What you need to do to register for Healthcare in France (PUMA)

If you’re staying in France long-term, the EHIC/GHIC won’t cover you beyond short-term or emergency healthcare. As a long-term resident, you’ll need to integrate into the French healthcare system. Here’s a guide on what to do:

1. Register for the French Healthcare System (PUMA)

The Protection Universelle Maladie (PUMA) allows residents to access France’s public healthcare system. You’ll pay into the system based on your income, which gives you access to comprehensive healthcare services.

Eligibility:

• You have been living in France for more than 3 months.

• You plan to reside in France long-term (e.g., for work, retirement, or family reasons).

Steps to Register:

1. Apply through CPAM (Caisse Primaire d’Assurance Maladie):

• Contact your local CPAM office (found at your local CPAM branch or via Ameli.fr).

2. Prepare Required Documents:

Typical documents include:

• Proof of residence (e.g., utility bill or rental agreement).

• Passport or residence permit (Carte de Séjour).

• Birth certificate (translated into French if necessary).

• Proof of income (to calculate your contributions).

3. Wait for Your Carte Vitale:

Once registered, you’ll receive a Carte Vitale, a green card used to access public healthcare services.

2. Supplemental Insurance (Mutuelle)

France’s public healthcare system typically reimburses about 70% of medical costs, leaving you to cover the rest. To avoid high out-of-pocket expenses, many residents purchase a mutuelle (private top-up insurance).

• What it Covers: The remaining 30% of medical costs, as well as additional services like dental care, glasses, or private rooms in hospitals.

• Cost: Mutuelle premiums vary based on coverage but typically range between €30–€100 per month.

3. Work-Based Healthcare (If Employed)

If you’re working in France, your employer will automatically enrol you in the French healthcare system and provide basic group mutuelle insurance. They’ll deduct contributions directly from your salary.

4. If Retired or Not Working

• Retired: UK retirees can use the S1 form, which transfers UK-funded healthcare coverage to France.

• Apply for the S1 form through the NHS Overseas Healthcare Services.

• Register the S1 form with CPAM to access French healthcare without paying additional contributions.

• Not Working: If you’re self-sufficient (e.g., supported by savings or investments), you’ll pay a contribution based on your income (around 8% of your earnings over €10,421 per year).

5. Travel Insurance or Private Health Insurance (Temporary Solution)

If you’re still waiting to register for PUMA or need coverage for the first few months in France:

• Get private health insurance to cover medical expenses.

• Many expats use international health insurance providers for seamless coverage.

Key Takeaways

• After 3 months in France, register with CPAM for PUMA.

• Get a mutuelle for additional coverage.

• Retirees should apply for the S1 form for seamless healthcare access.

• Until fully registered, use private health insurance for peace of mind.