Healthcare In France

The French state healthcare system differs significantly from the UK’s NHS. This article outlines some of the aspects of the system that people moving permanently to France from the UK ought to be aware of.

Eligibility
If you don’t intend to work or run a business in France, and are not a dependant of someone who is in the French system, you will probably need a form S1 to entitle you, initially at least, to state healthcare. You should apply for an S1 well in advance of leaving the UK. If you’re retired, contact the DWP Overseas Healthcare Team (0191 218 1999); if you’re going to continue working in the UK, contact HMRC.

France’s criteria for giving early retirees from the UK long-term access to French state healthcare have been under review recently, and certain ambiguities have arisen. Early retirees should keep checking the latest situation regarding their entitlements.

Anyone living permanently in France who does not meet the criteria for joining the state health service must take out private health insurance.

Contributions Sociales
If you’re employed under a French work contract, or if you’re self-employed or run a business in France, you (and your employer if you have one) will pay contributions to the healthcare system. Compared to NI contributions in the UK, contributions sociales are quite high.

Carte Vitale
This card contains a microchip which confirms your identity and social security number. When you pay for consultations, treatment or prescriptions, you will be asked for your CV. Your reimbursements will then be refunded automatically into your bank account.

If you don’t have a carte vitale, or the health provider doesn’t have a card reader, you’ll be given a document called a feuille de soins. This must be presented to your caisse d’assurance, along with proof of entitlement, to claim reimbursement.

Reimbursements
The reimbursement system is complex. In certain circumstances reimbursement is 100%. Some expenses are reimbursed 0%. For most routine medical consultations the state reimburses 70%. For full details (in French) click here

Top-up Insurance - Complémentaire santé
Since the state only reimburses a proportion of your medical costs, you are expected to take out ‘top-up’ insurance. Numerous private companies and mutuelles (non-profit) offer top-up policies ranging from basic hospital plans, to comprehensive policies that can cover almost every expense you are ever likely to incur. Take advice, get several quotes, and read the small print.

CPAM
(Caisse Primaire d’Assurance Maladie) is the largest of the numerous state organisations that deal with contributions and reimbursements. If you hold an S1, you will register with CPAM and your reimbursements will be processed by CPAM. Other caisses include URSSAF and the RSI (Régime Social des Indépendants) which deal with employers and self-employed.

For an introduction to healthcare abroad click here

and for a detailed explanation (in English) of the French healthcare system, click here.