitioner, specialist, or pharmacy, you simply present your card at the start of the appointment or transaction. The practitioner will insert the card into their computer system to verify your entitlement and automatically transmit your treatment information to l’Assurance Maladie.
This process allows for:
- Automatic reimbursement of eligible medical expenses
- Reduced upfront costs where applicable
- A digital record of your consultations and prescriptions
It’s important to note that your Carte Vitale does not carry personal medical history—it only contains administrative information such as your social security number and healthcare affiliation. For this reason, many patients also carry a medical file or “dossier” or use a digital health account like Mon Espace Santé.
If you forget your Carte Vitale during a visit, the provider may give you a feuille de soins (treatment form), which you’ll need to fill out and post to your local CPAM for manual reimbursement. This can slow down the process considerably.
Reimbursement rates and how they work
The French healthcare system operates on a co-payment basis, known as the ticket modérateur. This means that l’Assurance Maladie reimburses a set percentage of the official base rate for each type of medical service, while the patient covers the remaining portion—either out of pocket or via complementary health insurance (mutuelle).
This reimbursement is calculated based on the BRSS (Base de Remboursement de la Sécurité Sociale)—the reference price determined by the French health insurance system. It is important to note that the BRSS is not necessarily the same as the amount charged by a doctor, especially for specialists or non-conventionné practitioners.
For example:
- If the BRSS for a GP visit is 25 € and the reimbursement rate is 70%, l’Assurance Maladie will refund 17.50 €.
- If the actual fee charged is higher (say 35 €), the patient is responsible for the difference, plus the remaining co-payment—unless they have a mutuelle that covers the excess.
Here’s a general breakdown of standard BRSS-based reimbursement rates:
- GP and specialist visits: 70% of the BRSS reimbursed by Assurance Maladie
- Pharmacy prescriptions: 15% to 100% of the BRSS, depending on the type of medication
- Laboratory tests and medical imaging: Approximately 60% to 70% of the BRSS
- Hospital stays: Typically up to 80% of the BRSS covered, plus a fixed daily hospital fee (forfait journalier), which is usually not reimbursed
The remaining costs—often referred to as the ticket modérateur and any amount exceeding the BRSS—can be fully or partially covered by your mutuelle. If your Carte Vitale is linked with your mutuelle, the tiers payant system enables automatic processing of both the Assurance Maladie and mutuelle contributions, allowing you to pay little to nothing upfront.
Understanding how the BRSS works is crucial for managing your healthcare expenses in France, especially when comparing different doctors, clinics, and treatment options.
When you still need to pay upfront
Despite the efficiency of the Carte Vitale system, there are still situations where you’ll need to pay upfront and be reimbursed later:
- If the provider is not conventionné (contracted) with the health system
- If you don’t present your Carte Vitale
- For certain specialists or alternative therapies that are not fully reimbursed
- When using private clinics or choosing services outside the standard care pathway
In these cases, you’ll pay the full consultation fee and receive a feuille de soins to claim your reimbursement manually, unless the provider offers a digital transmission of the claim.
In all cases, ensure you keep your Carte Vitale up to date—especially after changes to your address, marital status, or mutuelle coverage. You can update the card at CPAM offices, many pharmacies, or healthcare kiosks located in public facilities.
Do you still need private health insurance?
What a Carte Vitale covers
While the Carte Vitale gives you access to France’s highly regarded public healthcare system, it does not mean that all medical costs are covered in full. Instead, the Carte Vitale allows you to benefit from reimbursements through l’Assurance Maladie, which typically covers only a percentage of the official tariff for each medical service, based on the Base de Remboursement de la Sécurité Sociale (BRSS).
For example, standard GP visits are reimbursed at 70% of the BRSS, and medications can range from 15% to 100% coverage depending on classification. Hospital stays are covered up to 80%, but fixed daily fees (forfait journalier) and any charges above the BRSS remain your responsibility.
Why a mutuelle is still essential
To bridge the gap between what l’Assurance Maladie reimburses and the actual cost of care, most residents in France take out private complementary health insurance, known as a mutuelle.
A mutuelle typically covers:
- The remaining co-payment (ticket modérateur)
- Fees above the BRSS if you see a non-conventionné specialist
- Daily hospital charges not reimbursed by the state
- Additional services like dental and vision care, which are often poorly reimbursed under the state system
Without a mutuelle, you could find yourself paying significant out-of-pocket costs, especially for hospital treatment, dental work, or specialist care. Many employers in France are legally required to provide a mutuelle for their staff, but this is not the case for retirees, self-employed individuals, or foreign residents without employment.
FAQ Carte Vitale for expats in France
Do I need a Carte Vitale to see a doctor in France?
No, you don’t strictly need a Carte Vitale to see a doctor in France. You can still receive medical care and pay out of pocket, then request reimbursement using a paper form (feuille de soins). However, having a Carte Vitale simplifies the process significantly, as it allows for automatic reimbursements and access to the tiers payant system, meaning you often don’t have to pay the full cost upfront.
Can I apply for the Carte Vitale before arriving in France?
No, you must be living in France and have a valid residency status before applying for a Carte Vitale. It is not possible to apply from abroad. You’ll need to register with the French Social Security system (CPAM) and provide proof of residence, identity, and your legal right to stay in France.
What is the difference between the Carte Vitale and private insurance?
The Carte Vitale is not an insurance policy—it’s a health card that links you to the French public healthcare system and facilitates reimbursements from l’Assurance Maladie. Private insurance, or a mutuelle, is a separate plan that covers the portion of costs not reimbursed by the state. Most residents in France have both to ensure comprehensive health coverage.
Can my spouse or dependents apply as well?
Yes. Spouses and dependents can also apply for their own Carte Vitale as long as they are legally residing in France and meet the eligibility criteria. Children can be added to one parent’s social security account until a certain age, after which they may apply independently.
What if I’m only staying in France temporarily?
If your stay is under 3 months, you may not be eligible for a Carte Vitale. In this case, it is advisable to obtain private international health insurance that covers your healthcare needs during your time in France. For longer stays with a valid visa, you can apply after settling in and registering with the French healthcare system.
Is the Carte Vitale linked to tax residency?
No, holding a Carte Vitale does not automatically make you a tax resident in France. However, it does demonstrate a link to the French social system, which could be taken into consideration alongside other factors if your tax residency is ever under review. If you’re concerned about tax implications, it’s best to seek advice from a tax specialist familiar with international situations.
First published: October 2023
Updated: April 2025
