How does healthcare work in France, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in France?

What is the quality of healthcare in France?

• Healthcare in France is among the best in the world. The country also has one of the most accessible healthcare systems in the world, including for expats.
• The language barrier can be a problem. In Paris, you will certainly find hospitals where doctors speak English, but outside the big city this can be different.
• The country has a two-tier healthcare system with both public and private providers. All healthcare, both public and private, is accessible to everyone.
• Most general practitioners are available during the day and on weekdays. If you have problems outside office hours, there are other doctors who can help you via the Maisons médicales de garde (MMG). To do this, call the nearest police station (gerdarmerie), who will refer you to a doctor. This often costs extra, but it can be reimbursed by your insurance.
• There are many pharmacies in France, the buildings with a large red or green cross. In the big cities you can even find 24-hour pharmacies. You can also get simple medication such as paracetamol from supermarkets.
• The emergency medical services are fast and reliable and are run by the Service d'Aide Médicale d'Urgence (SAMU). Call 112 in case of general emergency, or 15 for the SAMU.

How does the public healthcare system work in France?

• Public health care in France is of very good quality. The system works, there are usually no long waiting times, making appointments is easy and care is affordable.
• In France, the majority of hospitals are public and non-profit.
• The public health care system, Protection Maladie Universelle (PUMA), offers universal health care to more than 95% of the inhabitants, including foreigners. Hospital care, rehabilitation and physiotherapy, specialist care, maternity care, preventive care for children, diagnostic services and medicines are all covered under this system. It even provides coverage for alternative therapies such as acupuncture, homeopathy and chiropractic.
• There is a public health insurance scheme available in France, the Caisse Primaire Assurance Maladie (CPAM). Expats in France, people who are retired in their home country and self-employed people who contribute can all use the scheme if they are staying in France for more than three months. The first three months must be covered by private health insurance. To register, you must go to your local social security office. Sometimes your employer will do this.
• In general, the health system covers 70, 80 or even 100% of the costs.
• Once you are registered with the public health system, you can apply for a health insurance card (carte vitale). This contains all the administrative information that healthcare institutions need. This card needs to be updated once a year, or when your details change (such as a new job, different doctor, new address, etc.).
• EU citizens can use their European Health Insurance Card (EHIC) for short visits to access the public healthcare system, UK residents can use their Global Health Insurance Card (GHIC).
• The majority of the costs are covered by the public health insurance. In some cases, an additional contribution is requested when visiting a GP or when staying in hospital.

How does the private healthcare system work in France?

• Although public insurance covers a lot, there are also things that are not covered, such as extensive dental care. For this reason, the majority of the population also has voluntary, private health insurance, often offered by the employer. This insurance can be taken out with a non-profit company, which is then called l’assurance complémentaire santé or mutuelle.
• Emigrants must have private health insurance for the first three months in France before they can register with the public system. People who are not entitled to public health insurance at all must take out private health insurance for the time they are in France.

How is the general practitioner arranged in France?

• When you register for public health insurance, you also immediately choose your family doctor, or médecin traitant. If you do not do this, you will pay higher costs later. Children usually have the same family doctor as their parents.
• In France, you choose your own family doctor and hospital. It is also easy to change doctors and hospitals. General practices, called cabinets in French, are often run by multiple doctors.
• It can be difficult to find an English-speaking doctor. Check if your embassy has a list of English-speaking doctors, or look at the Australian or American embassies, for example.
• You can also go to a specialist in France without a referral from your GP, but then the full costs will not be reimbursed.

How is the dentist arranged in France?

• Dental care, like the rest of the healthcare, is of very good quality. In recent years, the number of dentists has increased. You are free to choose your own dentist.
• The healthcare system divides dentists into contracted or non-contracted (conventionnes or non-conventionne). The first group is also divided into sector 1 and 2. Sector 1 dentists adhere to the rates set by the government, sector 2 choose their own rates, but adhere to government regulations. Sector 3 dentists are completely free and the most expensive. They are also hardly reimbursed by social insurance.
• Most dentists work in the public sector. Children in the public sector receive mandatory and free dental care at the ages of 6, 9, 12, 15 and 18.
• Basic dental care is mostly covered by public insurance, but more complex care is not. Many dentists also charge more than what the government recommends, which makes the costs high. For this reason, many French and foreigners take out private insurance.

How is pregnancy care arranged in France?

• Once you are pregnant and have had your first examination by the gynaecologist, you will receive a document called declaration de grossesse (proof of pregnancy). You need this document to declare the healthcare costs during and after your pregnancy. You must send the document to the Caisse d’Assurance Maladie and the Caisse d’allocations familiales before your 14th week of pregnancy.
• After the first check-up, you are entitled to 8 further check-ups during the pregnancy. For this, you will receive a pregnancy booklet in which all the details will be entered.
• Most women give birth in the hospital, the public health insurance covers all costs for the first 12 days in hospital. Deliveries in a private hospital cost up to 5000 euros without insurance.
• For home births, it is difficult to obtain full insurance coverage because of the risks. However, the social insurance covers part of the costs.
• Abortion is legal up to and including 12 weeks of pregnancy, or later if the birth poses a risk to the mother or the child. The emergency contraceptive pill, contraception d’urgence, can be purchased at the pharmacy.

How safe or unsafe is a trip or stay in France?

What should you pay attention to in terms of safety in France?

• France is generally safe, but in major cities such as Paris, Marseille and Lyon, opportunistic crime such as pickpocketing and petty theft is more common. Tourist areas such as the Eiffel Tower, Montmartre and train stations can be hotspots, including for scams.
• In urban areas and suburbs, there is a slight risk of burglary. Good locks and security systems are recommended.
• France is known for its frequent strikes and protests, which sometimes involve disruptions to public transport.
• Do not leave valuables visible in your car or bag.
• Keep copies of important documents such as passports and IDs.
• Download apps such as "SAIP" or other local alert tools to stay informed of emergencies.

What should you look out for in terms of diseases in France?

• Tap water is of good quality and food hygiene is generally excellent.
• Heat waves can occur during the summer months, especially in the South of France. Stay hydrated and avoid the sun during the hottest hours.
• Tick bites are particularly common in wooded areas in the Alps, Pyrenees and other rural areas. Check your skin after walks.
• In larger cities such as Paris, air pollution can be a problem, especially for people with respiratory conditions.

What should you pay attention to when it comes to traffic in France?

• France has an excellent road network, including motorways (autoroutes). Many motorways are toll roads, which incur additional costs.
• France also has relatively good road safety records, but be extra careful in mountainous areas or on narrow, rural roads.
• The rules are strictly enforced. Speed ​​cameras are everywhere, and fines for speeding can be high.
• The blood alcohol limit is 0.5 per mille. For novice drivers, the limit is 0.2 per mille. Alcohol checks are frequent.
• Parking in cities is difficult and often expensive. If possible, park in underground garages to avoid fines or damage.
• Always carry a warning triangle and reflective vest (and breathalyser kit) in your car. This is a legal requirement.
• Drive carefully in mountainous areas during the winter months, where snow chains may be necessary.
• Cities such as Strasbourg and Bordeaux are bike-friendly. Make sure you have lights and be aware of cars in busy cities. The French TGV network is fast and reliable for long distances. However, local trains can be delayed, especially during strikes.
• In large cities such as Paris, public transport is efficient, but in rural areas it is less frequent and a car is better.
• In cities, taxis and Uber are available, but taxis can be more expensive than expected.

What work and travel insurance policies are suitable for short and long stays in France?

• Is the trip to France and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for France if you are going to live there for a while?

• Health insurance is mandatory in France. If you stay longer than three months, you must register with the national health system. If you stay for a shorter period, you must arrange your own health insurance if you need a visa (for example, if you come from outside the EU). Nevertheless, many locals and foreigners purchase private health insurance anyway in order to benefit from 100% coverage of healthcare costs and to be covered in other countries and for medical repatriation.
• Read more about insurances for abroad on Expatinsurances.org.