In surveys which rate the national health service of countries worldwide, the French healthcare system consistently comes out near the top. The World Health Organisation has said that France has one of the best performing systems in the world in terms of availability and organisation of health care providers.
That said, the organisation of healthcare in France for expats from anywhere else can seem overly complex and difficult to navigate.
Outside of hospitals, most health professionals, including doctors are self-employed. They charge a visitation fee to their patient and the patient has this partly refunded by the French healthcare system and partly by voluntary insurance (if they have it).
In order to be eligible for reimbursement, patients must register with a primary care doctor who will be required to maintain medical records (something that has not been a requirement previously).
How the French healthcare system works
1. There is a state controlled health insurance social security system – l’assurance maladie (website for Assurance Maladie). This provides for some reimbursement of charges to patients.
2. There is a voluntary health insurance system called assurance complémentaire. Also known as “top-up” insurance and provided by private insurance companies and non-profit mutual companies (called Mutuels). This provides for the “rest” of the charges to the patient. When we say “the rest” – that amount depends on the level of cover that you take out with your “top-up” insurance; this is not a mandatory requirement.
In order to be able to access the health service in France, and thereby receive reimbursement of costs, you need to be registered with l’assurance maladie (expat eligibility for state healthcare).
l’assurance maladie is comprised of a number of different insurance funds which operate under Government supervision which bears the financial responsibility.
The main health insurance fund is a General Fund called the Régime Général that covers about 85% of the population working in industry and commerce, as well as the unemployed and those retired and not affiliated to another fund, e.g. retired expatriates
Within the Régime Général there is a health insurance fund for those not affiliated through business or employment. This is called the Couverture maladie universelle (CMU) and is the system for retired expatriates.
At a local level the General Fund is administered by the Caisse Primaire d’Assurance Maladie (CPAM). They have offices throughout France in most major towns.
For the self-employed including self-employed expats in France there is a separate State controlled insurance scheme called Régime Social des Indépendants (RSI). They have regional offices and any healthcare enquiries for the self-employed go through them rather than through the local CPAM office.
For those employed in other areas of work not covered by the Regime General or CMU there are separate health insurance funds for agricultural workers and specialist professions, such as doctors and civil servants.
If you are an expat employed in France your employer will take charge of your registration with the correct department.
We have lots of helpful guides for visitors and expats in France just click on the healthcare section for more information.