Health Insurance France for Expats: 2026 Complete Guide
How French health insurance works for foreign residents in 2026: the public Sécurité sociale, the private mutuelle, international expat plans, costs, and how to enrol step by step.
Key Takeaways
- • Most non-EU expats need at least €30,000 of private health cover to obtain a long-stay French visa.
- • After three months of stable residence, you qualify for the public scheme PUMA and you can apply for a Carte Vitale.
- • A French mutuelle costs roughly €30 to €100 per month for an adult and is the cheapest way to top up Sécu reimbursements.
- • Since the law of 14 July 2019 you can cancel any mutuelle after one year, with one month notice.
- • International plans (AXA Global, Allianz Care, Cigna Global, Bupa Global) make sense before PUMA enrolment or for cross-border lifestyles.
1. Who needs health insurance in France?
Health coverage in France is not optional for residents. Whether it comes from the public system, a private contract, or both, you need a clear answer for every member of your household before you arrive and once you settle in.
Non-EU long-stay visa applicants
French consulates ask for proof of private health insurance with the visa application. The standard threshold used across Schengen short-stay visas is €30,000 of cover, and the same expectation applies to most long-stay categories such as visitor (VLS-TS visiteur), retiree, accompanying family and digital nomad. Workers and students often switch to the public system shortly after arrival.
EU and EEA residents
EU and EEA citizens can use a European Health Insurance Card (EHIC) for medically necessary care during temporary stays. Once France becomes your main residence, you join the public scheme like any French national.
UK nationals after Brexit
UK pensioners drawing a UK state pension and resident in France can apply for an S1 form through the NHS Business Services Authority. The S1 entitles them to French public healthcare with the cost reimbursed by the UK. UK Global Health Insurance Card (GHIC) only covers temporary stays.
If you are moving to France permanently, also read our moving to France guide for the wider administrative checklist (utilities, banking, civil status).
2. How French healthcare works
French healthcare is a two-layer system. Layer one is the public Assurance Maladie, often called Sécurité sociale or simply Sécu. It reimburses a fixed percentage of regulated tariffs. Layer two is the optional mutuelle, a private complementary contract that fills the gap.
Example: a GP visit in 2026
- Consultation tariff (médecin secteur 1): €30
- Sécurité sociale reimbursement (70%): €20
- Flat participation kept by the patient: €2
- Out-of-pocket without a mutuelle: €9
- With a standard responsible mutuelle: €2 (the participation is never reimbursed)
Source: ameli.fr, Convention médicale 2024 (tariff effective 22 December 2024); décret n° 2024-401 of 30 April 2024 (participation forfaitaire). Indicative figures, médecin conventionné secteur 1.
The pattern repeats across every kind of care. The tariff conventionnel sets the base, the public system covers a percentage of it, and the patient or the mutuelle pays the rest. Specialist visits, hospital stays, prescriptions, dental work and optical equipment all follow the same logic with different rates.
3. Public coverage options: PUMA, AME, CSS
Protection universelle maladie (PUMA)
PUMA covers anyone living in France in a stable and regular manner for more than three consecutive months. It is the entry point for almost all foreign residents who become regular taxpayers. Source: article L160-1 of the Code de la sécurité sociale.
Aide médicale d'État (AME)
AME covers undocumented foreign residents who have lived in France continuously for more than three months and earn less than the official ceiling, indicatively €10,421 per year for a single person in 2025. It pays for a defined basket of essential medical care. Source: service-public.fr.
Complémentaire santé solidaire (CSS)
CSS replaces the older CMU-C and ACS schemes. It is a free or low-cost mutuelle granted by the state to low-income residents who already have basic Sécu cover. The income ceilings are revised every year and depend on household composition. Source: complementaire-sante-solidaire.gouv.fr.
4. How to get your Carte Vitale
The Carte Vitale is the green chip card that proves you belong to the French public health system. It speeds up reimbursements and unlocks the third-payer system at pharmacies, hospitals and labs.
- Wait for the three-month residency rule. PUMA requires stable and regular residence in France for at least three consecutive months. S1 holders and EU citizens with EHIC do not need to wait.
- Gather your documents. Passport or national ID, long-stay visa or residence permit, proof of address less than three months old, birth certificate (translated and apostilled if foreign), and a French RIB.
- Fill in form S1106. Cerfa form "Demande d'ouverture des droits à l'Assurance maladie" available on ameli.fr.
- Send the file to your local CPAM. Caisse primaire d'assurance maladie of the département where you live. Keep a copy of every page and a postal receipt.
- Receive your social security number, then your Carte Vitale. CPAM issues a provisional attestation first, then the physical card by post in roughly two to three weeks.
You can also create an account on ameli.fr once your file is open, and use the digital Carte Vitale via the "carte Vitale" mobile app while you wait for the physical card.
5. Private health insurers for expats in France
Two families of insurers serve foreign residents in France: international expat-focused providers, and French companies offering English-speaking service. The right pick depends on whether you stay long term, whether you travel often, and whether you have already joined PUMA.
| Insurer | Type | Best fit |
|---|---|---|
| AXA Global Healthcare | International | Long-term expats wanting global cover |
| Allianz Care | International | Families and corporate assignees |
| Cigna Global | International | Frequent travellers, US-linked plans |
| Bupa Global | International | UK nationals familiar with Bupa |
| Britline (Crédit Agricole) | French, English service | UK and Irish residents in rural France |
| FAB French Insurance | French broker | Multi-product expats with second home |
| Feather Insurance | Digital broker | Younger expats, fully online onboarding |
| April International | Hybrid | Self-employed and short-stay visitors |
List provided for informational purposes only. comparatif24.fr is independent and has no commercial agreement with the providers above.
6. What a mutuelle covers
Hospitalisation
Daily room rate, private room supplement, surgeon and anaesthetist excess fees. Usually the most painful gap if you do not have a mutuelle.
Routine care
GP and specialist visits, medical imaging, lab tests and prescriptions. Watch the cover for excess fees billed by sector 2 doctors.
Optical
Frames, lenses and contact lenses. The 100% Santé basket gives you a no-cost option.
Dental
Routine care, crowns, bridges and orthodontics. Sécu reimburses crowns and prostheses poorly, so this is where mutuelles compete.
Hearing
Class I hearing aids fall under 100% Santé. Higher classes can cost over €1,500 per ear without a strong mutuelle.
7. 100% Santé reform
100% Santé is a regulated basket of optical, dental and hearing equipment that you can buy with no out-of-pocket cost when you combine the public scheme with a responsible mutuelle. Optical and dental rolled out in January 2020, hearing followed in January 2021. Source: ameli.fr.
Optical
Defined frames and lenses, no out-of-pocket cost.
Dental
Crowns, bridges and removable prostheses in the basket.
Hearing
Class I hearing aids, no out-of-pocket cost.
8. How much does it cost in 2026?
Mutuelle pricing depends on age, region, household size and the level of cover. The bands below come from public quote comparisons published by consumer associations and brokers in early 2026 and are indicative.
| Profile | Basic | Mid-range | Premium |
|---|---|---|---|
| Young adult (18-30) | €20-35/mo | €35-60/mo | €60-100/mo |
| Adult (30-55) | €30-50/mo | €50-80/mo | €80-130/mo |
| Senior (55+) | €50-80/mo | €80-120/mo | €120-200/mo |
| Family | €80-120/mo | €120-180/mo | €180-300/mo |
| International expat plan | €80-150/mo | €150-250/mo | €250-500/mo |
Indicative ranges from public mutuelle comparators (UFC-Que Choisir, LeLynx, MutuelleConseil) and broker quote tools, January-March 2026. Actual rates depend on insurer, age, postcode and chosen guarantees.
9. How to switch your mutuelle
Since the law of 14 July 2019 (n° 2019-733), codified at article L113-15-2 of the Code des assurances, you can cancel a mutuelle contract at any time once it has been active for one year. Cancellation takes effect one month after the insurer receives the request. The new insurer can take care of the formalities for you.
- Wait until your contract anniversary, or invoke a life-event reason (move, marriage, retirement) before that date.
- Compare guarantees rather than headline price. Hospitalisation, dental and optical reimbursement levels matter more than the monthly premium.
- Confirm the new contract is "responsable" so you keep access to the 100% Santé basket.
- Let the new insurer send the cancellation letter on your behalf and check the first direct debit.
If you also have credit insurance attached to a mortgage, the rules are different and follow the Lemoine law for borrower insurance. For non-life insurance such as motor or home, see our Hamon law guide.
10. Special cases
Students
International students are automatically affiliated to the public scheme via Sécurité sociale étudiante on enrolment. A student mutuelle is then optional. Heyme and LMDE remain the historical references but any standard insurer accepts students.
Self-employed and freelancers
Self-employed workers (auto-entrepreneurs, professions libérales) are also covered by the public scheme via the Caisse primaire d'assurance maladie. They can deduct part of their mutuelle premium under the Madelin loi.
Retirees with an S1 form
UK and other EU pensioners settled in France can request an S1 from the country that pays their state pension. With S1 in hand they enrol in CPAM and access French public healthcare without paying French contributions.
Owners of a French holiday home
If France is not your main residence, you stay covered by your home country plan or by a private international policy. You will still need French home insurance for the property itself, and that contract often packages an emergency medical assistance option.
11. Frequently asked questions
Do expats need private health insurance in France?▼
Most non-EU expats need at least €30,000 of private health cover to obtain a long-stay visa. Once you are a French resident and meet the three-month rule, you can enrol in PUMA and the private cover becomes a top-up.
What is the average cost of health insurance in France for expats?▼
A French mutuelle typically costs €30 to €100 per month for a single adult. International plans usually start near €80 per month. All figures are indicative and depend on age, region and chosen guarantees.
What is the difference between Sécu and a mutuelle?▼
The Assurance Maladie reimburses a percentage of regulated tariffs. A mutuelle is a private contract that covers all or part of the remaining cost.
How long do I need to live in France to qualify for PUMA?▼
PUMA requires stable and regular residence for more than three consecutive months. UK pensioners with an S1 form, EU citizens with EHIC and posted workers can be covered earlier under bilateral rules.
Can I keep my UK NHS or EU public cover after moving to France?▼
EU citizens can use EHIC for short stays. UK pensioners can apply for an S1 form. UK GHIC only covers temporary stays.
What is 100% Santé?▼
100% Santé gives access to a defined basket of glasses, dental crowns and Class I hearing aids with no out-of-pocket cost when you combine Sécu with a responsible mutuelle.
How do I get a Carte Vitale as a new resident?▼
After three months of residence, send form S1106 to your local CPAM with your ID, residence permit, proof of address, birth certificate and a French RIB. The card arrives by post in two to three weeks.
Can I cancel my mutuelle at any time?▼
Yes, after one year of contract you can cancel any time under the law of 14 July 2019. Cancellation takes effect one month later.
Are international expat plans worth it?▼
They make sense before PUMA enrolment, for short-stay residents, for digital nomads and for people who want global cover. Once settled and enrolled in Sécu, a French mutuelle is usually cheaper.
Is health insurance mandatory in France?▼
Public coverage is mandatory once you become a French resident. A private mutuelle is mandatory for private-sector employees since 1 January 2016. For others it stays optional but recommended.
Official sources
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Disclaimer: The information in this article is provided for informational purposes only and does not constitute medical, legal or financial advice. Tariffs, ceilings and procedures are accurate as of April 2026 according to the cited official sources and may change. Compare quotes and read every contract carefully before subscribing.