New health fee: which countries have a bilateral social security agreement with France?

A new healthcare fee may soon be payable by those living in France on a visitor visa, a type of visa often used by retirees. 

However exemptions are expected for people coming from several countries which have a reciprocal bilateral social security agreement with France. 

An amendment to the 2026 budget looking to introduce a new minimal healthcare fee was passed by MPs last week and, depending on the law’s progression in the Senate and final adoption before the end of the year, could be in place by 2026.

The fee is aimed at a so-called ‘anomaly’ in the system where people living on a visitor visa can access the French healthcare system without paying into it provided they have lived in France for three months.

You can read more about it in our article here. 

Several countries have social security agreements in place 

The exact details of the fee – including the level of the minimal fee and who would be affected – will be made available in a later ministerial decree if the measure is adopted in the budget.

However, not all non-French nationals in France will be affected.

Firstly, EU citizens will not be impacted as their right to live in France derives from EU citizenship rights shared in common with French citizens.

Non-EU foreigners on visa/residency card statuses other than ‘visiteur’ will also not be affected, including Britons with Brexit WA cards or foreign people with the right to work in France.

In addition, Britons (especially UK state pensioners) living in France who have an S1 health form are highly unlikely to be impacted, as their healthcare is paid for by the UK government. However, Britons in France on the visiteur status and lacking an S1 (typically early retirees) may be affected by the new rule.

The rule would also not apply to those who are only in France on ‘temporary’ long-stay visas such as those coming to spend six months at second homes. 

MPs who tabled the amendment spoke mainly of American and Canadian citizens benefitting from the current arrangement. The MPs said some may be influenced to move to France due to high healthcare costs in their countries, “whereas reciprocity is not always forthcoming” [eg. for French people who move to North America].

However, an amendment was added to the bill that stipulates, subject to clarification in a decree, that some countries that have a bilateral health or social security agreement with France would not see their citizens impacted. 

According to information from the international social security body Cleiss, social security agreements are in place between France and the following countries: 

• Algeria

• Andorra

• Argentina

• Benin

• Bosnia and Herzegovina

• Brazil

• Cameroon

• Canada

• Cape Verde

• Chile

• Congo

• Gabon

• India

• Israel

• Ivory Coast

• Japan

• Kosovo

• Madagascar

• Mali

• Morocco

• Mauritania

• Monaco

• Montenegro

• Niger

• North Macedonia

• Philippines

• San Marino

• Senegal

• Serbia

• South Korea

• Togo

• Tunisia

• Turkey

• Uruguay

• United States

Agreements with China and Moldova were signed in September 2025 but have yet to come into force.

In addition, several agreements with French Overseas territories (St Pierre and Miquelon, New Caledonia, French Polynesia) and UK dependencies in the Channel Islands (including Guernsey and Jersey) exist. 

However inclusion on this list does not automatically mean those coming from these countries will be excluded from the rule. 

It is possible that the different conventions will be examined with regard to their rules on healthcare rights and the level of reciprocity. 

For example, French people moving to the US will have to take out a comprehensive private healthcare policy, as there is no universal healthcare right linked to residency.

More clarity will be available when the decree is published.