How do Americans in France register for public health insurance?

Reader question: How does an American apply for health insurance when moving to France?

As a resident of France, having health insurance, either private or public, is mandatory.

If you are employed by a French company and pay social contributions, you will automatically be eligible for (public) health insurance though your social security contributions on work, and your employer should deal with this.

The same applies in the case of doing self-employed work.

However, if you are moving as a retiree or early-retiree, then part of your visa requirements will be showing you have a private health insurance policy in place to cover you in the first instance, usually for at least a year.

Various providers both French and foreign can offer a comprehensive policy; in theory it should provide similar cover to the French state reimbursements, but there is no system of specific 'accredited' policies.

A comprehensive policy is not the same as 'top-up' health insurance (also called a mutuelle), which is a policy from a private company or not-for-profit body and is for people in the French system, to coverremaining costs of healthcare over and above what is paid for by Assurance Maladie.

For many kinds of healthcare the latter covers most, but not all, of the costs, for example it only covers 70% of the cost of seeing a GP. French employers are required to offer a subsidised mutuelle to employees.

To cover any interim period before you are eligible for public health insurance, many people recommend getting private insurance.

In this question, we are essentially looking at obtaining public health insurance through the state-run Assurance Maladie as a non-working American moving to France.

Where and how do I apply?

To apply for public health insurance you must have your primary residence in France, meaning you must intend to live in France for at least six months of the year.

You must have been living in France for at least three months at the time of applying for public healthcare.

You will need proof of your residency (rental contract, rent receipts, energy bills...), as well as your passport, and your visa/residency permit.

You will also need a French bank account and will have to give your bank details Rib (relevé d'identité bancaire).

You apply for health insurance through your local Cpam (Caisse Primaire d’Assurance Maladie), where you can make an appointment to register (walk-ins are no longer available for the service). It is also possible to print out and fill in a form, and send it in with supporting documents.

Read more: Which French public services do Connexion readers find ‘most helpful’?

If you have trouble making an appointment, you can call the English-speaking advice line for the service via +33 9 74 75 36 46 (open weekdays 8:30 to 17:30).

The Cpam appointment will (of course) be in French so if you cannot speak the language you should bring somebody with you that can translate. After the meeting, you should be able to apply for the carte Vitale, France’s health insurance card.

The length of time it takes for applications to be approved can be variable, but can take several months. In the first instance you should receive an attestation de droits (proof of rights), in a second stage you should obtain a carte Vitale, a card that makes the reimbursement process simpler. Before you get your card, you will have to pay upfront and keep forms proving your costs incurred, called feuilles de soins, which you can send in to Cpam for reimbursment into your bank account.

Related links

How do I get a free healthcare check-up in France?

Must Americans declare their French bank accounts to the US?

Can Americans access US Social Security income when living in France?