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The French healthcare system

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The French healthcare system is the envy of many countries around the world. The high quality of services in the public system, medical innovations and the affordability and accessibility of public healthcare makes France a poster child for equality. Whether you are a millionaire or on unemployment benefits, you can rest assured that you will benefit from top-notch services. However, the system has its flaws, and the deficits of the public system have been a major point of contention during the last cycle of presidential elections.

Financing healthcare

In fact, the Social Security system is partly financed by compulsory contributions. Besides government and individual contributions, it also benefits from the 7.5% contributions made by employees and the 13.10% contributions made by employers. The system provides basic coverage in case of illness, maternity, incapacity, death, occupational accidents and diseases, old age and for families. It applies to all residents in the country, whether or not they are working.

Medical visits and treatments are refunded by the social security at a rate of 70%. The remaining 30% is the patient's responsibility. In the case of serious or long duration illnesses, 100% coverage is provided. Since a few years, many beneficiaries have also subscribed to private health insurance so as to benefit from the remaining 30% which they have to pay.

In most cases, individuals will adhere to private health insurance to cover those services which are not reimbursed by social security, such as refunds for glasses. Additionally, most employers will offer some sort of insurance program to its staff.

Conditions

All more than 16 years old persons, residing legally in France, must be in possession of a Carte Vitale and a Social Security number. They are required to produce their card at any visit to the doctor, hospital, dentist, etc. This will ensure a rapid refund, without having to fill relating documents. The system has been modernized in recent years, and in most cases there is no need to fill in any paperwork, since the Carte Vitale consists of a chip which transfers your details directly to the server of the social security services.

Formalities

Nationals of the European Union and European Economic Area who are coming to work in France must subscribe to the French social security system. You must therefore take care of the following before travelling there:

  • Obtain a E104 form from your current affiliating organization (certification regarding the aggregation of periods of insurance, employment or residence – sickness, maternity, paternity)
  • Fill the form and produce it to the nearest health insurance office (Caisse d'Assurance Maladie Française) to your new place of residence in the country

Family members, known as 'rights holders', are also entitled to coverage, whether or not they are residents in the country. If they remain residents of their home country, you are required to request the S1 document (certificate for the registration of members of the family of the employed or self-employed) from the nearest health insurance office (Caisse d'Assurance Maladie Française) to your new place of residence in France. You then have to produce this form to the relevant health insurance organisation once you are in the country.

Non-European nationals who are coming to work in France also have to subscribe to the French Social Security system. To be eligible, they must be legal residents of the country and contribute to the social security fund. In fact, employers are liable for the registration of their foreign employees to the Caisse Primaire d’Assurance Maladie (CPAM) by sending a declaration of employment within 8 days following the hiring date or start of employment.

Expatriates may also subscribe to the CPAM on their own by contacting the office closest to their place of residence. This applies to both employees (with the exception of agricultural workers) and unemployed individuals. In the case of agricultural workers, they have to contact the Caisse de la Mutualité Sociale Agricole (MSA). Finally, independent workers (artisans, traders and liberal professionals) have to register at the Caisse du Régime Social des Indépendants (RSI).

In general, the following documents have to be produced:

  • A passport or identity card
  • A civil status document with filiation (bearing the names of the applicant's father and mother) stamped or legalised by the issuing country's authorities

Please note that the formalities can appear to be somewhat complicated, but once you are fully registered and in possession of your Carte Vitale, the process of being refunded is extremely simple. In any case, the administrative burden of your initial application is a small price to pay for the high quality of services you can benefit from in France.

 Useful links:

Social Security
Service-Public – Health insurance
April International – Health insurance
Ameli – Health Insurance
Ameli – Information on registration of foreign nationals
Registration of EU nationals

We do our best to provide accurate and up to date information. However, if you have noticed any inaccuracies in this article, please let us know in the comments section below.
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