Registering with the French Healthcare System
France is known for its world-class healthcare system, offering excellent medical care at accessible costs. Whether you’re relocating to work, retire, or enjoy a new chapter of life, joining the French public healthcare system (l’Assurance Maladie) is an essential step in settling in successfully.
That said, French bureaucracy can be daunting — especially if you’re not fluent in the language or familiar with the process. Here’s a clear overview of how the system works, why registration matters, etc.
Written : 18/11/2025
Understanding the French Healthcare System
France’s public health insurance, l’Assurance Maladie, ensures that all residents have access to medical care, with costs largely reimbursed by the state. Once registered, you’ll receive your Carte Vitale — a green health card that stores your insurance details and allows automatic reimbursements at pharmacies, clinics, and hospitals. French Healthcare system is also known as « PUMA – Protection Universelle Maladie« .
Depending on your situation, around 70–100% of medical costs are reimbursed by the state. Many residents also take out a mutuelle (top-up insurance) to cover the remainder.
For official information, visit ameli.fr.
Who Can Register with the French Healthcare System
- All French residents can register with the French Healthcare system.
- If you are working in France, it is mandatory your register with the French Healthcare system as soon as you start working.
- If you are not working in France, then you can register after having been in France for 3 months.
- If you are retired and benefit from an S1 form, then you can register with the French Healthcare system as soon as you arrive in France.
Non-EU nationals will also need to show proof of legal residence to qualify for Protection Universelle Maladie (PUMA), the universal health coverage scheme.
How to register and costs
The process varies slightly depending on your circumstances but typically includes these steps:
- Gather your documents, such as:
- Passport or ID card
- Proof of residence (rental contract, utility bill, etc.)
- Birth certificate
- Proof professional situation
- Residency permit (for non-EU citizens)
- Bank details
- Application form (CERFA N° 15763*02)
- Submit your application to your local CPAM (Caisse Primaire d’Assurance Maladie).
- Receive your confirmation (attestation de droits) and later your Carte Vitale by post.
- Create your online account at Ameli.fr.
Processing times vary — anywhere from a few weeks to several months.
About costs, unless you are liable for PUMA tax, there are at this day no costs associated to register with the French Healthcare system.
PUMA Tax, also known as CSM (Cotisation Subsidiaire Maladie) : you are liable to pay if you meet the following criteria (2024) :
- French professional income is below 9 274 € net
- Capital income (dividends, rent, etc.) exceed 23 1847€
- No « replacement income » : no pension, job seeker’s allowance, etc.
- Registered with French healthcare system
Making the Most of Your French Healthcare Coverage
Once you’re registered, here are a few important next steps to make sure you’re fully covered and reimbursed correctly.
Get a Mutuelle (Top-Up Insurance)
While Assurance Maladie reimburses most standard costs, it rarely covers everything. A mutuelle covers the remaining portion — for example, dental, optical, or hospital fees.
We partner with trusted mutuelle providers offering flexible, English-speaking support and tailored coverage options.
Get in touch if you want more information about top up insurance providers.
Choose Your Médecin Traitant
Your médecin traitant is your regular GP — the doctor who coordinates your care and referrals. Declaring one is essential for higher reimbursement rates.
You can choose any GP who agrees to take you on as a patient. Together, you’ll fill in the form “Déclaration de choix du médecin traitant” — your doctor will usually submit it electronically to Assurance Maladie.
Keep Your Feuille de Soins for Reimbursements
If your Carte Vitale isn’t accepted (for example, at some specialists or before you receive it), you’ll be given a brown paper form called a feuille de soins. Keep it safe! You’ll need to send it to your local CPAM office to claim your reimbursement. Attach any prescriptions or receipts, and always keep a copy for your records, they are known to lose paperwork!
Once you have your Carte Vitale, most payments are processed automatically within a few days to your French bank account.
Create Your Ameli Account
Once your registration is complete, you can manage everything online through your Ameli account at ameli.fr.
This secure online portal allows you to:
- View your reimbursements and healthcare history
- Update personal information (address, bank details, etc.)
- Download your attestation de droits or social security number confirmation
- Communicate with your local CPAM office directly
Creating an account is easy once you have your social security number and attestation de droits. Simply go to ameli.fr and select “Créer mon compte”.
If the paperwork sounds to daunting, France Admin can assist with your Healthcare application and deal with the back and forth communications with the CPAM. We can also recommend Top up insurance providers if you are seeking for one!
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