Expat Health Insurance & Private Medical Care in France


The French health care system has worked extremely well for its residents and gives them an excellent level of all-round care. Consumers have greater choice and the standard of care is considered to be better than in Britain, although new drugs are limited. France now needs a decent health budget if it is to make health care advances, as its current budget has been under strain for many years. An inconvenience for patients has been losing their right to see their chosen doctor.

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Healthcare Options for Expats in France

International medical insurance companies, advise expatriates who are permanently living in the country, to join the national state health insurance system, despite the recent limits on self-referral. One of the best options for expats remains the Couverture Maladie Universelle (CMU).

Once expats have been accepted onto this scheme, pre-existing medical problems will be disregarded but some commercial insurers may not accept this as it can mean increased costs which would need to be reflected in higher premiums.

Expats, who have retired, are eligible for CMU and will need to have the E121/S1 form, which is given out by the department of work and pensions. This recognises the holder’s long-term commitment to stay abroad and will give them automatic access. The E106/S1 form extends cover for up to two years for those who have paid into the plan and retire earlier.

The European Health Insurance Card

The EHIC is created to give care for European holidaymakers in other EU states but this shouldn’t be used by British people going to France, who  want to settle. British people may be able to use this for a short amount of time.

The CMU is administered throughout hundreds of local offices across the country. These offices are known as Caisse Primaire Assurance Maladieand and as well as handling reimbursements, they also verify new arrivals on production of documents such as proof of long-term residence and proof of identity.

 Health Cover for early retirees in France

Expatriates, who are not included in CMU, continue to press through Brussels for exemption to the 2007 circular. This circular, which was issue in 2011, states that there is a 5 year eligibility rule, which for new CMU applicants, can only be accepted in cases of:

  • The loss of health care cover through loss of employment of a spouse
  • Cost of private insurance becoming too heavy due to high costs of treatment
  • Any un-noticed financial collapse making purchase of health insurance impossible
  • The loss of health cover due to unexpected events and problems out of their control

Individuals, who are moving to France and seeking to join CMU, should ensure that they keep documents safe as they will need to prove that they have permanent residency, giving them access to the system after five years.

What non-CMU expats might pay

Private medical insurance premiums are spread widely for expats with premiums covering hospitals expenses as well as outpatients fees. The categories for the plans are specifically designed to include both benefits and some of these plans can be extended across Europe and may even reach into Asia

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Top-up insurance

Simply being in the French system does not give access to free use of services. Membership of CMU will allow expats to get reimbursement of roughly 70% of fees, and top-up insurance, usually taken out by the French, should cover the remaining 30%.

Drug costs are reimbursed at a rate of 15%, 30%, 65% and 100% depending upon the perceived necessity and some other factors. In addition to this, hospital costs are reimbursed at up to 80% and other levels of cover may be offered by different insurers.

Insurance tax

Exclusive Healthcare, which is an insurer which can be accessed through a broker, specialises in foreign nationals living in France and offers cover on seven different levels. These plans are created to merge with the state care cover plans. Since 2010 top-up insurance has been subject to a 7% tax and some people have been forced to renounce their top-up cover because of this. Insurers play an important role in the campaign to include non-working expats and others in CMU and there is some state aid provided for hard-up families and individuals.

Channel hoppers

French law, states that those who spend over 183 days a year in the country will have to register and pay the CMU levy. BUPA International has designed a specific plan for those who stay for less than 6 months in France and avoids some of the premiums charged for full international insurance. Another insurer, similar to BUPA International, is IMG Europe.

The international set

An added cost for international private medical insurance may come via the CMU tax for business people who are located in France. Those who can show they are not residents in the country will not be expected to pay this extra cost.

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