France · Healthcare
How the France healthcare system works — public vs private care, eligibility, and costs for residents and visitors.
AI-drafted, editorially reviewed. Confirm specifics with the official authority.
France's Assurance Maladie covers anyone working or residing in France on a stable, regular basis through the Protection Universelle Maladie (PUMa). The model is reimbursement rather than free-at-point-of-use: the scheme repays a large share of costs and most people take a complementary "mutuelle" to cover the remainder. You manage cover, reimbursements and your carte Vitale through an Ameli account.
France's public health insurance (Assurance Maladie) covers anyone working or residing in France on a stable, regular basis through the Protection Universelle Maladie (PUMa). It reimburses a large share of medical costs; most people also take a complementary "mutuelle" to cover the remainder. You manage your cover and reimbursements through your Ameli account.
- PUMa covers anyone working or stably residing in France; you register with Assurance Maladie (sécurité sociale).
- The system reimburses a large part of costs; a complementary "mutuelle" covers most of the rest.
- You manage cover, reimbursements and your carte Vitale through your Ameli account.
- Coverage starts once you meet the stable-residence condition — check Service-Public/Ameli for current rules.
- 1
Check the stable-residence condition
PUMa covers anyone working or stably residing in France. Coverage starts once you meet that condition, so check the current rules on Ameli or Service-Public rather than assuming immediate cover.
- 2
Register with Assurance Maladie
Register with the sécurité sociale to obtain your social-security number and enter the system. This is the step everything else depends on.
- 3
Set up your Ameli account and carte Vitale
You manage cover, reimbursements and your carte Vitale through Ameli. The carte Vitale is what makes reimbursement automatic at most providers.
- 4
Take a complementary mutuelle
The scheme reimburses a large part of costs but not all of it. Most people take a mutuelle to cover the remainder, and employers often offer one.
- 5
Expect to pay then be reimbursed
Because the model is reimbursement, you often pay the provider first and are repaid afterwards. Keep some cash flow available for that cycle, especially before your carte Vitale arrives.
- Stable-residence or work condition met for PUMa
- Registered with Assurance Maladie
- Social-security number obtained
- Ameli account created
- Carte Vitale requested
- Complementary mutuelle arranged
- Cash flow planned for the pay-then-reimburse cycle
- Assurance Maladie (ameli.fr) — PUMa
Official health-insurance portal.
- Universal Health Protection (Service-Public)
Official guide to PUMa eligibility.
Frequently asked questions
Is French healthcare free at the point of use?
Not in the way a fully public system is. The model is reimbursement: the scheme repays a large share of costs, and most people take a complementary mutuelle for the remainder. Expect to pay providers first in many cases and be reimbursed afterwards.
What is a mutuelle and do I need one?
It is complementary insurance covering the part Assurance Maladie does not reimburse. Most people take one, and employers often provide access — without it you carry the remainder yourself, which adds up over a year.
What is the carte Vitale for?
It is the card that links you to the system and makes reimbursement automatic at most providers. Until it arrives you may need to claim manually through your Ameli account, so set that up early.
Government portals
- Government of France — Office of the French Prime Minister — government policies, ministers, and key legislation
- France Public Services (Service-Public) — France's unified administrative services — residence permits, taxes, social security, civil records
- French General Tax Directorate (DGFiP) — French income tax, VAT, wealth tax filing; tax residency determination; French tax number (NIF) application