GovWire

You must have health insurance cover to live in France.

State healthcare in France is not free. Healthcare costs are covered by both the state and through patient contributions. These are known as co-payments.

You may have to pay upfront for some treatments. The French national insurance fund, Caisse Primaire dAssurance Maladie (CPAM), will then repay you for part of the costs later.

UK nationals usually access the French healthcare system in one of these ways:

• making French social security contributions through their employer or as a self-employed person
• using a European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) for temporary stays when studying, or as a posted (detached) worker
• registering a UK-issued S1 form with the local CPAM office (see UK-funded healthcare: getting and using an S1 form in France below)

Healthcare if you live and work in France

If you are planning on moving to France, see the guidance on Living in France for more information about visa and residency requirements.

In some cases you must show proof of healthcare cover:

• before you can register as a resident
• when you apply for a visa

For details about the healthcare cover required for residency applications, contact local authorities in France or the appropriate French embassy or consulate in the UK.

You can apply to be covered by the French healthcare system (Protection Universelle Maladie or PUMa) if youve been a resident in France for at least 3 months. Youll have access to state healthcare on the same basis as a French citizen.

If youre employed in France, your employer must initiate your registration for PUMa via the employers online portal before you start work. Read Ameli guidance on registering a foreign national for healthcare in France (in French).

You must apply for your social security number at your local CPAM office as soon as you start work. Read Ameli guidance on what steps to take depending on your worker status (in French). You should buy private health insurance while waiting for the registration process to be completed.

Youll pay for PUMa through social security contributions if you are employed or self-employed in France.

If you are not employed you may have to pay into PUMa yourself. Theres more information on the CPAM website (in French).

You may be entitled to a French EHIC for travel, including visits to the UK. You cannot use a UK-issued EHIC in France if you live and work there on a French contract.

You may also have the right to apply for a UK S1 if you start drawing a UK State Pension (see UK-funded healthcare: getting and using an S1 form in France below).

How to register for healthcare

You can apply for PUMa through your local CPAM office. Theres information about how to register online.

Once registered, youll get a temporary social security number by post after 1 to 3 months.

Youll then receive a document called an attestation de droits lassurance maladie. This confirms your right to French state healthcare and your French social security number.

Once youve got that document, you can apply for your French state healthcare card, the carte vitale. Take it with you whenever you visit a doctor, pharmacy or specialist provider.

It can take 6 months or longer to get a carte vitale. If you have questions about your application, contact your local CPAM office.

If you need healthcare before you receive your card, use your social security number. Ask your healthcare provider for a feuille de soins and send it to your CPAM office to be refunded for any treatment youve paid for.

How to access healthcare services

Find your nearest hospital or clinic on the Hopital.fr website (in French).

How much youll pay

State healthcare in France is not free. You may have to pay some of the cost of any treatment.

Make sure you understand what youll be charged and how much of that youll get back through state healthcare cover. Theres information (in French) about reimbursements online.

You can also get top-up insurance called a mutuelle. This will cover all or part of your medical costs not covered by the state.

If your UK employer has sent you to France temporarily (posted workers)

A posted worker, also known as a detached worker, is someone who is employed or self-employed in the UK, but temporarily sent to a European Economic Area (EEA) country.

UK posted workers can access healthcare in France using an EHIC, GHIC or S1 form.

HMRC has a helpline for National Insurance enquiries from non-UK residents. They can answer questions about posted worker status and explain which documents you will need to get healthcare while posted.

You should register your S1 with your local CPAM. Read Ameli guidance for posted workers and secondees (in French).

You may also need a UK-issued A1 certificate to show that you pay national insurance in the UK. You can get this from HMRC.

If youre using an EHIC or GHIC, youll need to show the card when you go to your appointment.

UK-funded healthcare: getting and using an S1 form in France

Theres different guidance if you have an S1 as a posted worker (see If your UK employer has sent you to France temporarily (posted workers) above).

You may be entitled to state healthcare paid for by the UK if youre a resident in France and receive a UK State Pension or an exportable benefit. See Planning your healthcare abroad on the NHS website for more information about eligibility.

You may also be entitled to an S1 form if youre a frontier worker (someone who works in one state and lives in another). You must contact HMRC National Insurance enquiries to find out if youre eligible.

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