France – Doctors

How does the healthcare system in France work, and does it cover expats?

France’s healthcare system rests on a primarily public foundation (Assurance Maladie), with a supplementary private layer — the mutuelle, or complementary health insurance — sitting alongside it. This differs markedly from a fully public model like the NHS, where most treatments cost nothing at the point of delivery. In France, you generally pay the provider first and then reclaim a set proportion of that cost from the state.

PUMa (Protection Universelle Maladie) came into force on 1 January 2016 and guarantees medical insurance to all legal residents, whether or not they are engaged in paid work. Under PUMa, anyone carrying out a professional activity in France or who has maintained a stable and continuous presence there for at least three months is entitled to coverage of their healthcare costs.

The social security system is funded through a combination of taxation and contributions from both employees and employers. On average, the basic state health insurance reimburses roughly 70% of medical expenditure — covering GP consultations, prescribed medicines, and surgical procedures. As in a social insurance model, contributions are income-linked; for employees, they are deducted automatically from wages each month.

Assurance Maladie is the health arm of Sécurité sociale — the body that pays the statutory share of your medical bills. Your local health insurance office, the CPAM (Caisse Primaire d’Assurance Maladie), is the institution that handles enrolment, processes your file, and administers your benefits on a day-to-day basis. Most routine interactions with CPAM take place through the online portal ameli.fr.

Since its introduction in 2016, PUMa has extended health coverage to every legal resident living or working in France for a minimum of three months, regardless of age, medical background, or contribution history. That said, the rules around contributions can vary depending on your nationality and the source of your income, and they are subject to revision. It is always advisable to confirm your current eligibility directly with Assurance Maladie (ameli.fr) or your local CPAM office.

In December 2025, the French National Assembly passed an amendment affecting non-EU holders of “visitor” visas. Previously, visitor visa holders with no professional income could access PUMa at no charge after three months of residency. From 2026 onwards, these residents will be required to pay a flat annual contribution before a Carte Vitale can be issued. The reform does not alter the quality or breadth of public healthcare itself — it only changes the conditions of eligibility. Once enrolled, residents will retain the same access to doctors, hospitals, and prescription reimbursements as any other resident. Visit ameli.fr for the latest guidance on eligibility and contribution obligations.

How do you find and register with a doctor in France?

Living in France means you will want to register with a médecin traitant — your primary doctor, who maintains your medical history and coordinates your wider care. No one is automatically assigned a médecin traitant; every resident over the age of 16 is responsible for finding and declaring one themselves, so it is important to take the initiative.

It is worth bearing in mind that a doctor is under no obligation to accept you as a patient — many practices are already at capacity and are not taking on new registrations. Depending on where you live, you may need to contact several surgeries before finding one that can accommodate you. In Paris this is rarely a major issue, but in smaller cities and rural areas, shortages of médecins généralistes can make the process more challenging.

There are several avenues for locating a GP who is currently accepting patients:

• ameli.fr — Assurance Maladie’s official website lets you search for doctors by location and specialty, and indicates whether they fall within the public system (Sector 1 or Sector 2). It is the most dependable source for current and accurate listings.
• Doctolib.fr — the most widely used booking platform in France. Particularly popular in larger cities, it allows you to filter by specialty, location, and sometimes spoken language, and to see available appointment slots and book online immediately.
• Local health centres (maisons de santé or centres de santé) — if you struggle to find a private GP with availability, these multi-practitioner clinics often have greater capacity and can be a reliable alternative.
• Personal recommendations — word of mouth remains one of the most effective methods, especially when you are looking for a doctor who speaks a particular language or who is known for being accommodating with newcomers.

Once you have chosen a doctor, formally registering them as your médecin traitant is a simple process. The doctor will either submit the registration electronically via your Carte Vitale, or provide you with the Déclaration de choix du médecin traitant (Cerfa form n°12485*03) to sign and forward to your local CPAM. From that point, all future visits and referrals will be linked to this GP.

To enter the French healthcare system, you will need to submit a registration application to CPAM. For many expats, this is the most frustrating step — not because it is impossible, but because it involves a fair amount of paperwork. Documents typically required include a valid identity document (passport or residency permit where applicable), proof of French address, a copy of your birth certificate (translated into French by a certified translator), a proof of address less than three months old (such as a lease agreement or recent utility bill), and your bank details (RIB/IBAN) in your name.

The step-by-step process for registering with the French healthcare system is as follows:

1. Confirm that you have resided legally and continuously in France for at least three consecutive months — or that you are employed there, in which case registration starts from your hire date.
2. If you are employed, your employer will declare your engagement to URSSAF. You will then need to open an account on ameli.fr and upload the required documents.
3. If you are self-employed, a student, or economically inactive, you must apply for affiliation either online or by post through your local CPAM. The precise requirements differ according to your situation.
4. Once registered, you will be issued a provisional social security number, followed in due course by a permanent one. You can then apply for your Carte Vitale — the smart card that stores your health data and automates the reimbursement process.
5. Bear in mind that receiving your Carte Vitale can take several weeks, particularly when applying for the first time. Retain all receipts and medical documents in the interim so that you can claim refunds manually.
6. Once your Carte Vitale arrives, contact a GP and formally register them as your médecin traitant.

CPAM affiliation is not a prerequisite for visiting a GP in France. Newly arrived expats, visitors, and those still awaiting their social security number can all book an appointment with any doctor and pay on the day. However, to obtain reimbursements and benefit from the coordinated care pathway (parcours de soins), you must eventually be registered with CPAM and have an officially declared médecin traitant.

How do you pay for a doctor’s appointment in France?

Healthcare in France is not free at the point of delivery — you settle the fee at the time of your appointment and are later reimbursed by the state. When choosing a doctor, you will notice they are classified as either Sector 1 or Sector 2: Sector 1 practitioners charge the standard regulated consultation fee of €30 (as of 2025). Sector 2 doctors are permitted to charge above this regulated rate, though the state’s reimbursement calculation is still based on the standard fee.

Assurance Maladie typically reimburses 70% of the base fee. The outstanding 30% — referred to as the ticket modérateur — is ordinarily covered by your mutuelle. If you do not hold a mutuelle, this portion comes out of your own pocket.

Some practices operate the tiers payant arrangement, under which you pay nothing upfront beyond the small non-refundable portion — the participation forfaitaire of €1 per visit. In December 2025 the French government considered doubling fixed co-payments but ultimately dropped the proposal. The co-payment therefore remains €1 per medicine box and €1 per consultation, with the annual ceiling held at €50 per person (as of 2025). Always check current fee and co-payment levels at ameli.fr.

To qualify for the standard reimbursement rate of around 70% from Assurance Maladie, you must have formally declared a médecin traitant. Without one, your reimbursement drops to approximately 30%, and specialist visits will also cost you more. Within the system, expats and French nationals are treated identically once registered — the same fees, the same reimbursement percentages, and the same rules apply irrespective of nationality.

Hospital admissions are reimbursed at 80%, and chronic conditions are covered at 100%. For these serious or ongoing conditions — classified as Affections de Longue Durée (ALD) — no complementary insurance is needed for the treatments that fall within the scope of coverage. Consult ameli.fr for a full list of ALD conditions and their associated reimbursement levels.

Do you need private health insurance to see a doctor in France?

All long-term residents of France are required to have health insurance, whether through the state scheme, a private provider, or a combination of the two. Private health insurance in France does not replace the public system — it complements it.

Because the social security system typically covers only a moderate share of overall healthcare spending, most people living in France carry optional supplementary coverage in the form of a mutuelle. A mutuelle is not compulsory, but it is strongly advisable — state insurance usually reimburses around 70% of standard medical costs, and many services such as dental treatment, prescription glasses, and hospital stays receive comparatively poor coverage without a top-up policy.

On the visa and residency side: if you are relocating to France on a long-stay visa, having private health insurance that covers you as a resident — not merely as a traveller — is a legal requirement for visa approval, designed to ensure comprehensive medical protection from the outset. Once you have lived in France for at least three consecutive months and satisfy the residency criteria, you can apply for PUMa. At that stage, many expats opt to combine public coverage with a mutuelle to achieve full protection.

For stays of less than three months, private travel insurance providing at least €30,000 of coverage — including repatriation — is typically a legal visa requirement. Always confirm the current insurance conditions for your specific visa category with the French immigration authorities at service-public.fr or the relevant French consulate before submitting your application.

While awaiting CPAM approval and the arrival of your Carte Vitale, it is sensible to maintain the private health insurance you were required to obtain for your visa. This protects you against being left without coverage during the administrative processing period, which can run to several weeks.

How do you transfer your medical records to a doctor in France?

Because no universal international standard governs the transfer of medical records, some preparation is needed before you arrive in France or shortly thereafter. The most practical first step is to request a comprehensive medical summary from your current or most recent doctor before leaving your home country — this might be called a GP summary, patient record extract, or discharge letter, depending on the healthcare system you are coming from.

When attending your first appointment with a new French doctor, it helps to bring whatever records you have, a complete list of your current medications, and information about any allergies or prior health conditions. While French practitioners do not require your overseas records in order to treat you, presenting a clear written summary — even in your own language, supplemented by a translation app or a certified translation for complex issues — can meaningfully improve the quality of that initial consultation.

For complicated conditions or ongoing specialist treatment, consider having key documents such as diagnoses, surgical reports, and prescription lists translated into French by a qualified medical translator. This becomes especially important when seeing a specialist or when your medical history directly influences the medications likely to be prescribed for you in France.

In January 2022, the French government launched a new digital health platform called Mon Espace Santé, which replaced the previous Dossier Médical Partagé. Once you are registered with CPAM and have a social security number, you can activate your account on this platform and use it to store medical files, manage appointments, and control which healthcare providers can access your data. The platform is accessible at monespacesante.fr.

Your médecin traitant can record consultation notes and clinical summaries directly in Mon Espace Santé, building up a medical history over time that any authorised treating professional can view. This is particularly valuable when you need to consult a specialist or undergo hospital treatment, as it prevents unnecessary duplication of tests and helps ensure seamless continuity of care.

What should expats know about language barriers and finding a doctor who consults in other languages?

In larger cities, a good number of doctors have at least a working knowledge of English, and platforms such as Doctolib, Maiia, and Mobi Doctor allow you to filter specifically for practitioners who offer consultations in languages other than French. In Paris and other major urban centres, finding an English-speaking doctor is generally feasible, though by no means guaranteed.

In certain parts of France — rural areas in particular — GP shortages make it difficult to find any doctor at all, let alone one who can consult in a foreign language. If you are planning to settle outside a major city, it is worth thinking about language access when making your healthcare arrangements before you arrive.

Doctolib is the dominant appointment booking platform in France, and it allows you to filter results by language, location, and availability. To find English-speaking practitioners, select “Anglais” (English) under the “Langues parlées” (spoken languages) filter. Other platforms — including Maiia, Qare, Livi, and Alan — also offer multilingual options and can serve as a useful temporary or supplementary resource.

When browsing online profiles, look for doctors who list “Anglais parlé” (English spoken) — this detail can reduce stress considerably when you need to discuss something complex. That said, a listing does not always reflect full fluency, so it is worth checking language comfort directly before your first appointment.

A translation app on your phone, or a French-speaking companion for more involved consultations, can also be a practical solution. Some public doctors may ask for an interpreter to be arranged for complicated medical discussions. Many embassies and consulates compile lists of local healthcare providers recommended by their expatriate communities — it is worth checking your home country’s embassy website in France for any such resources.

For medical issues that arise outside normal surgery hours, you can call the French Medical Advice Line on 116 117, which will connect you with an on-call GP (médecin de garde) in your area. SOS Médecins (dialled as 36 24 from a French phone) provides round-the-clock access to home visits, in-clinic appointments, and telemedicine consultations.

What do expats need to know about prescriptions and medication in France?

Any prescription can be taken to any pharmacy in France — there is no waiting period, and you will receive your medication immediately. Prescriptions in France are typically issued for a one-month supply at a time. French pharmacies are plentiful and staffed by qualified pharmacists who are well placed to advise on minor ailments, which can often save you an unnecessary GP visit.

Prescriptions issued abroad are not automatically honoured in France. A French doctor must evaluate your condition and, where appropriate, write a new French prescription (ordonnance). It is important to bring a full written list of your current medications to your first appointment, including both the brand name and the international non-proprietary (generic) name, since many drugs are marketed under different brand names in France. Your doctor or pharmacist can help identify the French equivalent.

Prescription costs are handled through the same reimbursement framework that applies to consultations. In many cases, no payment is required at the pharmacy counter, as the charges are processed automatically — with appropriate amounts debited from your account and direct payments made to the healthcare system by your complementary insurer. The level of reimbursement applicable to each medicine is printed on the receipt attached to the back of the prescription, and this figure varies by product.

In France, medicines are categorised according to their reimbursement rate. Essential drugs and those prescribed for chronic conditions are generally reimbursed at higher rates — up to 100% for certain ALD treatments — while over-the-counter products and some branded medications attract lower or no reimbursement. As of 2025, the co-payment for prescription medicine boxes stands at €1 per box, subject to an annual ceiling of €50 per person. For current reimbursement rates on specific medications, consult the official database on the Assurance Maladie website (ameli.fr) or speak to your pharmacist.

Online consultations via platforms such as Doctolib are particularly well suited to repeat prescriptions. In many cases, doctors are able to issue a prescription electronically, which you can then take directly to a pharmacy. This is especially convenient for patients with stable, long-term conditions who simply need a routine renewal.

Frequently asked questions

What do I do in a medical emergency in France?

In an emergency, dial 15 to reach SAMU (the emergency medical service), or head directly to urgences (accident and emergency) at your nearest hospital. If your French is limited, asking “Do you speak English, please?” will often result in being transferred to a member of staff who does. Emergency treatment will be provided regardless of your insurance status or registration with CPAM — you will not be refused care.

How long does it take to get registered with CPAM and receive a Carte Vitale?

Receiving your provisional social security number — which enables you to access care and submit reimbursement claims — typically takes between four and eight weeks. Your permanent number and Carte Vitale, the green health card used in France, will follow at a later stage. Keeping your private health insurance active throughout this waiting period is strongly recommended.

Are pre-existing conditions covered by the French public health system?

PUMa grants health coverage to all legal residents irrespective of age, medical background, or prior contribution history. France does not apply any exclusions for pre-existing conditions within the public scheme — once you are registered, existing conditions are treated on the same terms as any other. Certain serious long-term conditions classified as Affections de Longue Durée even qualify for 100% reimbursement of approved treatment costs.

What happens to my healthcare coverage if I change jobs or become self-employed?

If you move into self-employment, you register your business with URSSAF and obtain a SIRET number, but your health coverage continues to run through CPAM. Your entitlement to Assurance Maladie does not lapse when your employment status changes, but you are required to notify your CPAM and ensure that contributions are maintained under your new status. Consult ameli.fr for the correct registration process applicable to your situation.

Can I see a specialist directly without going through my GP?

It is possible to consult a specialist without a GP referral, but doing so will result in a reduced reimbursement. State insurance covers 70% of specialist costs when you have a referral from your registered médecin traitant. If you bypass the coordinated care pathway (parcours de soins) and approach a specialist directly, your reimbursement rate falls from 70% to 50%. Exceptions apply to direct consultations with an ophthalmologist or gynaecologist.

Will my prescription medication from abroad be accepted at a French pharmacy?

As a general rule, foreign prescriptions cannot be dispensed at French pharmacies. You will need to consult a French GP or specialist, who can assess your condition and issue a French ordonnance. Bringing a detailed record of your current medications — ideally including both brand names and generic (INN) names — to your first appointment will help your new doctor identify the most appropriate equivalent available in France.

What is a mutuelle and do I really need one?

A mutuelle is complementary private health insurance that covers co-payments, dental treatment, optical care, and in some cases private hospital rooms. The practical difference it makes is significant — it can reduce your out-of-pocket cost for a GP visit from around €11 to just €2. Although a mutuelle is not legally required for most residents already within the PUMa system, the majority of people living in France regard it as indispensable for keeping costs manageable, particularly for dental, optical, and specialist services.

Can I use the European Health Insurance Card (EHIC) in France?

Citizens of EU and EEA countries, as well as Switzerland, may present their European Health Insurance Card (EHIC) during temporary stays in France. For long-term residency, however, enrolling in the French system is the appropriate course of action. The EHIC is designed for short-term or occasional visits — it does not confer the same level of protection as full registration with Assurance Maladie, and it does not entitle you to declare a médecin traitant or claim reimbursements at the standard resident rate.