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Expat guide to medical top-up insurance in France

medical top up insurance france

“Top-up/Voluntary insurance in France is an insurance policy which provides for reimbursement of medical costs in addition to the State insurance fund. How much additional reimbursement you get depends on what level of cover you pay for.

Finding the right voluntary (called “top-up”) insurance provider isn’t that easy in France. There is such a wide choice between providers that it is hard to make comparisons but the main criteria for cost is your age and the level of cover you require.

When it comes to choosing the right health insurer for your “top-up” or voluntary insurance,  you need to bear in mind a few questions – none, one or more may be relevant to you:

Your age

If you are over 60, some private insurance companies (and some non-profit mutual companies – called mutuelles) will not accept you.  If you’re over 65 the number of companies who will not accept you increases. So if this applies to you the first search criteria is to seek a company who will accept you as a client and have a tailored policy for over 60s/over 65s.


if you are not fluent in French and can’t fully understand what you are signing up to you might want to consider a company with an English speaking helpline.

Your health

If you are aware of a pre-existing medical condition then a non-profit mutual company is probably going to be more suitable for you than a private health insurance company. The former will not require you to complete a medical questionnaire, the latter will and may exclude you on the grounds of a pre-existing medical condition.

Mutuelles do not consider your health circumstances when considering your application – private insurers may do so and may also exclude cover for certain illnesses contracted before the insurance was taken out.  Therefore the amount you pay through a Mutuelle will not be affected by your health but premiums charged by private health insurer could be higher or result in rejection of your application.

Level of Cover

The amount you pay will depend on the level of cover you want from 1 to 5. This will differentiate reimbursement costs according to what treatment you may have including consultants, specialist treatment, dentistry etc.

Level 5 isn’t necessarily the best value and also means you are highly likely to have to submit to a medical examination.

To give you an idea of costs:

UK Expat, aged 60, unemployed, registered for national health service care in France might expect to pay about €30 per month for level 1 cover. The same person might expect to pay €100 p.m. for level 5 cover.

UK Expat, age 65, retired (and receiving state pension), registered for national health service care in France might expect to pay about €35 per month for level 1 cover.  The same person might expect to pay €112 p.m. for level 5 cover.

You can also purchase temporary insurance cover for the time between arriving in France and registering in France – but this is generally an expensive option so, if you are eligible for state health care, don’t delay getting registered, make it a priority.

Premiums are calculated and charged pro-rata from the date of issue to 31st December and thereafter renewed on 1st January in each following year as French law requires policies to be issued on a calendar year basis.  Where you take out a policy for the first time, a deposit is payable followed by monthly payments terminating at the end of the Calendar year. The Policy renewal process then kicks in on a Calendar year basis. Additionally there is a tax charged on the provision of voluntary insurance.

If you want to change insurers in France, you must notify your current insurer of termination in writing at least a month before the policy comes up for renewal.

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