France (FR)

France is a unitary semi-presidential republic and the EU's most visited country, renowned for its world-class cuisine and wine, the iconic City of Light that is Paris, the French Riviera, iconic Alpine ski resorts, and a generous social state offering universal healthcare, extensive family benefits, and strong worker protections.

Capital: Paris

Region: Europe

Language: French

Currency: EUR (€)

Cost of living: Expensive (index 74)

Emergency: 112

Healthcare in France

France has a universal, Bismarck-style multi-payer healthcare system repeatedly ranked among the best in the world (WHO #1 in 2000; consistently top 10 since). Funded through social contributions (CSG/CRDS + employer/employee Sécurité sociale), it is administered by the Assurance Maladie (Sécurité sociale) via CPAM, MSA (agricultural), and independent schemes. Coverage is near-universal thanks to PUMa (Protection Universelle Maladie, 2016) — any stable resident is covered.

Consistently top 10 globally. ~11.3% of GDP spent on health (2026). Extensive network of public (hôpitaux publics) and private (cliniques) providers. Ultra-short waits for GPs (same-day possible via Doctolib); specialists 2–6 weeks.

Public healthcare: Assurance Maladie (Sécurité sociale)

National Health Insurance under PUMa

Eligibility:Anyone legally and stably resident in France (3+ months of continuous residence) is affiliated via PUMa. Employees and self-employed are automatic; inactive residents join the régime général via CPAM. Foreign students register free on ameli.fr. EU citizens can use S1 to transfer rights; non-EU become eligible after 3 months of residence.

Monthly cost:No direct premium for employees (funded through employer + CSG/CRDS). Self-employed: built into URSSAF cotisations. Non-working residents: cotisation subsidiaire maladie (CSM) of 6.5% on investment income and capital gains above ~€22,000/year, for those not having professional activity. Students: free.

What's included:

GP and specialist visits (70% tariff reimbursement; 100% on 30 chronic "ALD" conditions)
Hospital stays (80% reimbursed + €20/day forfait journalier hospitalier)
Prescription medication (15–100% reimbursed depending on "SMR" level)
Pregnancy, childbirth, post-natal (100% from 6th month; all maternity covered by Sécu)
Preventive check-ups: Examen de santé périodique free at CPAM centres
Dental check-ups and basic care (70% tariff reimbursement); "100% Santé" reform covers full prosthetics since 2021
Mental health: 8 séances/year with a CPAM-partnered psychologue (Mon Soutien Psy, since 2022)
Physiotherapy (kinésithérapeute) with doctor's prescription
Optical (glasses, contacts) — "100% Santé" reform covers basic glasses in full

Not included (or co-pay required):

The remaining 30% (ticket modérateur) — covered by your mutuelle if you have one
Depassements d'honoraires (secteur 2 doctors who charge more than the tariff) — partial reimbursement depending on OPTAM affiliation and mutuelle
Private hospital chambre particulière (single room supplement ~€50–100/night)
Unregistered alternative medicines (homeopathy delisted in 2021; acupuncture partly covered if by MD)
Cosmetic surgery, most fertility treatments beyond national caps

Co-payments:Participation forfaitaire: €2 per GP visit (capped at €50/year), €1 per medical procedure, €1 per paramedical act. Forfait journalier hospitalier: €20/day in hospital. Franchises médicales: €1 per medicine (€50/year cap). These are not reimbursable by mutuelle — they are deducted at source. Minors, pregnant women (from 6th month), CMU-C/CSS beneficiaries and ALD patients are exempt.

How to enrol:Employees: your employer declares you via DSN to URSSAF on your first day. You then register online at ameli.fr using your numéro de Sécurité sociale (NIR). Self-employed: registered automatically via URSSAF when you create your activity. Non-working residents: apply via the "Demande d'affiliation au régime général" on ameli.fr or at your local CPAM, providing justificatif de domicile + 3 months' residence + passport. Your Carte Vitale arrives by post 4–8 weeks later.

Waiting period:3 months of continuous, stable residence to qualify via PUMa (apart from automatic affiliation via employment or studies which is immediate).

Private healthcare: Mutuelles santé & Assurances complémentaires

Who can use it:All French residents can voluntarily subscribe to a mutuelle or assurance complémentaire santé to cover the 30% ticket modérateur + depassements + dental/optical/hearing. Since 2016, employers must offer a mutuelle d'entreprise covering ≥50% of the premium for all employees (mandatory collective contract under ANI). Low-income residents (<€10,166/year single, 2026) qualify for Complémentaire Santé Solidaire (CSS) — formerly CMU-C — free or at €8–30/month.

When it makes sense:Everyone should have a mutuelle — being without one means paying the 30% ticket modérateur yourself. Employees get a mutuelle collective through work (mandatory); self-employed and retirees subscribe individually. Compare on lesfurets.com, lelynx.fr, or ask your union/association for group rates.

Monthly cost:Individual mutuelle: €30–90/month single, €60–160/month family. Senior mutuelle (60+): €80–180/month. Entry-level contracts often limit dental/optical. CSS (free or capped at €8–30/month for those eligible).

Major providers:

Harmonie Mutuelle (largest)MGEN (originally for teachers)MAIF / MACIFAXA SantéGeneraliAlan (tech-friendly)Apivia MacifMalakoff Humanis

Accessing care

GP system

Everyone 16+ must declare a "médecin traitant" (referring GP) with CPAM — failure to do so means reimbursements drop from 70% to 30% ("parcours de soins coordonnés"). You can change at any time. GP consultation: €30 (Secteur 1 tariff, €25 until 2025). Book via Doctolib.fr or phone. Same-day / next-day appointments usually possible.

Specialist referral

To get full reimbursement, specialists must be seen via a referral (courrier) from your médecin traitant. Some specialists (gynécologue, ophtalmologue, psychiatre up to 26 years old, stomatologue) are accessible directly with full reimbursement. Secteur 1 respects official tariffs (€30–60); Secteur 2 can charge more (depassements) — check before booking.

Emergency care

Call 15 (SAMU — medical emergency) or 112 (European number) for life-threatening emergencies. Services d'urgence at public hospitals (Urgences) always treat — €20/day forfait + consultation fee. Expect 2–6 hour waits for non-urgent cases in Paris, Lyon, Marseille. SOS Médecins will visit your home for €55–80 (doctors rotate 24/7).

Out of hours

Call 116 117 (service d'accès aux soins, SAS) for non-life-threatening problems outside GP hours — routes you to the Permanence des soins médecin de garde in your zone. Alternative: SOS Médecins on 3624 (nationwide) — home visit or clinic consultation €55–85, reimbursed 70% by CPAM. Pharmacie de garde signposted on every chemist's door.

Prescriptions

Prescriptions (ordonnances) can be printed or e-prescribed directly to your Carte Vitale. Bring your Carte Vitale + ordonnance to any pharmacy — the pharmacist dispenses and CPAM is billed directly (tiers payant). You pay only the non-reimbursed portion (0–100% depending on medicine SMR level, minus your mutuelle cover). Generic substitution is mandatory unless the doctor marks "non substituable".

Dental

Basic check-ups and cleanings (détartrage) covered 70% at tariff. Major work (crowns, bridges, dentures) covered under the "100% Santé" reform — basic-tier devices are fully reimbursed (no out-of-pocket) with Sécu + mutuelle. Implants remain largely out-of-pocket. Orthodontics covered for under-16s. Book via Doctolib.

Mental health

Mon Soutien Psy (since 2022): 12 sessions/year with a CPAM-partnered psychologue, fully reimbursed, for 3+ years olds with anxiety/depression. Referral from GP required. Consultations with a psychiatre (MD) are reimbursed at 70% in Secteur 1. Online therapy platforms: Qare, Livi, Doctolib-Téléconsultation — reimbursed under standard rules. Crisis: 3114 (national prevention suicide) 24/7.

Maternity

Pregnancy and childbirth fully covered (100% from the 6th month). Prénatal follow-up includes 7 obligatory consultations + 3 échographies + amniocentesis if indicated. Sage-femme (midwife) can handle low-risk pregnancies. Registered birth in your chosen public or private maternité (Plateau 1/2A/2B/3 depending on risk). PAJE benefits activate at birth via CAF (prime à la naissance ~€1,096).

Expat-specific advice

First steps on arrival:

First month: gather passport, visa, birth certificate (apostilled + translated), RIB, justificatif de domicile
Apply for numéro de Sécurité sociale (NIR) via your employer or direct application to CPAM with form S1106
Receive NIR and "attestation de droits" within 4–8 weeks
Request Carte Vitale: submit photo + ID via ameli.fr — delivered 4 weeks later by post
Declare a médecin traitant on ameli.fr (prevents the 30% reimbursement penalty)
Sign up for a mutuelle (via employer if applicable, or individual contract)
Register children with a CPAM-enrolled médecin and pédiatre

Finding English-speaking doctors:Paris and major cities have many English-speaking practitioners. Filter Doctolib.fr by "langues parlées". The American Hospital of Paris (Neuilly), Hôpital Franco-Britannique (Levallois), and the Hertford British Hospital (Paris) historically serve anglophone expats. Most under-40 doctors speak passable English; bring a bilingual friend or translator for complex consultations.

International insurance:Non-EU new arrivals should take private expat insurance (Cigna Global, APRIL International, Allianz Care Expat) to cover the first 3 months before PUMa eligibility. After PUMa + mutuelle kicks in, dropping international cover usually saves money. EU new arrivals can use EHIC/CEAM for the transition.

Emergency card info:Carry your Carte Vitale (green) at all times — it contains your NIR and digital reimbursement data. Memorise 15 (SAMU), 18 (Pompiers), 17 (Police), 112 (EU generic). Note your médecin traitant's number. For allergies or chronic conditions, wear a médaille d'alerte médicale and keep your liste d'antécédents médicaux in your phone.

EHIC notes:EU/EEA/Swiss citizens: the European Health Insurance Card (CEAM) covers medically necessary care during temporary stays — but is NOT valid once you become a resident. After 3 months, switch to PUMa. UK nationals with GHIC retain similar rights for temporary stays post-Brexit.

Pharmacies (Pharmacie (officine))

Hours:Typically Mon–Sat 9:00–19:30, with lunch closure 12:30–14:30 in small towns. Most close Sundays. All pharmacies display the opening hours of the nearest pharmacie de garde.

After-hours / emergency:Every commune has a rotating pharmacie de garde covering nights, Sundays and public holidays. List posted on every pharmacy door, or via 3237 (service payant €0.34/min), or servicepublic.fr locator. Night surcharge of €8.05 per prescription applies 20:00–08:00 (reimbursable).

Prescription rules:Médicaments sur prescription (Liste I, II, Stupéfiants) require an ordonnance from a French-registered médecin or professional. Médicaments conseil: available without prescription at the pharmacist's counter (not self-service). OTC (médication officinale) since 2008: a small shelf of products can be self-selected. Codeine and Tramadol require prescription since 2017.

Available over-the-counter:

Pain relief: Doliprane (paracétamol), Spedifen (ibuprofène), Aspégic
Cold & flu: Actifed, Dolirhume, Humex, Oscillococcinum (homeopathic)
Allergy: Aerius, Cetirizine
Digestive: Smecta, Imodium, Gaviscon, Citrate de Bétaïne
Probiotics, magnésium marin, vitamines
Antiseptics: Biseptine, Bétadine
Throat lozenges, sirops antitussifs, pastilles

Typical costs

GP visit (with insurance)	€0–9 after Sécu (70% of €30) + mutuelle usually covers the rest
GP visit (private pay)	€30 (Secteur 1) to €60+ (Secteur 2)
Specialist visit	€0 (fully covered via mutuelle) to €30–80 out-of-pocket if Secteur 2
Emergency visit	€20/day forfait hospitalier + 20% ticket modérateur (covered by mutuelle)
MRI scan	€69–300 base tariff; 70% Sécu reimbursement + mutuelle covers most
Prescription average	€0–4 out-of-pocket after Sécu + mutuelle
Dental check-up	€28.92 (Secteur 1); 70% Sécu + mutuelle = usually €0
Baby delivery	€0 with Sécu + mutuelle; private clinic dépassement €200–1,500

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