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 HEYME, 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 HEYME, 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.
Registration for the French social security system
Have you created an ameli account? It's a secure personal area that makes everything health-related simpler!
What is an ameli account for?
This is a secure personal area that you can log in to from a computer, smartphone, or tablet to access all of the French health insurance system ("l'Assurance Maladie")'s online services. The ameli app is available on App Store and Google Play.
You can use it to:
• Check your health care reimbursements;
• Download your certificate of entitlement, which you can use if you don't have your health insurance card ("carte Vitale") on you;
• Order a French health insurance card ("carte Vitale") or report it as lost or stolen;
• Order a European health insurance card (EHIC);
• Update and manage your personal information (address, phone number, email address, banking information, etc.);
• Chat with amelibot (the French health insurance system's chatbot, which can answer all your questions and help you through your online paperwork, or email one of our caseworkers directly.
To learn more
How do I create one?
To open an ameli account, you will need to have been issued with your permanent French Social Security number (NIR). You will then need to call 3646 (no surcharge) to get a temporary code by phone. Once your account is open, you will be able to access all of our online services, which also means you can track the production of your French health insurance card (while you are waiting for your "carte Vitale", you can download your certificate of entitlement as proof of membership in the French health insurance system to show to health care professionals, etc.)
To learn more
Updating your contact information
Your (cell and/or landline) phone numbers, mailing address, banking information, email address, and more, all need to be up-to-date so that we can keep you current on all health-related matters. If we have your current information, "l'Assurance Maladie" can contact you directly to offer you a range of services that are in line with your needs.
If you are having trouble registering for French health insurance coverage, please call 3646 (no surcharge) Monday through Friday from 8:30 a.m. to 5:30 p.m. You can ask for an English-speaking phone representative who can set up an appointment for you.
ameli.fr for information on news, entitlements and how to apply, reimbursements, and health
Your ameli account to use all of the services available through your personal account
The forum ameli for any general questions
By calling 3646 (no surcharge) Monday through Friday from 8:30 a.m. to 5:30 p.m.
In person, by going to your local health insurance fund (« CPAM »)
En accueil de la caisse d’assurance maladie de votre lieu de résidence