Health insurance in France

French healthcare runs on two layers. The state scheme (Assurance Maladie — you qualify after three months of stable residence under PUMA) reimburses a percentage of regulated tariffs: roughly 70% of doctor visits, 80% of hospital costs. The second layer, the « mutuelle » (complementary insurance), picks up most of the remainder — which is why over 95% of residents carry one. Employees get one automatically (employers must pay at least half); everyone else buys individually, from €30 to €180/month depending on age and cover.

Expats’ classic path: EU stays with an EHIC card → PUMA registration once resident → a mutuelle sized to your real needs (dental and optical drive most of the price). Before PUMA kicks in, private international cover bridges the gap.

If you would rather have it all in one place, the health chapter of our complete expat pack walks through Assurance Maladie, the carte Vitale, the S1 form and choosing a mutuelle in plain English, and the cancellation kit included in the pack has the French letter to end an individual mutuelle after one year.

Frequently asked questions

Is a mutuelle mandatory in France?

Not legally for individuals — but employers must provide one to employees (with at least 50% employer funding), and going without one exposes you to the 20-30% co-payments and hospital daily fees the state does not cover. Low-income residents qualify for the free/subsidised Complémentaire santé solidaire.

Can I use French healthcare before having a carte Vitale?

Yes: you pay upfront and claim reimbursement with paper forms (feuilles de soins) once registered. Keep every receipt — reimbursement is retroactive to your entitlement date in most cases.

Related guides: Health cover in France: sécu + mutuelle, decoded. Full details (profiles, breed pages, comparisons) on the French page.