What you need to know

Compulsory health cover: French health insurance (Assurance maladie)

The social security scheme consists of several organizations which aim to protect citizens against life’s uncertainties (sickness, old age, unemployment, etc.).

In France, being registered with the French health insurance scheme (Caisse Primaire d’Assurance Maladie or CPAM) is compulsory: everyone who lives or works in France in a stable and regular manner receives a social security number. This number can be temporary or permanent, and will enable you to be easily identified with the CPAM and with all other social security organizations.

The French health insurance scheme covers a portion of the expenses associated with visits to a doctor or specialist, medicinal products and hospitalization.

To give you a better understanding, here is a breakdown of the health costs associated with a doctor's consultation.

  • Consultation cost: € 25.00
  • The amount reimbursed by social security: € 17.50
  • Supplementary amount (reimbursed by the complementary health insurance or ‘mutuelle’ – optional): € 7.50
  • Fixed contribution (the amount that the patient is liable to pay): € 1.00

The Carte Vitale

The Carte Vitale is a free card which includes your health insurance number and provides easy access to health care and direct reimbursement. The French health insurance scheme reimburses a portion of the expenses associated with healthcare expenses, such as a visit to the doctor.

If you do not have a Carte Vitale, you are still entitled to this reimbursement; however, you will have to pay for your consultation up-front. You will then be reimbursed a few days or weeks later, on the condition that you provide a treatment form which is filled by the doctor and given to you at the end of the consultation.

Using your Carte Vitale means that there is no need to fill in this treatment form, as the reimbursement request is automatically sent to your health insurance: it is faster and more convenient... But it is not mandatory!

Social Security Number

Your social security number is unique and personal, and it enables you to be easily identified with the CPAM and with all other social security organizations. It is a 15-digit number that is automatically assigned to you when you register with the CPAM; everyone who lives in France must be registered with the CPAM.

A social security number is essential for reimbursing health costs, collecting sick pay and receiving family allowances. It is also used as an identification code to create and connect to your ameli account.

Upon registration, the CPAM may assign you a temporary social security number, in order to have time to thoroughly review your application. This temporary number allows you to be reimbursed for health care expenses by the French health insurance scheme.

Your primary care physician

In order to be effectively reimbursed, you must follow the health insurance scheme’s recommended care pathway: you must choose a primary care physician. They are to prescribe your medication and refer you to see medical specialists... You should ask a doctor if they agree to become your primary care physician; they will then make the request electronically, or give you a form to send to the French health insurance scheme. It is as simple as that – but you must remember that doctors are in very high demand: they do not have to accept you as their patient if they already have too many.

To find the contact details of doctors in your area, visit the handy website: http://annuairesante.ameli.fr/

The care pathway

These are the steps you need to follow for access to care, and to be effectively reimbursed when you see a medical specialist. For this, you must first consult your primary care physician. There are a few exceptions to this rule: gynecologists, psychiatrists (if you are between 16 and 25 years old) and ophthalmologists may be seen without a referral.

Physician consultation fees

Physicians may charge a range of different consultation fees – depending on their specialty and sector (sector 1 or 2), however, your basic health insurance only covers a set amount: any excess fees will be at your expense.

  • A sector 1 physician operates charges the fees that are covered by the basic health insurance scheme: there are no excess fees, except in particular cases (a consultation outside normal working hours for example)
  • A sector 2 physician may charge extra fees in addition to the basic consultation fees (this is often the case in city centers). These extra fees are not reimbursed by the basic health insurance scheme.

Good to know: before making an appointment, you can check which sector a healthcare professional is registered under by visiting the healthcare directory website, ameli.fr.

Complementary health insurance / mutuelle

The basic French health insurance scheme reimburses a portion of healthcare fees, but not all: you still have the “complementary portion” (and the fixed contribution) to pay. For optimal health cover, you can opt to take out complementary health insurance – a supplementary health cover known as a “mutuelle”. This is not mandatory, but is strongly recommended: you should choose the complementary health insurance plan that best suits your needs, including any foreseeable healthcare costs, such as glasses, dental braces, etc.

  • Complémentaire santé solidaire:
    Starting on November 1, 2019, the CMU-C and ACS merge to give way to a simpler device: the Complémentaire santé solidaire (financial help to cover your health expenses if you are on a tight budget). This allows access to quality care without dependents, for no or limited financial participation.
    ► Find out more (FR)
     
  • Other complementary health insurances (mutuelles):
    If your income does not allow you to claim CMU-C or ACS, you can opt to take out a mutuelle (complementary health insurance) of your choice – once again, be sure to look into the different available offers and choose the one that best suits your healthcare needs.

Register

Health protection

As of August 31, 2019, the special student social security scheme will no longer exist, and will be replaced by a single scheme attached to the CPAM of your place of residence.

In France, being registered with the French health insurance scheme is mandatory: students arriving in France for the 2019-2020 academic year must register with the CPAM (Caisse Primaire d’Assurance Maladie) by visiting the web page: etudiant-etranger.ameli.fr, exceptions are noted below.

Students who were affiliated with the SMERRA or the LMDE for the 2018-2019 academic year (the student social security schemes) will automatically be affiliated with the CPAM for their place of residence, effective as of August 31, 2019.

This does not concern you:

  • If you are already affiliated through a family member who is an international official, to the social security scheme established by their international organization (for example, the European Union social regime), you should not register on this site.
  • If you are a citizen of the European Union, the European Economic Area or Switzerland, you may apply to your country of origin’s social welfare organization for a European health insurance card (EHIC). As long as it is valid until at least the end of the academic year, your country’s social welfare organization will continue to cover your reimbursements. In case of illness, you will only be liable to pay the fixed contribution, provided that you present this card or the EHIC provisional certificate of issue when consulting health professionals and institutions. You do not have to register on the etudiant-etranger.ameli.fr. website
  • If you are a citizen of the Principality of Monaco, before your departure, ask your Monegasque social security organization for a certificate of entitlement, specifying your affiliation to the Monegasque health insurance scheme. You do not have to register on the etudiant-etranger.ameli.fr. website. From the moment you arrive in France, you should present this form when consulting health professionals and institutions.

► Find out more

Healthcare advice

  • Each year, the Students Welcome Desk, in partnership with Lyon’s health services, publishes a small practical guide which gives you a list of useful numbers (family planning clinics, dental surgeries, etc.). You can download the PDF version in the “Useful documents” section
  • All insured individuals have the right to a free annual health check. To make an appointment for your free annual check-up, contact your local healthcare clinic.