The health system in France: first steps

Given the state of emergency of the pandemic years, more and more people have asked me how the situation was handled in Paris. Beyond this unprecedented global crisis, to know at least part of the answer you need to know how the health system works in France. Secondly, understanding its functioning is essential if we are to moving to France and make the most of its services.

Do not make the mistake of neglecting local health care, finding yourself without insurance and postponing all medical visits to your return to Italy. Health is very important and at any time you may need a doctor.

But then how to have a doctor based in France? How to deal with hospitalization? Are the medicines reimbursed or not? To know, dozens of articles and explanations would not suffice. The health care system in France is very complex and can be a major obstacle for the expat In the bud.

To begin with, I suggest you remember at least three keywords: Life Cards, mutuals and médecin tractor.

1. Vital Cards

The Life Cards, As the name itself says, it is vitally important if you decide to live in France. It represents the equivalent of our national health card, as well as physical support to benefit from reimbursements for almost all medical expenses, from medicines to specialist visits.

The first step in obtaining the Life Cards is to register for a social security scheme, the Caisse d’assurance maladie (CPAM). In some cases, your employer arranges registration and you will only be required to provide him with the documents. If you want to do it yourself, you must go to the CPAM closer to your home, with the following documentation:

• an identity document, such as passport;
• the multilingual birth certificate extract (an indispensable document in France!);
• a proof of residence in France (rent contract, gas bill, electricity bill or Internet subscription);
• the last 3 payrolls or a document relating to the last tax return;
• your French IBAN (RIB);
• a copy of the French employment contract.

Once the documents have been received, CPAM will process your file and provide you with the provisional number of Social sécurité, which you should receive between 3 and 5 months.

You will receive the final number of Social sécurité and finally the long awaited Life Cards. I advise you to memorize your number of Social sécurité because it will in effect be a "tax code", a passe-partout may be requested by the administration on several occasions.

The complete list of Caisses d’assurance maladie of the Ile-de-France region (Paris region) can be consulted Here. To find the one closest to your accommodation, do not forget the name of your region but especially of the department of belonging!

What happens after you get the Life Cards?

The possession of the Vital Cards and a number of Social sécurité Attests your registration to CPAM. From now on it is enough to present the Vital Cards each time you go to your doctor or pharmacy, with a recent medical prescription.

In some cases, you will pay nothing if the medical center or pharmacy apply the policy of tiers payant: the beneficiary will not have to advance any amount of money before being reimbursed by CPAM. In other cases, you will have to pay the part of the benefit received and wait for the refund, which you are directly responsible for insurance maladie and that happens within a few weeks.

In possession of only Vital Cards, the maximum reimbursement of basic medical expenses is 75%. But there are some exceptions. For example, dietary supplements such as magnesium and vitamin C are not refunded by CPAM, as well as paracetamol and other counter medicines without prescription requirement. If the doctor prescribes painkillers, you will be entitled to reimbursement. The same cannot be said of products such as coughing and sore throat pills, generally non-refundable.

2. Loans

If basic health insurance allows partial reimbursement of medical expenses, insurance complémentaire or mutuals allows most of the times a total refund, obviously based on the benefits and the type of insurance chosen.

Complementary to Social security the mutuals it is private and can be signed by itself or through the company for which you work. It tends to be compulsory for employees of private companies, who scale the monthly share directly from salary. The cost can vary from 20 to 100 euros per month, depending on the services offered.

If you have vision problems or often need dentists or other specialists, a mutuals More expensive could certainly be the case for you. In other words, thanks toinsurance maladie and mutuals I had the chance to buy new glasses and contact lenses at zero cost!

3. Médecin traitant

Once registered in CPAM and in possession of Life cards, you will eventually need a médecin tractor, the equivalent of Family doctor.

The médecin tractor is a point of reference that focuses on centralizing all the most important information about a patient. You must contact him in case of imminent surgery, hospitalization or change of health. The doctor himself will also direct you to a particular specialist examination when necessary. Once the médecin tractor If you need it, please fill out a form at the doctor’ s office and send it to the doctor’ s office.Insurance Maladie Reference.

All procedures, documentation and useful addresses are available on the website (in French) of theInsurance Maladie ameli.fr.

Account From Assured, thanks to which you can consult important data, download useful documents and verify any refunds, can be created online through This link.

Although the process may seem long and tortuous, understanding the health care system in France is absolutely necessary to live your experience abroad.

Remember, health is no joke!