Settling in a new country raises a lot of questions. What should you do in case of illness? How can you obtain health coverage services in France? Here you will find everything you always wanted to know about the French social security system (but were afraid to ask).

New:

Starting the 2018-2019 academic year, the student social security scheme is modified (undergraduate, graduate and PhD students). For more information, refer to the paragraphs below. 

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Health coverage: a compulsory requirement

French law requires all individuals residing in France to have health insurance that will cover medical expenses (doctor visits, prescription medication, hospitalisation, etc.).

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Choose the health coverage that best suits your situation

Learn how to apply for a health coverage that best suits your situation.

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The French social security system: how does it work?

How does the French social security work? What is covered? What other options are there?

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Useful information

Health related information you will need in France: how to find a doctor, health glossary, emergency phone numbers, etc.

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French law requires all individuals living in France to have health insurance

This health insurance covers medical expenses, such as doctor visits, prescription medication, hospitalisation, surgery, etc.

Your age and conditions of your stay in France will determine which of these following requirements is applicable for you. You either must:

  • Join the French social security system (Sécurité Sociale, commonly known as “la Sécu”) to be covered by health insurance, or;
  • Remain affiliated to the social security system of your previous country of residence (make sure it will cover your medical expenses in France), or;
  • Take out a health insurance in France, or;
  • Take out a health insurance in your country of residence.  

It is compulsory that you arrive in France with civil liability insurance and healthcare covering repatriation

We strongly advise you to take out a private insurance for the 4-month period following your arrival while completing the French social security application: registration may take several weeks. Check with the insurance company the terms and conditions of the coverage you have chosen. Make sure that your insurance guarantees repatriation and that you are covered by a civil liability insurance. If you are coming to France for a stay of over 3 months, you can choose later on the health coverage that best suits your needs and situation.   

 

Type of insurances

For students, interns, PhD students holding a scholarship and their family members (spouse and/or children):

PhD students and researchers with a French employment contract and their families:

 

In short
  • You must have a health coverage that covers medical expenses, hospitalization, surgical interventions and repatriation and a civil liability insurance from the first day you arrive in France;
  • This insurance should preferably be French;
  • If, later on, you must or decide to join the French social security system (depending on your situation), take into account that the process may take a few months. You will have to submit the required documents as soon as possible. The sooner you apply, the sooner your medical expenses will be covered. We strongly recommend you to take out a private insurance for the 4-month period following your arrival.

Please note

Before undertaking any procedure by yourself, we strongly advise you to contact your institution.

If you are a researcher and are accompanied by your family, please inform your institution.

You are coming to France to complete a Bachelor's or Master’s degree

Please note: If you are a resident but not a national of one of the above-mentioned countries and are travelling to Denmark or the United Kingdom, you will not be able to benefit from the provisions listed below. The same applies vice-versa.

  1. Prior to your arrival, you must gather certain documents that will be requested at the time of your affiliation to the French social security:
    • Your European Health Insurance Card (EHIC) and the S1 form. Contact your local health insurance fund to obtain these two documents.
    • A proof of income for the last 12 months specifying your name or your parents’: it may be a tax assessment (avis d’imposition) or a declaration on your honour– or your parents’, if you are economically dependent on them – (attestation sur l’honneur) stating you have sufficient funds to live in France (at least € 615 monthly). 
  2. Once in France, you will have to register with the French social security through the website etudiant-etranger.ameli.fr (available from September 1st 2018). You will have to provide several supporting documents, including those mentioned above. For more information on supporting documents and the step-by-step procedure, download the To-do list for international students enrolling for the first time in a higher education institution for the 2018-2019 academic year (in French). You can also refer to the social security website (in French).

Please note: you will only be able to register with the social security once you have paid the CVEC administrative fee and have completed your academic registration with your institution.  

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 

Please note:

You are a national of a country that has signed a bilateral Social Security Convention with France

To find out if your country of origin has signed a Social Security Convention with France, please visit the website of the Centre of European and International Liaisons for Social Security (Cleiss). If a convention has been signed, check the conditions that allow you to remain affiliated to your current health insurance scheme. 

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 
You are a national of a country that has not signed a Social Security Convention with France
  • You must register with the French social security through the website etudiant-etranger.ameli.fr (available from September 1st 2018). You will have to provide several supporting documents. For more information on supporting documents and the step-by-step procedure, download the To-do list for international students enrolling for the first time in a higher education institution for the 2018-2019 academic year (in French). You can also refer to the social security website (in French).
  • Please note: you will only be able to register with the social security once you have paid the CVEC administrative fee and have completed your academic registration with your institution.  Therefore, if you are coming to France before the start of the academic year (i.e. in the framework of optional language courses), you will have to take out a private health insurance that will cover the period between your arrival and your academic registrationACS Assurances offers different health coverage schemes that can meet your needs. If you take out an insurance in your country of residence, make sure you understand the terms and conditions of the different offers before signing up to anything. Your insurance must guarantee repatriation and you must be covered by a civil liability insurance. Do not forget to ask for a health insurance certificate (in English or in French) to prove that you are covered during this period. 

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 

Please note:

You are coming to France to complete a PhD, you hold a scholarship and you are enrolled at a French higher education institution

Please note: If you are a resident but not a national of one of the above-mentioned countries and are travelling to Denmark or the United Kingdom, you will not be able to benefit from the provisions listed below. The same applies vice-versa. 

  1. Prior to your arrival, you must gather certain documents that will be requested at the time of your affiliation to the French social security:
    • Your European Health Insurance Card (EHIC) and the S1 form. Contact your local health insurance fund to obtain these two documents.
    • A proof of income for the last 12 months specifying your name or your parents’: it may be a tax assessment (avis d’imposition) or a declaration on your honour– or your parents’, if you are economically dependent on them – (attestation sur l’honneur) stating you have sufficient funds to live in France (at least € 615 monthly). 
  2. Once in France, you will have to register with the French social security through the website etudiant-etranger.ameli.fr (available from September 1st 2018). You will have to provide several supporting documents, including those mentioned above. For more information on supporting documents and the step-by-step procedure, download the To-do list for international doctoral students enrolling for the first time in a higher education institution for the 2018-2019 academic year (in French). You can also refer to the social security website (in French).

Please note: you will only be able to register with the social security once you have paid the CVEC administrative fee and have completed your academic registration with your institution.  

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 

Please note:

You are a national of a country that has signed a bilateral Social Security Convention with France

To find out if your country of origin has signed a Social Security Convention with France, please visit the website of the Centre of European and International Liaisons for Social Security (Cleiss). If a convention has been signed, check the conditions that allow you to remain affiliated to your current health insurance scheme. 

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 

You are a national of a country that has not signed a bilateral Social Security Convention with France
  • You must register with the French social security through the website etudiant-etranger.ameli.fr (available from September 1st 2018). You will have to provide several supporting documents. For more information on supporting documents and the step-by-step procedure, download the To-do list for international doctoral students enrolling for the first time in a higher education institution for the 2018-2019 academic year (in French). You can also refer to the social security website (in French).
  • Please note: you will only be able to register with the social security once you have paid the CVEC administrative fee and have completed your academic registration with your institution.  Therefore, if you are coming to France before the start of the academic year (i.e. in the framework of optional language courses), you will have to take out a private health insurance that will cover the period between your arrival and your academic registrationACS Assurances offers different health coverage schemes that can meet your needs. If you take out an insurance in your country of residence, make sure you understand the terms and conditions of the different offers before signing up to anything. Your insurance must guarantee repatriation and you must be covered by a civil liability insurance. Do not forget to ask for a health insurance certificate (in English or in French) to prove that you are covered during this period. 

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 

Please note:

You are a researcher or a PhD student and have a French employment contract

Please note that the enrollment process may take several months. We strongly advise you to take out a private health insurance that will cover the waiting period. The Fondation nationale Alfred Kastler and ACS Assurances offer different health coverage schemes to all PhD students and researchers.

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

You are a researcher or a PhD student, you have a foreign employment contract and are coming to France for a short stay in order to work in one of our laboratories

Your employer must grant you a mission order (ordre de mission). With this document, he/she guarantees that you are covered during the whole period of your stay.

You are completing a degree at a foreign university and are coming to France within the framework of an exchange program (up to 3 months) or an internship (up to 6 months)

Please note: If you are a resident but not a national of one of the above-mentioned countries and are travelling to Denmark or the United Kingdom, you will not be able to benefit from the provisions listed below. The same applies vice-versa.

  • Prior to your arrival, you must request your European Health Insurance Card (EHIC) and/or the S1 form from your local health insurance fund. 
  • Always have them with you when going to a medical consultation, buying medicine at the pharmacy or in the event of hospitalization. Always ask for an invoice.
  • Keep all originals of invoices and prescriptions as you will need them when seeking reimbursement of your medical expenses. Wait until you have returned to your country of habitual residence to seek reimbursement from your health insurance fund.

 

  • If you do not have the EHIC or the S1 form, you will have to take out a private health insurance in France or in your country of habitual residence. In France, ACS Assurances offers different health coverage schemes. If you take out an insurance in your country of residence, make sure you understands the terms and conditions of the different offers before signing up to anything. Your insurance must guarantee repatriation and you must be covered by a civil liability insurance. Do not forget to ask for a health insurance certificate (in English or in French) to prove that you are covered during this period. 

 

Please note:

  • If you are a student and will be staying in France for more than 3 months, refer to the paragraph “You are coming to France to complete a Bachelor’s or Master’s degree”.
  • If you are a PhD student, you hold a scholarship and are coming to France for more than 3 months, refer to the paragraph “You are coming to France to complete a PhD, you hold a scholarship and you are enrolled at a French higher education institution”.  
You are a national of a country that has signed a bilateral Social Security Convention with France

To find out if your country of origin has signed a Social Security Convention with France, please visit the website of the Centre of European and International Liaisons for Social Security (Cleiss). If a convention has been signed, check the conditions that allow you to remain affiliated to your current health insurance scheme. 

 
You are a national of a country that has not signed a bilateral Social Security convention with France

Check with the social security system of your country of residence or your health insurance company to find out if your medical expenses and repatriation will be covered during the period of your stay in France. Make sure you have a civil liability insurance. If it is not the case, you will have to take out a private health insurance in France or in your home country that will cover your health expenses during your entire stay in France. ACS Assurances offers different health coverage schemes. Do not forget to ask for a health insurance certificate (in English or in French) to prove that you are covered during your stay in France.

 

Please note:

  • If you are a student and will be staying in France for more than 3 months, refer to the paragraph “You are coming to France to complete a Bachelor’s or Master’s degree”.
  • If you are a PhD student, you hold a scholarship and are coming to France for more than 3 months, refer to the paragraph “You are coming to France to complete a PhD, you hold a scholarship and you are enrolled at a French higher education institution”.  

Family members of a researcher or PhD student with a French employment contract

Your spouse and children (under and over 18 years old) can be registered with the French social security at the same time as you. Your employer will request their registration. You will have to notify the human resources department that you are accompanied by your family. You will also have to provide a series of supporting documents :

Please note that the enrollment process may take several months. We strongly advise you to take out a private health insurance that will cover the waiting period. The Fondation nationale Alfred Kastler and ACS Assurances offer different health coverage schemes to all PhD students and researchers.

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 

Please note: 

  • If your spouse is employed, he/she will be registered with the social security by his/her employer.
  • If your adult child (18 years and over) is employed, he/she will be registered with the social security by his/her employer. 
  • If your adult child (18 years and over) is a student, he/she must register with the social security through the website etudiant-etranger.ameli.fr (available from September 1st 2018). For more information, please read the section "You are coming to France to complete a Bachelor's or Master's degree".

Family members of a PhD student benefiting from a scholarship

Please note: If you are a resident but not a national of one of the above-mentioned countries and are travelling to Denmark or the United Kingdom, you will not be able to benefit from the provisions listed below. The same applies vice-versa.

  • Prior to your arrival, you must request your European Health Insurance Card (EHIC) and/or the S1 form from your local health insurance fund. 
  • Once in France, your medical expenses will be covered under the same terms and conditions as those insured under the French social security system. Should you require any further information or seek reimbursement, please contact the International relations department of the CPAM (Caisse Primaire Assurance Maladie) of your place of residence. Download the explanatory note
  • Please note: if you will be staying in France for 3 months or less, you are strongly advised to wait until you return to your country of habitual residence to seek reimbursement of your medical expenses. Remember to keep the originals of all invoices and prescriptions.

 

  • If you do not have the EHIC or the S1 form, please read the paragraph "Non-EEA or Swiss nationals" below in order to know what your best option regarding health coverage is. 

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

Your options are the following:
1st option:

Your spouse and adult children, provided they are unemployed, as well as your minor children, can join the Protection Universelle Maladie (PUMa) scheme of the social security system. They will have to request an affiliation to the health insurance fund (Caisse Primaire d’Assurance Maladie – CPAM) of your place of residence. Download the list of required documents for the PUMa registration process

Please note that the registration process may take several months. We strongly advise you to take out a private health insurance which will cover the waiting period between the arrival until the end of 4th month in France. The Fondation nationale Alfred Kastler, and ACS Assurances offer different health coverage schemes to all PhD students and their families.

In any case, don't forget to take out a supplementary health insurance to access full reimbursement. 

 

2nd option:

Your spouse as well as your minor and/or adult children remain affiliated to the social security system of their previous country of residence (nationals of a country that has signed a social security convention with France). Make sure it will cover their medical expenses, guarantee repatriation and that they are covered by a civil liability insurance.

 

3rd option:

Your spouse as well as your minor and/or adult children take out a health insurance in France. The Fondation nationale Alfred Kastler, and ACS Assurances offer different health coverage schemes to all PhD students or researchers and their families.

 

4th option:

Your spouse as well as your minor and/or adult children take out a health insurance in your country of residence that will cover their health expenses and repatriation. Make sure that they are covered by a civil liability insurance. Do not forget to ask for a health insurance certificate (in English or French) to prove that they are insured.

 

Please note: 

  • If your spouse is employed, he/she will be registered with the social security by his/her employer.
  • If your adult child (18 years and over) is employed, he/she will be registered with the social security by his/her employer. 
  • If your adult child (18 years and over) is a student, he/she must register with the social security through the website etudiant-etranger.ameli.fr (available from September 1st 2018). For more information, please read the section "You are coming to France to complete a Bachelor's or Master's degree".

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.

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. The GP of your choice will fill out a form (see example) 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.

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.

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.

The French use the terms "Assurance Maladie", "Sécurité Sociale" and "CPAM" indifferently. All of these terms refer to the same body and the same benefits: the social security’s health insurance.  

For more information, you can check:

Emergency numbers in France