Your healthcare depends on your reason for coming

The way in which your healthcare in France will be covered varies according to your nationality and how your residency rights are organised.

Factors that come into play include whether you are an early retiree (someone who is below state retirement age but not working), a state pensioner, an employee, or someone who will be starting a business.

There are also differences between EU and non-EU nationals. Brexit brought some changes, but in essence, healthcare rights continue as before for Britons who were already living in France on December 31, 2020 and who hold specific WA cartes de séjour, showing they benefit from the Withdrawal Agreement.

For other Britons, some key benefits have been maintained in the Brexit deals. These include the right of state pensioners coming to France to have an S1 form for their healthcare cover, meaning the UK pays for them. 

The right for UK visitors to continue using EHICs (European Health Insurance Cards) or GHICs for tourist trips and visits to second homes has also been maintained.

Visitors to France from another EU country or from the UK are able to use the EHIC card or the UK equivalent, the GHIC, to cover their healthcare during temporary visits.

Other foreign visitors should check any arrangements for reciprocal healthcare between their country and France. However, in most cases, a private health insurance policy is required.

Who can use an EHIC, GHIC, or an S1 form?

Everyone who settles in France longterm will eventually be entitled to join the state health system, which now has a concept of healthcare rights by (legal, stable) residency.

This includes Americans, Britons and other non-EU nationals who come on a visa and then move onto one of the various residency cards depending on their work status and reason for coming.

It also includes British people who hold Brexit Withdrawal Agreement (WA) residency cards.

EU nationals coming to France will in the first instance be able to use Ehics for reimbursement of necessary healthcare as EU temporary visitors do, while they apply to join the French healthcare system.

British people who wish to move to live in France can no longer come on an Ehic/Ghic and move seamlessly to living in France – post-Brexit they need to apply for a visa from the UK in order to move to become residents.

Many non-EU nationals and British early-retirees who seek visas to come to France will be asked to take out private health insurance as a condition of obtaining the visa.

One exception to this is Britons who come to France to work as salaried employees. The Connexion was told by French government sources that this group will be entitled to healthcare as soon as they are employed, via their social security contributions on their salaries. As a result they should not usually be required to take out a private healthcare policy as well.

As explained in the previous chapter, social security coverage by the state pays only a set percentage of medical costs and the outstanding balance must be paid either through top-up insurance or out of the individual’s pocket.

Self-employed newcomers are covered for healthcare in France once they have set their business up properly.

Like employees, they pay a proportion of their income as social charges, some of which go to pay for their healthcare.

UK and EU state pensioners belong to a different category and access their healthcare in France via an S1 form, which means that the country that pays their state pension also compensates France for their healthcare costs.

The UK successfully negotiated for British state pensioners – and some other Britons with certain exportable disability or incapacity benefits – to maintain the right to S1 forms.

This therefore continues to apply to UK state pensioners settling in France post Brexit. British early-retirees (non workers who are not yet eligible for a UK or EU state pension) will eventually be able to join the French system under the Puma rules but will be asked to show private insurance covering their visa’s validity period (usually a year) in the first instance.

Some early-retirees opt to stay on comprehensive private insurance rather than applying to their Cpam but this may have become less common since France’s move to healthcare by residency.

No matter how people access the French system most people will not have all expenses covered and many opt for a top-up policy, with employers being required to offer a subsidised one to employees.