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Chapter 6 of 15

Health insurance

Sécurité sociale, carte vitale, mutuelle, CPAM, registering for healthcare

Summary

The French healthcare system is among the best in the world and consists of two layers: mandatory basic insurance through the Sécurité sociale (reimbursed via the carte vitale) and supplementary insurance (mutuelle or complémentaire santé). As an EU citizen, you are entitled to the Sécurité sociale after settling in France. The CPAM (Caisse Primaire d'Assurance Maladie) is the agency that handles your registration and reimbursements.

How the French healthcare system works

Layer 1: Sécurité sociale (Assurance Maladie)

The Sécurité sociale reimburses an average of 70% of medical costs (consultations, medication, hospital stays). You receive a carte vitale (digital health card) through which reimbursements are processed automatically. The remaining 30% — the ticket modérateur — you pay yourself or through a mutuelle.

Layer 2: Mutuelle (complémentaire santé)

The mutuelle covers the remaining amount (30%) and often provides additional coverage for dental care, glasses, physiotherapy, and alternative medicine. Employers are legally required to offer a mutuelle to employees (at least 50% paid by the employer). If self-employed or retired, you arrange your own mutuelle.

What is covered?

| Care | Sécurité sociale reimbursement | With mutuelle |

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Knowledge Base

Glossary
  • Carte de Séjour (Residence Permit)

    The French residence permit. EU citizens do not need to apply for a carte de séjour but can obtain one as proof of residence rights. Non-EU citizens must apply for one.

  • Carte Vitale (Health Card)

    The French health card that gives you access to the healthcare system. Medical costs are directly reimbursed with this card. Apply at the CPAM after your PUMA registration.

  • CPAM (Primary Health Insurance Fund)

    The local health insurance institution. Here you register for French health insurance, apply for your Carte Vitale and submit claims.

  • CAF (Family Benefits Fund)

    The French family benefits agency: child benefit, housing assistance (APL), living allowance. If you live and work in France, you are entitled to many of these benefits.

  • Impôt sur le Revenu (Income Tax)

    The French income tax. Progressive rates from 0% to 45%. Calculated per "foyer fiscal" (household). Since 2019 the tax is withheld directly from your salary.

  • Mairie (Town Hall)

    The French town hall. Here you handle registration, marriages, and request various documents. Every village and city has a mairie.

  • Sécurité Sociale (Social Security)

    The French social security system. Covers healthcare, pensions, family benefits and unemployment. Your numéro de sécurité sociale (15 digits) is your key to the system.

  • OFII (French Immigration Office)

    The French immigration office. Non-EU citizens must validate their visa and activate their residence permit here after arriving in France.

  • PUMA (Universal Health Coverage)

    The French universal health coverage system. Everyone who lives stably in France (3+ months) is entitled to PUMA coverage, regardless of employment status.

  • Taxe d'Habitation (Residence Tax)

    A local tax on your main residence. Largely abolished for main residences since 2023, but still applies to second homes.

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