Private Vs Public Health Insurance In France

All legal residents, including expats, who meet residency requirements (refers to a person who has spent time living in France for three months to stay for another three months minimum) can benefit from the French healthcare system and health insurance scheme. France’s universal hybrid healthcare system is said to be one of the best healthcare systems in the world, providing high-quality medical care. Healthcare costs in France are borne by both the state and the individual.

Our guide will assist you in navigating all of this: it will provide an overview of the French healthcare system, comparing private and public health insurance, relevant information on finding a doctor, giving birth in France, private health insurance, and much more.

Comparing Private And Public Health Insurance In France

Let us compare private and public health insurance in France quickly.

Why Go For Public Health Insurance Coverage In France

• Free emergency care
• 70% to 80% reimbursement for general practitioner visits
• 80% reimbursement for hospital visits
• 100% reimbursement for medical expenses in case of major illness
• Basic dental care such as consultations, cavities, tooth extractions, and dental prostheses
• Up to 100% of prescribed medication cost
• When referred by GP, reimbursement for specialist care
• Free birth control methods (pills, IUDs, contraceptive patches, and other methods) for women aged between 18-25
• Free preventative care: check-ups every two year
• 100% reimbursed for free pair of spectacles every two years for adults and children every year

Why Go For Private Health Insurance Coverage In France

Consultations with psychologists, osteopaths, chiropractors, and other specialists are typically not covered by state insurance.

• If you require specialized care, private insurance provides the same care you would receive at home.
• Private care costs vary depending on the type of coverage required and factors such as the applicant’s age; however, few mutuelles require your health information prior to approval.
• Basic packages focus on hospital care and medicine but may include some dental coverage. 

To get the best insurance coverage for yourself, you should always research and compare plans before moving.

Best Health Insurance Providers For Expats In France

Some of the best insurance providers for expats in France include the following:

French ‘mutuelles’ (Non-Profit Insurance Funds):

• MGEN
• Mutualia
• Mutuelle Générale
• Unéo
• Harmonie Mutuelle
• MNT

Private Insurance Companies (International Health Insurance):

• AXA
• Allianz
• GeoBlue
• AETNA

How Healthcare Works In France

Is healthcare in France free? Mostly. The French healthcare system is frequently regarded as one of the best in the world. To get you started, here are some health-related facts:

• It’s a well-served system, with more than one doctor for every 1,000 people.
• In France, the average life expectancy is 83 years.
• The universal system is a hybrid, and healthcare costs in France are financed partly by the state and partly by individuals or private insurers.
• Employee and employer taxes both contribute to the healthcare system.

The France Healthcare System Explained

A high-quality healthcare system comes at a cost. So, how exactly does healthcare work in France? France has a high tax burden, and the country spends more than 11% of the national GDP on mandatory healthcare. Nonetheless, the French are content with their high-quality healthcare system, which is unlikely to change anytime soon. Patients spend relatively little on healthcare because the government subsidizes the majority of it.

French Healthcare System: Pros and Cons

Pros

• The system is quick. In general, there are no lengthy waits at the doctor’s office, and scheduling an appointment is simple.
• The French healthcare system provides high-quality, low-cost care.
• All legal residents, including those who are unemployed, have access to the healthcare system.
• Expats can access French healthcare after three months or sooner if they are working and paying social security.
• France provides free preventive care to all citizens, including free medical check-ups every two years.
• Specialists can be reached without a doctor’s referral.

Cons

• To support and maintain their universal healthcare system, the French and those working in France must pay a significant amount in taxes.
• For the first three months, an expat must purchase private health insurance until they are enrolled in the public healthcare system.

What Does Public Healthcare Cover?

In France, the healthcare system will normally cover 70% of doctor’s fees and 80% of hospital costs. If you have a major illness, your expenses are fully covered. This is due to the fact that France operates on the principle of solidarity, which states that the sickest people should pay the least, preventing them from becoming financially disadvantaged. The remainder is covered by the individual or by additional private health insurance. The patient is responsible for a small fee, such as 1 EUR (1 USD) per doctor visit.

The 2016 PUMA scheme will protect you if you are covered under France’s universal healthcare system (Protection Universelle Maladie). If you are a legal resident of France, regardless of your employment status, you will be eligible for health insurance. This differs from the previous system, in which dependents were only insured if they met certain living or employment requirements.

Getting Public Health Insurance As A Foreigner

You must meet the residency requirements to be eligible for this coverage. An expat who moves to France will not be automatically enrolled in the insurance scheme. So, to qualify, you must have spent time living in France for three months or be working in the country (and have been offered insurance by your employer), as well as plan to live in France for at least six months of the year. It is recommended that you purchase private insurance until you are eligible.

You will be eligible to apply for a European Health Insurance Card if you enter the French state healthcare system (EHIC). This entitles you to free or reduced-cost medical treatment while visiting another EU country.

You can use your EHIC card from your home country to access France’s healthcare system if you are an EU citizen. However, suppose you are a resident or intend to stay in France for an extended period of time. In that case, you will have to register with the French health insurance and social security system in order to access healthcare.

Does The Public Healthcare Cover Dental Care?

Basic dentistry (such as consultations, cavities, and tooth extractions) is covered by the state, but cosmetic treatments or more complex treatments are usually more expensive, and patients must bear the costs themselves or obtain private insurance. However, dental prostheses will be fully reimbursed under the system beginning in 2021.

Between the ages of 6 and 18, all the children receive free dental check-ups every three years. The Caisse Primaire d’Assurance Maladie will send you a letter entitling your children to their regular examination. You will not have to pay any charges for the consultation if you bring this letter to the dentist.

Eye And Vision Care

Beginning in 2020, certain glasses were fully reimbursed. Since 2021, adults have been able to receive one free pair of glasses every two years, while children will receive one pair each year.

France Health Card: Carte Vitale

Once you are enrolled in the French healthcare system, you can obtain a carte Vitale (health insurance card). The card contains administrative information required by medical professionals, like any other private insurance you may have, your doctor, and information about any work-related accidents or illnesses. It is directly linked to your health insurance provider.

The actual application for the carte Vitale is made concurrently with the application for your social security number, which is done at your local Caisse Primaire d’Assurance Maladie (CPAM). 

It is critical to keep your carte Vitale up to date once you have one. You must update your card once a year or whenever any details, such as your employer, address, doctor, or becoming a parent, change. You can update your card at bornes, automatic information points located at various health facilities, or a local pharmacy.

An Overview Of Private Health Insurance

Is health insurance required in France? The majority of French citizens purchase an additional policy to cover costs not covered by the state. So, this is a way to ensure that you are completely protected. This type of health insurance is usually obtained from a non-profit organization and is known as l’assurance complémentaire santé or mutuelle.

However, one of the most notable differences between private health insurance in France and other European countries is that private does not always imply faster service. It is simply a method of providing people with full coverage while requiring them to pay nothing out of pocket (or at least get reimbursed in case they do have to pay something upfront).

Is Private Health Insurance Required In France?

Because the state does not cover things like chiropractors, osteopaths, or psychologist consultations, private health insurance is a great option for those with chronic illnesses. It is also advantageous for some prescription medications because the state only covers a portion of what they consider “essential” medication. Some prescription medications can cost more than 100 EUR (112 USD), so private insurance is recommended in these cases.

How To Sign-Up

Aside from signing up for private health insurance on your own, you can also obtain health insurance in France through your French spouse’s plan or through your employer’s benefits package.

Since 2016, private French companies have been required to provide healthcare coverage to their employees. This type of medical insurance typically covers the remaining 30% of your medical expenses, including emergency hospitalization. If you are a duly and regularly registered self-employed worker in France, you will have access to the Régime Social des Indépendants’ medical insurance (RSI). As a student in France, you should get private insurance to cover the rest of your expenses.

If a person is unable to access or is ineligible for the state system, they may be required to purchase a private health insurance policy. Private coverage is significantly more expensive than the hybrid system and is not available to everyone. The private health insurance cost depends on several factors, including the applicant’s age and health history. You will be subjected to a medical questionnaire before being approved for any policy, and depending on the answers, your premium may be higher, or you may even be denied insurance.

How Much Does French Health Insurance Cost?

The average cost of health insurance (monthly) in France is 40 EUR (45 USD). Indeed, the prices vary depending on the policy: the more comprehensive the policy, the more you will pay for health insurance. There are numerous types of health insurance policies. Some are tailored to specific job occupations, while others are designed specifically for expats and English speakers. It is best to shop around, get recommendations, compare prices online, and find the best policy for your needs.

What Are The Documents Needed For A Hospital Visit?

If you go to the hospital, you must bring your carte Vitale, EHIC, or proof of insurance. If you are in a public hospital, you must also bring a copy of the notice stating that you are entitled to state health care. If you are uninsured, you will not be denied healthcare in France; however, you will be expected to pay for everything yourself. In this case, you may be eligible to apply for Aide médicale d’Etat (AME), a social benefit that assists low-income foreigners (non-residents) in irregular situations in the country with medical expenses. You must have spent time living in France for at least three months to be eligible.

You can still be attended to and treated if you have forgotten your Carte Vitale. You will be given a form called feuille de soins to fill out (a document containing information about medical costs incurred). After that, you can submit the form to your health insurance provider to be reimbursed.

Are There English-Speaking Hospitals?

You’re in luck if you live in Paris and don’t speak French. In Paris, a few hospitals have bilingual doctors and medical staff. English-speaking expats can seek treatment at institutions such as the Hertford British Hospital and the American Hospital of Paris.

Bilingual hospitals may be harder to find outside of the capital, and your doctor is not guaranteed to speak English. In this case, bringing a French-speaking friend or learning some basic phrases related to your condition before your visit is recommended.

How To Find A Doctor Or Dentist

Getting sick while traveling is always a hassle, but the extra stress can be avoided if you know where to find a doctor and dentist. Here are some pointers for locating a doctor or a dentist in France.

How To Find A Family Doctor

When you register for health insurance, you must select a “treating doctor” or médecin traitant. Otherwise, you risk being penalized with higher medical fees and receiving a lower reimbursement rate. The same doctor usually sees children as their parents, but this is not required.

Cabinets are what doctors’ offices are called. These practices are frequently joint ventures between several doctors. You can ask your local pharmacy where the nearest office is or search for a doctor’s office online.

If your French is still rusty, you might want to look for an English-speaking doctor, though this may only be possible in large cities. The websites of the Australian and American embassies in France both have a list of English-speaking doctors. For expats who are more confident in their French, you can find a local doctor by searching for “médicin” in the Pages Jaunes or using Doctolib.

How To Find Specialists For Treatment

Your médecin traitant will keep a record of your medical history and, if necessary, will refer you to specialists or other doctors.

While it is possible to avoid the médecin traitant and find your own specialist, the reimbursement rate will be reduced if you do not follow the pathway system, and healthcare fees will be higher. There are exceptions to this rule. They depend on whether you want to consult an ophthalmologist, pediatrician, or gynecologist or are in an emergency situation. You will not be penalized for finding your own specialist without a referral.

What If I Get Sick Outside Of Working Hours?

If you become ill outside of normal working hours, you will not be able to show up at the cabinet. Doctors’ offices, like shops, pharmacies, and all government services in France, are typically closed in the evenings and on Sundays. If you need help after hours, some doctors are available in all major cities and even some smaller towns.

To use this service, known as Maisons médicales de garde (MMG), contact your local gendarmerie (police station). You will be directed to the on-call doctor. There is information available online for residents of Paris and other major cities. There is usually an extra charge for treatment outside of office hours at an MMG, but this is often reimbursed through France’s social security system, thanks to private health insurance.

SOS Médecins offers an after-hours service that will send a doctor straight to your home in approximately under an hour. The fee for this is approximately 70 EUR (78 USD).

Out-of-hours medical care is frequently unavailable in rural areas. In this case, dial 15 to reach Service d’Aide Médicale Urgente (translates to Urgent Medical Aid Service) for emergency medical treatment.

How To Find A Dentist

It is relatively simple to locate a dentist in France. For recommendations, consult the yellow pages, search online, or contact your local town hall. Because dentists are free to set their own rates, selecting several dentists and comparing prices is best. Check to see if they have a good reputation and the necessary experience.

Average Waiting Time To See A Doctor In France

The waiting time for seeing a doctor in France can vary from 6 to 80 days, depending on the reason for seeing a doctor and the treatment you require. But on average, it is usually around six days from the time you contact the doctor to the time of the consultation itself. Wait times for certain specialists are typically longer.

• Pediatrician or radiologist – three weeks
• Dentist – one month (average 17 days)
• Gynecologist – six weeks (average 32 days)
• Cardiologist – 50 days
• Dermatologist – two months
• Ophthalmologist – 80 days

Giving Birth In France

France has a good reputation for childbirth, and non-residents (as long as they meet the residency requirements) can benefit from giving birth there. So, whether you are a permanent resident or non-resident or giving birth in France, you need not be concerned because France has a universal healthcare system in place. Endless regular check-ups and services are available throughout and beyond the pregnancy.

How To Safely Give Birth In France As A Foreigner

In France, a pregnancy test is known as a test de grossesse in French and is available in almost all pharmacies and supermarkets. Once you’ve confirmed the good news, you should consult with an accoucheur, a gynecologist who is also an obstetrician.

If you are a foreigner expecting a child in France, finding a gynecologist who speaks English may be difficult, but it isn’t impossible. Request some recommendations. You can select one on your own or be referred to one by your doctor. Keep in mind that if you give birth in a public hospital, the actual childbirth is not always handled by the chosen gynecologist but rather by the team on duty.

In France, it is customary to reveal the sex of the baby, so if you wish this to be a surprise, make sure to inform your gynecologist ahead of time.

Prenatal Care

Following your first prenatal exam, you will be given a three-page document called your declaration de grossesse (proof of pregnancy). This is required in order to receive social security and health insurance benefits. You must submit these documents to Caisse d’allocations familiales and Caisse d’Assurance Maladie by the 14th week of your pregnancy. You risk losing some of your benefits if you don’t. Your health insurance provider will send you a pregnancy guide that includes medical exams and maternity leave dates.

After the initial examination, mothers are entitled to eight additional examinations before birth, including ultrasound scans and delivery preparations. Your gynecologist will give you a maternity record book, known as the carnet de santé maternité, in which each medical examination and its details will be recorded.

Aside from the healthcare benefits, another advantage of giving birth in France is the three payments new mothers receive from the CAF or Family Allowance Fund.

Costs Of Having A Baby In France

Many French women prefer to give birth in a hospital. Public health insurance for hospital births, excluding private hospital deliveries, covers all expenses for the first twelve days in the hospital, implying that the birth will almost certainly be free. After childbirth, the average hospital stay is three days. In addition, mothers who are discharged within five days are entitled to home visits by a midwife. Giving birth in France without insurance can cost up to 5,000 EUR in private hospital fees alone if you choose to deliver in a private hospital. As a result, coverage is critical in this case.

On the other hand, mothers who decide to give birth at home should keep in mind that getting full insurance in this situation is difficult due to the risks connected with home birth. Nonetheless, your social security will cover a portion of the costs of giving birth at home, and a midwife will still attend the delivery.

Cause For Celebration: After The Birth

Babies should be registered within three working days of birth. This step is known as the Déclaration de Naissance and can be completed at the Mairie or local town hall. If you intend to give birth in France for the purpose of obtaining citizenship, keep in mind that the child can only get French nationality at birth if a parent has French nationality. Non-French children who are still living in France at the age of 18 are eligible for French citizenship if they have lived in France for at least five years since the age of eleven. A child can also obtain citizenship at the age of sixteen if they request it and have lived in France for at least five years since the age of eleven.

In France, mothers have the right to a postnatal examination and, if necessary, physiotherapy within the first eight weeks after giving birth. The child will then be subjected to examinations until the age of six. There are also local maternal and child health clinics that offer vaccinations, health, and nutritional advice.

Unwanted Pregnancies

Abortion is legal in France until twelve weeks into a pregnancy or fourteen weeks after the last menstrual cycle. Abortions at later stages are permitted if two physicians agree that the child or mother is at high risk of incurable illness or death. The state will cover the termination at public hospitals if the mother is registered with the French social security system.

The morning-after pill, also known as la contraception d’urgence, is also available and can be purchased without a prescription at pharmacies.

Conclusion

This guide will fully help you understand the French Healthcare system and decide the type of health insurance best fit you. Public healthcare insurance is great on its own. A few excellent aspects are Free emergency care, 70% to 80% reimbursement for general practitioner visits, 80% reimbursement for hospital visits, 100% reimbursement for medical expenses in case of major illness, and Basic dental care such as consultations, cavities, tooth extractions, and dental prostheses. If you require specialized care, private insurance provides the same care you would receive at home. To get the best insurance coverage for yourself, you should always research and compare plans before moving.