Guide to healthcare system in France for American expats

If you are planning to move to France as an American expat, understanding how the healthcare system works is essential. France offers a high-quality, efficient healthcare system that is often regarded as one of the best in the world. Navigating the French healthcare system as a foreigner requires some knowledge and preparation. Let’s explore the essentials of healthcare in France for American expats, including how to register, whether healthcare is free or not, and the importance of health insurance.

Guide to Healthcare System in France for American Expats

Overview if the healthcare system in France

France has one of the most highly regarded healthcare systems globally, offering a hybrid model that combines public and private services. The system is designed to ensure comprehensive medical care for all residents, including expats, at an affordable cost while maintaining high standards of treatment and accessibility.

National health insurance: Sécurité sociale

At the core of the French healthcare system is sécurité sociale, the national health insurance scheme. This public insurance covers roughly 70% of medical expenses, including doctor visits, hospital stays and specialist treatments. Every resident in France, including in American expats who meet the residency or employment requirements can access this system.

Employers and employees both contribute to the funding of sécurité sociale through payroll taxes. For expats who aren’t employed, like retirees or self-employed individuals, contributions can be made directly after registration with the PUMA (Protection Universelle Maladie) scheme. Expats who register receive a Carte Vitale, a green health card that allows for easy billing and reimbursements at healthcare facilities. 

> You might be interested in this article: Guide to the carte vitale for expats

Private health insurance: Mutuelle

While sécurité sociale covers the majority of medical costs, the remaining 30% can be covered by private insurance known as a mutuelle. Many French residents and expats choose to supplement their public coverage with a mutuelle to reduce out-of-pocket expenses. This additional insurance typically cover costs that aren’t fully reimbursed, such as dental care, vision, and specialist consultations. 

Public and private healthcare providers

In France, both public and private healthcare providers participate in the national system, and expats can access care from either sector. Public hospitals and clinics provide excellent care, but private facilities, which also accept sécurité sociale, may offer more luxurious amenities and shorter waiting time. The level of care remains consistent across both sectors. 

Is healthcare in France free?

While France has a universal healthcare system, it is not entirely free. However, the cost of healthcare is significantly lower compared to the US. Patients are expected to pay a portion of their medical bills, but the state reimburses a substantial part through sécurité sociale. Doctor visits, hospital stays, and specialist appointments all require you to pay but much of it is covered through the national insurance scheme. For instance, a general practitioner visit typically costs around 25 €, with up to 70% reimbursed. 

> You might be interested in this article: Choose and declare your GP in France

Can US citizens get healthcare in France?

Yes, American expats in France can access the French healthcare system, but they need to follow specific steps to register. The first requirement is to become part of sécurité sociale, the public health insurance system. American expats must typically have resided in France for at least three months before they can apply for public healthcare coverage under PUMA. 

For expats who are employed in France, the process is straightforward. Social contributions for healthcare are automatically deducted from their salary, which grants them access to the national healthcare system. These contributions cover a portion of the cost for doctor visits, hospital stays, and prescription medications, making it easier to manage healthcare expenses. 

For retirees or those who are not working, registering for PUMA involves providing residency in France, providing necessary documentation, and demonstrating financial stability. This ensures that individuals not employed are still able to contribute to the healthcare system and receive medical care. 

Once registered, expats receive a carte vitale, a green health card that serves as proof of health insurance. This card is essential for accessing medical services in France, as it allows patient to receive care and get reimbursed for medical expenses. In most cases, the carte vitale streamlines billing and ensures that expats can quickly claim reimbursement for the majority of their healthcare costs. 

What happens if an American expat needs medical care in France?

If an American expat in France falls ill or needs medical care, the process is efficient and straightforward. Most expats first consult a médecin généraliste (general practitioner), who serves as the primary point of contact for routine medical care. Appointments with a GP are usually easy to book, and wait times are often shorter than in the US.

For example, if you wake up with the flu, you can visit a nearby GP who may prescribe medication and provide a treatment plan. The cost of the visit will typically be around 25 €, but with the carte vitale, the system automatically covers 70% of the fee, and the remainder can be claimed through private insurance (mutuelle)

In emergencies, France’s hospital system is highly advanced and well-equipped to handle urgent medical situations. Emergency rooms provide immediate care, and an efficient ambulance service is available by dialling 15. If you suffer a serious injury or sudden illness, calling for an ambulance or heading to a hospital ensures you receive professional medical assistance. 

For most non-emergency situations, you don’t have to pay upfront. Thanks to the Carte Vitale, doctors, specialists, and hospitals bill the French healthcare system directly. This simplifies the process and alleviates the stress of managing healthcare costs on the spot. The card streamlines your access to care, ensuring American expats receive prompt, affordable, and high-quality medical attention when needed.

> You might be interested in this article: Healthcare for retired expat living in France

Do I need health insurance as an American expat?

Yes, American expats do need health insurance in France, as it is mandatory for all residents, including expats and immigrants.  Health insurance can be either public, private or a combination of both, depending on your specific situation. Once you’ve lived in France for more than three months, you’re subject to the same health insurance requirements as French nationals and can access the public healthcare system, known as PUMA. This allows you to benefit from the national health insurance scheme, but it’s often advisable to supplement it with private insurance to cover the remaining costs.

American expats are required to take out comprehensive private health insurance for the duration of their stay in France. This is a critical requirement, especially for those applying for visas or residency permits. Private insurance can cover additional costs that the public system doesn’t, such as certain admin fees or treatments. It’s also important to note that 82% of failed visa or carte de séjour applications are turned down due to insufficient health insurance coverage. Having a robust insurance plan is essential to avoid these issues. 

Final notes

For American expats in France, the healthcare system offers both quality and affordability, but understanding how it works is crucial. From registering with sécurité sociale to securing private health insurance, we want to help you navigate the healthcare system and ensure you’re well prepared for any medical needs while living abroad. 

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