A Guide to the French Healthcare System


The healthcare sector in France includes both private and public hospitals. It also includes doctors, nurses and other medical personnel who render healthcare services to inhabitants of France, irrespective of their age, religion or income. Foreigners can also have access to the French healthcare system.

The healthcare system in France is rated among the best in Europe, as well as the world. It has high performance in most of the criteria for rating healthcare systems. Also, the government takes care of most of the health costs incurred through an insurance scheme. It is, however, mandatory for you to be insured by a health insurer. It is also necessary to be registered with a doctor and stick mostly with this doctor for you to be reimbursed. 

The French healthcare system: how it works

There are several means through which the healthcare system in France is funded. One of them is the obligatory social security contributions, known in France as the sécurité sociale. This is an amount of money which is usually deducted from your salary.  Another means through which healthcare is funded in France is through the government. Furthermore, the patient is required to foot part of their medical bills.

There is a new healthcare system recently instituted for foreign nationals living in France. It is known as the Protection Universelle Maladie (PUMA) and it replaces the previous Couverture Maladie Universelle (CMU) system. The change is targeted towards the streamlining of the system, as well as ensuring that all permanent residents and workers in France have easy access to French healthcare. A permanent resident in France is someone who has been living in the country for more than three months.

Also, upfront payment by patients was abolished towards the end of 2017. Since then, medical organizations and doctors can only receive payment directly from either the government or the patient’s health insurer. The bulk of medical fees – up to 70% of doctors’ charges and 80% of hospital bills – is being offset by the government and will reimburse through the healthcare system. In fact, in some cases, the entire bills are covered by the government. The remaining fees not covered by the government will be paid by you or your insurer.

French healthcare system coverage for foreigners in France (PUMA)

Health insurance is mandatory for everybody living in France, even if they are not French citizens. To qualify for the Protection Universelle Maladie (PUMA) as a foreigner, you must be a resident in France for a minimum of three consecutive months. In addition, you must commit to spending upwards of 183 days in a year.

By law, all residents in France must have some form of health insurance, whether private or a state French health insurance scheme (read our guide to health insurance in France).

In the past, foreigners are also required to possess a residence permit as well as pay French social security contributions. Retirees and citizens of countries in the EU were however exempted from these requirements.

Doctor’s fees

Doctors charge consultation fees. However, there are national rates for the different categories of healthcare services and most doctors abide by these.

French hospitals

Hospitals in France are broadly classified into two they are hôpitaux, which are run by the government and cliniques, which are privately run. The private hospitals are approved by the government. Up to 70% of hospital bills are reimbursed but lodging costs are not. Hence, you might need top-up insurance for this.

Pharmacies in France

Pharmacies are in abundance in France. France has about twice the number of pharmacies in the UK. This is due to the fact that doctors in France tend to prescribe a lot of drugs to patients. Cost pharmaceutical bills are also subsidized. You are only required to pay a small proportion of the overall cost. Your insurer and the government pay the rest.

Pregnancy and maternity in France

If you are pregnant, you will be presented with a document declaring the pregnancy (déclaration de grossesse). You must submit this form to the Health Insurance Fund (Casse d’Assurance Maladie or CAM) and Family Allowance Fund (Caisse d’Allocations Familiales or CAF) within 14 weeks of the pregnancy in order to enjoy health benefits.