State Health Insurance in France
Information about the state healthcare system and French health insurance requirements...
All residents in France
are obliged by law to have health insurance. Most qualify
for the state health insurance (sécurité sociale); in local terms, this means affiliating to
the CPAM (Caisse Primaire L'Assurance
Maladie). This is the local
department level of the national health insurance administration. Those who do not qualify will have to take out
private health insurance.
Ameli.fr is the website portal for the French health
insurance program.
- French Health Insurance Advice Line Tel: 36 46 (from
France), 09 74 75 36 46 (English-speaking)
- Comprehensive
information from CLEISS (Centre des Liasons Européennes et
Internationales de Sécurité Sociale) in English
- Ameli (Assurance Maladie en Ligne)
(information in English)
Expatriates who have come to live in France
need to prove their income to CPAM. This is most easily done with a French tax
return. However these tax returns are submitted one year in arrears, in May
each year, so those who have not declared themselves as tax residents need to
show evidence of income. This can be another country's tax return, or evidence
of income such as pay slips, pension statements, or earnings from capital such
as bank deposits, coupons from government bond holdings or share dividends.
- More information
for Europeans in France from Service Public
(in French)
- To download an application in English to register
to the French Health Service
Joining French Social Security
Visit a local CPAM office and
ask for affiliation. Affiliation should then take place that day either
as attestation provisiore if not all the documents are available,
or as attestation d'affiliation. Claims from that day forward are covered by
CPAM to the percentage appropriate to the applicant's status. The following may
be needed when completing the form N° Cerfa :
60-3406 (declaration en vue de l'immatriculation d'un pensionné, ou de sa
veuve, ou d'un orphelin):
- Proof of identity:
passport or Titre
de Séjour
- Details of place of
birth (and for partner and children)
- Proof of address in
France with proof of ownership (deeds) or rental agreement
- Date of permanent
arrival in the departément
- Proof of having
lived in France for at least three months (three months' utility bills,
rent statements, or mortgage payments or a notarised statement of home
purchase)
- Marriage and birth
certificates, if partners are to be included
- A RIB (Relevé d'Identité Bancaire)
provided by the bank
- Evidence of income
for at least the previous 12 months, whether in France or elsewhere or an avis d'imposition or latest French tax bill
The Carte Vitale
Once affiliated to the social
security system, a Carte Vitale (green card) is issued. The Carte Vitale is
the national insurance card issued to anyone eligible aged 16 and over. It
gives evidence of membership and rights to French health insurance - an
affiliation to CPAM. It contains all the administrative information necessary
for the refund of care:
- Social security
number
- Details of health
insurance scheme and top-up insurance
- Details of the
relevant health insurance office
- Full name and date
of birth of the card holder and their dependants
- Details of any
exemption or reduction that apples to payments or entitlement to
supplementary universal cover
The Carte Vitale does not carry personal
medical information. The Carte Vitale should be handed over at every health
appointment (doctor, clinic, hospital, pharmacy) that is equipped with a
computer able to read it. The patient will generally receive reimbursement for
treatment or medicines directly into their bank account within five days.
Reimbursement is made according to income level and the Tarif de Convention (or
"approved treatment cost") currently in force. A Carte Vitale has no
expiry date but must be updated annually inserting it in the green box which
can be found at all CPAM offices and some hospitals and pharmacies. A person
without a Carte Vitale eligible for state health insurance will receive a feuille de soins (a
brown receipt form) from the doctor, pharmacist or hospital staff. This is
recognised by CPAM as a legitimate medical payment. It should be signed and
posted to CPAM (along with the doctor's prescription if medicines were issued)
for reimbursement.
- More information
about the Carte
Vitale (in French)
The new Carte Vitale
Updating
a Vitale card can be done online, at most pharmacies or at the
multi-service kiosks available at Health Insurance points.
A Carte Vitale can be ordered online via the Ameli website