Healthcare outside France: Ehic/Ceam cards

The French equivalent of the European Health Insurance Card (Ehic) is the Ceam (carte européenne d’assurance maladie). A Ceam covers the basic health rights of residents of France when they travel within the EU/EEA and to Switzerland and to the UK (the latter is due to the Brexit Trade and Cooperation deal). 

However, residents of France who are not EU/EEA/Swiss or UK nationals have to pay for treatment in Denmark, Iceland, Norway, Liechtenstein, Switzerland and the UK. In the latter case they should keep receipts and apply for reimbursement from their Cpam on return.

Like the Ehic – or ‘Ghic’ as most UK equivalent cards issued since 2021 are now called – the Ceam allows users to get healthcare on the same basis as a resident of the country they are visiting and the card is free.

If you visit a country requiring upfront payment, you apply for reimbursement from the country. French residents can get a Ceam from their Cpam. It takes about seven days. If you have an account on ameli.fr you can request a card from your personal space at Mes démarches. 

Alternatively call 3646 or use the ameli.fr app. Remember that each person travelling needs their own Ceam card.

A Ceam lasts two years, compared to five years for a UK Ehic. UK pensioners or others who have French healthcare funded by the UK via an S1 can use a UK Ehic/Ghic when travelling outside France to other EU countries. If you still have an old British Ehic issued before 2021 that is in its validity period, you can continue to use it. 

Otherwise, if you are a Withdrawal Agreement beneficiary, you can apply for a new British Ehic, which will be marked CRA (Citizens Rights Agreement). This applies to people who were living in France prior to Brexit and who have a registered S1 (or one of the older ‘E’ forms) because they receive a qualifying pension or benefit or because they are a cross-border worker (ie. living in France but working in the UK).

UK pensioners who moved to France after Brexit and have S1s can apply for a Ghic.

UK Ghics initially could not be used in Norway, Iceland and Liechtenstein but coverage has now been extended to these as well as the EU and, for UK/EU/Swiss nationals, Switzerland. A new British Ehic can also be used in all of these places. People are automatically sent an Ehic/Ghic application from the UK once they register their S1 with a French Cpam. If this does not happen, you can request one from overseas healthcare team.

A Pension Service advisor said your Ehic/Ghic cover starts once the S1 is registered with Cpam and, if required, they can send a temporary cover note. Ehics/Ghics for S1 holders are not to be used in France; they are for use if seeking healthcare elsewhere in the EU. 

Cover under Ceams/Ehics is basic and is not a replacement for travel insurance. The cards do not cover mountain rescue or travel back to France in an emergency and may not cover some private medical treatment. They are not designed for ‘health tourism’ but for ‘medically necessary’ care during a trip. They also do not cover the part of healthcare costs not covered by the French state.

Travel insurance is usually offered as an option when you buy flights and package holidays with key points being cancellation and repatriation, both of which may be covered by your credit card supplier (however check the amount of cover and any excess). Some private travel insurers insist you have an Ehic as well, while others will waive any excess if you have one.

A Ceam/Ehic covers you for pre-existing conditions and for routine maternity care as long as you do not deliberately go abroad to give birth. If your card has been lost or stolen contact your Cpam on 3646 (0033 184 90 36 46 outside France) or using online messaging by connecting to your account on ameli.fr and clicking Ma messagerie. 

If you seek healthcare without an Ehic/Ceam while abroad in the EU (this is not recommended) on your return you should be able to get your medical costs reimbursed by Cpam, but you must keep all receipts and submit them along with a form, S3125, available from ameli.fr. 

Refunds will usually be based on French rates, although you can opt on the form to be reimbursed according to the laws of the country you were visiting.

Early-retirees using comprehensive private healthcare are not entitled to Ehics/Ceams, therefore it is necessary to consider when taking out the policy whether it is operational outside France. If not, good travel insurance is all the more important. UK residents needing a Ghic, for example, to have while visiting a second home in France can obtain one. 

Note that the UK does not reimburse the non-reimbursed part of French healthcare (known as ‘Ehic co-payments’).