The French social security system: how does it work?

Reimbursement of medical expenses

If you are affiliated to the French social security system, you will be expected to pay the consultation fees at the end of your GP's or specialist's appointment. If you have not yet received your carte Vitale (see example), the doctor will hand you a form called feuille de soins (see example). You should send this form to your health insurance fund (CPAM) to seek reimbursement. If you already have your carte Vitale and have transmitted your bank details (RIB) to your CPAM, you have no additional administrative procedures to undertake: your fees will be automatically reimbursed via transfer to your bank account.

Please note that the French social security only reimburses a portion of your medical expenses. Reimbursement rates vary depending on the type of treatment and doctor, but are usually around 60% to 70% of the total fee. Pharmaceuticals are reimbursed at a rate of 15% to 65%, depending on the product.

Since Social Security only reimburses a portion of the total cost, we strongly recommend you to take out a supplementary health insurance, called a mutuelle, especially if you have children or if you have special healthcare needs. This insurance can help pay some of the healthcare costs that the Social Security doesn't cover and avoid onerous expenses. For more information about the mutuelle, read the section "supplementary health insurance" below.


Choosing a primary doctor

To access maximum reimbursement, you are required to register a general practitioner through your health insurance fund (CPAM). You will receive a déclaration de médecin traitant (see example). The GP of your choice will fill out a form that you will need to send by mail to your CPAM. General practitioners can charge different rates. You will obtain fuller reimbursement if you choose a ‘sector-1’ GP that charges official rates. The rates charged by your doctor are listed in the annuaire santé.


The carte vitale

Once you have joined the French social security system, you will receive a certificate with your personal data (attestation Vitale) and your health insurance card (carte Vitale). Keep your certificate and carte Vitale during your entire stay as you will need them in administrative procedures. You will have to bring your carte Vitale to each medical appointment and whenever you purchase prescription pharmaceuticals with an ordonnance (prescription).

You can receive medical treatment before obtaining your carte Vitale or your attestation Vitale. In this case, your doctor or health staff will hand you a form (feuille de soins). Make sure to keep it. Once you have received your attestation Vitale, send these bills for reimbursement to your CPAM. Make copies of all forms prior to sending and keep them until you are reimbursed.

Please keep in mind that you cannot pay with your carte Vitale. You will have to present your carte Vitale and pay the medical expenses. You will then be directly reimbursed via transfer in your French bank account.


Supplementary health insurance (mutuelle)

Medical expenses are not entirely reimbursed by the social security's health insurance. In order to access full reimbursement, we recommend that you take out a supplementary health insurance, called mutuelle. Depending on the chosen form, the mutuelle partially or fully reimburses the portion of the healthcare expenses that the social security doesn't.

  • You are coming to France to complete a Bachelor's or Master’s degree: can contact the SMEREP, the LMDE or any other private insurer.
  • You are coming to France to complete a PhD, you hold a scholarship, you do not have a French employment contract and are under 28 years old: PhD students under the age of 28 who do not have a French employment contract can contact the SMEREP, the LMDE or any other private insurer.
  • You are coming to France to complete a PhD, you hold a scholarship, you do not have a French employment contract and are 28 years old or over: PhD students who are 28 years and over and do not have a French employment contract can contact the Fondation nationale Alfred Kastler (FnAK). The FnAK has signed an agreement with ABC Assurances. For more information, please visit their website.  
  • You are a researcher or a PhD student and have a French employment contract: researchers and PhD students who have a French employment contract with a higher education and research institution will be offered a supplementary health insurance by their employer.