Health Insurance For Expats In France | What is PUMa & CPAM Program?

Health insurance for expats in France – here is a detailed guide.

Well, moving to France is an exciting prospect. This is a land known for its natural beauty and amazing culture. From the monuments and cuisines to the dramatic topography, France needs no introduction.

It also boasts one of the most developed economies in the world and living standards here are enviable.

From your end, you need to cover your bases to get the best out of your French experience. Health insurance is something you need to plan properly. Let us learn more about health insurance for expats in France and related details.

Healthcare In France

France is known for its strong health provisions to residents – including expats and students who are not permanent citizens. French welfare and health facilities and provisions make it one of the most socially developed countries in the world.

All those who reside legally in France are required by the law of the land to have health insurance or as they say in French – l’assurance maladie.

What Is The PUMa Program?

France has a universal healthcare program called the Protection Maladie Universelle or PUMa. It was introduced at the beginning of 2016. Compared to the older system, PUMa brings more people into the insurance ambit, including foreign residents.

Because you are legally required to have health insurance in France, if you happen to be in the country but you are not eligible for PUMa, there are other options that you need to consider (private health insurance).

PUMA Parameters For Expats

Let us delve into the parameters for expats to come under France’s PUMA program. PUMA makes it easier for legal residents, both EU and non-EU to get access to health facilities. They can apply for their carte Vitale and get insurance access after staying three months in France.

Expatriates who have been living in France for fewer than 5 years and have no paid employment can apply for the PUMA program. They should be under the retirement age (65 years) and they should not be receiving a pension from any other European country.

Non-EU students above 28 years of age and who are not receiving a salary are also eligible for PUMA and so are British early retirees who are not receiving a salary.

Are You Eligible For Expat Health Insurance In France?

The most basic eligibility requirement is that you have completed three months of residency. If you are an employed worker and paying social contributions or cotisations sociales then you are eligible for health insurance.

Business owners and freelancers too can get insurance through the Régime Social des Indépendants (RSI).

EU, EEA (Euro Economic Zone) and Swiss residents along with their unemployed family members (staying temporarily) can avail health facilities in France using the European Union Health Insurance Card or EHIC.

If you are a UK or EEA retiree and you are getting a pension from your home country, but your primary residence is in France, a valid S1 form will give you access to French health insurance.

Children under the age of sixteen are all eligible for French health insurance.

If you are a student, you are not typically regarded as a French resident so you will need to get your coverage via the mandatory Student’s Social Security or Sécurité Sociale Etudiante.

What Does French Health Insurance Cover?

If you are looking for Insurance for expats in France, you need to be familiar with some trends in the country’s health coverage. In France, you need to register yourself with a doctor.

Registration with a doctor or médecin traitant will protect you from higher fees and you will also get better reimbursement rates than a non-registered patient would.

Medical costs in France involve your contributions too. The reimbursement rates are usually around 70% for a doctor’s visit (including dentists and other specialists) and 80% for hospital expenditures.

French insurance usually covers 100% of your prescribed medications. The remaining costs will need to be filled up by you.

The fact that you have to pay a certain chunk of the medical expenses means that for longer treatments where expenses accumulate, you might end up having to spend a lot. Many healthcare service providers and physicians charge surplus amounts and this comes out of your pocket.

Therefore you have to choose your insurance provider carefully and read the details properly. Negotiating insurance plans and laws in a new place can be quite confusing so it is completely okay to ask questions until you are sure about everything.

Private Health Insurance Provider

If you don’t fall under the PUMa parameters, then you need to apply for private health insurance. In fact, even those who get state coverage prefer signing up for private insurance because it guarantees higher reimbursement rates and reduces their personal expenditures.

Private health insurance companies are referred to as mutuelles – there are many types of mutuelles. The four biggest private insurance providers in France are:

Aetna International
Cigna International
Bupa Global
Allianz Care

Most private health insurance providers will cover the remaining costs of your treatment if you have availed from the state health insurance already. Most of the basic health packages are focused on treatment and hospital-related services and care.

Compared to many other countries, private insurance in France is utilized more as filler for the reimbursement gap left from the state-sponsored plan, rather than an expressway for faster treatment or access to private practitioners.

Also, many expats tend to just glance over a 100% reimbursement clause in their insurance plan – this reimbursement refers only to the tariffs that have been approved by the state. It does not cover extra expenses that doctors may charge.

Private insurance still gives better coverage in certain areas. French public insurance does not cover chiropractor treatments, psychologist’s counseling, and several other treatments.

Carte Vitale And More – Getting Started With Health Insurance For Expats In France

If you are an expat working or studying in France, or you are there for any other reason, you need to register with one of the state health insurance providers – or the Caisse Primaire d’Assurance Maladie or CPAM.

You will be given a Carte Vitale, which you will have to present a doctor or health professional whenever you avail a medical service.

Registration Process For Health Insurance For Expats In France

If you are working under an employer, your employer would typically facilitate the registration process. Freelancers and independent business owners will have to register via the provisions of the Régime Social des Indépendants (RSI).

You can send your application for PUMA if you feel you are eligible. The organization that decides your PUMA eligibility is the URSSAF, the authority on social security matters in France. France has the CMU-C provision for economically weaker and vulnerable sections which provides free healthcare.

If you are in France and you are able to afford private insurance, it is recommended that you use this option to increase your reimbursement rate as much as possible.

From retirees to employed individuals and students, the health system in France provides enough platforms and facilities to ensure everyone gets access to top medical facilities.

Health Insurance For Expats In France – The Things You Should Know