Healthcare for Retirees in France: Your Options

The French healthcare system is known as ‘L’Assurance Maladie’, and it’s available to all French residents. However, the system isn’t free – it’s paid for by a combination of state funds and patient contributions (which may, in turn, be covered by a mutuelle or top-up insurance – more on that later).

It is mandatory for all French residents to have health insurance, and the minimum requirement is to be registered with the state health insurance, Protection Maladie Universelle or “PUMA”.

Retiring to France: Can I join the French healthcare system?

Anyone who is resident in France or living in France in a ‘stable and regular manner’ is eligible to register with L’Assurance Maladie, and this includes retirees. However, the process is slightly different for retirees.

If you move to France to work or study, you will be able to register with l’Assurance Maladie upon arrival in France and obtain a social security number (numéro de sécurité sociale). This will entitle you to state healthcare coverage in France. However, if you are moving to France as an ‘inactive’ resident (e.g. as a retiree), on arrival in France, you must wait three months until you can register for the French health system and receive your Carte Vitale (your French health insurance card).

This delay is why you must have sufficient private health insurance to cover you upon your arrival in France (more about that in a moment).

Applying for your Carte Vitale as a retiree

Registering for French healthcare for retirees in France is done by filling a ‘demande d’ouverture des droits’ form which you can find here. This is then sent to your local Caisse Primaire d’Assurance Maladie (CPAM for short) to begin the process. Read our guide to France’s Healthcare System: Applying for a Carte Vitale for more on this.

Access to the France’s healthcare service and PUMA is funded by your social security contributions (cotisations/contributions sociales), which is levied from your taxable income (separate to income tax). For retirees, you will typically fall under one of two options:

• You will pay French social security contributions on your pension income.

OR

• Your healthcare will be covered by an S1 form, indicating that your health insurance throughout your retirement is covered by the social security system of another country. This option is only available to those retiring to France from another EU or EEA country, or the UK. You can read more about this here.

If you are retiring to France from the UK, you might also want to read our guide Retiring to France after Brexit: Can I Get an S1 Form?

It’s important to understand that healthcare in France is not completely free (although, as American retirees may note, it is often far more affordable than some international healthcare systems). Once you are covered by the state’s Protection Universelle Maladie (PUMA) and have received your Carte Vitale, a large portion of your healthcare in France will be subsidised by the state.

All essential and urgent treatments, and many long-term illnesses and corresponding prescription medicines are covered 100%. However, for doctors’ visits, hospitalisations, visits to specialists, and many other prescriptions and treatments, the state only covers a percentage of the costs – typically 70%. The remaining percentage is left to the patient.

While Franch healthcare costs are not outrageous (read our guide to the Cost of Healthcare in France), these costs can quickly add up nonetheless. For this reason, most French residents also take out a top-up insurance, known as a ‘Mutuelle’in France.

Taking out a mutuelle top-up insurance is mandatory for workers and business owners, but it isn’t for retirees. However, it’s highly recommended, especially for those entering a period of their life when healthcare costs are likely to be much higher than before. French mutuelles are non-profit cooperative insurance bodies, and they are strictly regulated in France, meaning that they cannot discriminate for pre-existing conditions or refuse coverage.

A health insurance mutuelle is not private health insurance: instead, it serves as a top-up insurance funds the part of your healthcare costs not paid for by your state social security contributions. Top-up insurance policies are often very affordable, but they work on various tiers of payment, so it’s important to understand exactly what is and isn’t covered, and to what percentage.

As you enter your elderly years, higher levels of coverage may be advisable and could include additions such as dental or optical care, a greater level of comfort (such as a private room or post-treatment home visits in the case of a hospitalisation), or a higher percentage of cover (which may allow you greater freedom when choosing a specialist).

Our guide French ‘Mutuelles’ (Top-Up Health Insurance): What You Need to Know will take you through everything you need to know.

In order to register for France’s state healthcare, you need to be resident in France for a minimum of three months. Due to this delay, most long-stay visa applications (the first step in the road to residency in France) require that applicants hold sufficient private health insurance.

In this instance, you will need to take out a private international health insurance policy that covers the duration of your visa (12 months). This health insurance must provide a minimum coverage of €30,000 and be valid throughout the entire Schengen zone. It also must cover medical repatriation and emergency/hospital treatment.

Once you have successfully enrolled in the French health system, you can cancel your insurance policy if you wish. You will not need this when it comes to renewing your visa/applying for your Carte de Séjour.

Do UK expats need private healthcare for a French visa?

A common question for those applying for a French long-stay visa from the UK is whether or not the Global Health Insurance Card (GHIC) provides sufficient healthcare coverage for visa applications. The French Embassy in the UK has confirmed that a GHIC card will be accepted for long-stay visas up to 180 days – i.e. a temporary long-stay visa.

However, this is currently not acceptable for 1-year long-stay visa application unless it is accompanied by an S1. Although there is hope that this may be changed in the future, for the time being, if you are a retiree applying for a French long-stay visitor visa, you will probably need to take out a full private health insurance policy in order to meet requirements for your visa.

France’s healthcare puts a large focus on preventative care, and older residents in the French healthcare system are afforded a number of benefits. However, it can take time to adapt and adjust to your new life in France, and healthcare is no exception. Our Essential Reading articles are designed to simplify the process and provide all the information you might need, whether it’s visiting a doctor or picking up your prescriptions at the pharmacy.

From the age of 50, thyroid examinations, cardiovascular check-ups, cholesterol and blood sugar level controls, mammograms, smear tests,  bone density tests, dental check-ups, and eye exams are offered every two years, along with colonoscopies every five years. From 60 years, biennial hearing controls, DTP and shingles vaccinations, annual flu shots, and annual vision checks are also provided.

Additional help and assistance is also available for elderly residents in France: read our guide to Preparing for Old Age in France: Care Homes, Home Help, and Benefits.

From applying for residency and understanding your pension options, to life in France for the over 60s – FrenchEntrée is here to help! Let our Essential Reading articles guide you through the whole process, then visit our French Tax, Healthcare, Wills & French Inheritance, and Life in France zones for everything else you need to know.