Americans in France await details of new healthcare charge
We also look at questions around US Medicare for Americans who have moved to France
Many of the people affected are retired US citizens who moved to France with 'visitor' visas
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Healthcare is a key issue for Americans living in or moving to France, especially around access to the French system and whether to keep US cover.
Many are currently awaiting details of a new ‘financial participation’ fee that may be required for French healthcare.
The new fee is set out in the 2026 social security finance law, which states that it concerns people living on income exempt from French social charges under international treaties.
Probably the largest group is retired Americans who have moved to France with visas such as the ‘visitor’ visa (and therefore do not work) and rely on American pensions, which are not subject to income tax or social charges in France.
Despite this, they are entitled to French healthcare on residency grounds and are expected to enrol.
Only a minority, who also have large incomes from investments and property, have had to pay a healthcare contribution up to now.
Many newcomers take out comprehensive private policies while waiting to join the system, but cancel them once enrolled.
The new fee is expected to be payable at regular intervals. More details, including the rate, are awaited in a decree.
A related question concerns the rights of US citizens in France to be covered by Medicare – the US government’s health insurance system that is mainly for people aged 65 and over, and some younger people with disabilities.
This depends largely on whether they may one day move back to the US, as it does not cover healthcare costs in France.
If this is possible, it may be worth signing up when eligible. Most Americans approaching or reaching 65 can enrol in Part A (hospital cover) free of charge, if they worked in the US for at least 10 years.
The question then arises as to whether also to take out Part B (doctor visits) and Part D (prescription drugs).
The main dilemma relates to Part B, which, if not taken at 65, can lead to increasingly large late-enrolment penalties, while premiums are around $200 a month.
Exceptions exist via ‘special enrolment periods’, for example for people who were working prior to claiming and covered by a group workplace health plan.
However, it does not appear from our research that French state healthcare or a French mutuelle (even if employer-subsidised) would qualify as such.
