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.

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.