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Navigating the French Healthcare System

If you’re a non-EU citizen planning to move to France, understanding the healthcare system is a crucial step. Here’s a fun and informative guide to help you navigate the French healthcare system, especially if you’re a retiree or non-worker.

Understanding PUMA: Your Gateway to French Healthcare

The French healthcare system, known for its excellence, is accessible to all legal residents through the Protection Universelle Maladie (PUMA) program, implemented in 2016. PUMA ensures that everyone residing in France, regardless of employment status, has access to healthcare services. This is fantastic news for retirees and non-workers!

Enrolling in French Sécurité Sociale

Once you’ve been a legal resident in France for three months, you must enroll in the French Sécurité Sociale. This process, managed by the local health insurance entity CPAM, is essential for accessing healthcare services. Here’s how it works:

  1. Legal Residence: After three months of legal residence, you can apply.
  2. Exceptions: Expatriate workers sent by U.S. employers, employees of international organizations, and retirees with pensions from other EU countries (or the UK) might be exempt. British pensioners can apply through the S1 program, which provides healthcare coverage under specific post-Brexit agreements.

Costs and Contributions

While the French social security system offers extensive coverage, it is not entirely free. Contributions to PUMA depend on your income, and some residents may be subject to the Cotisation Subsidiaire Maladie (CSM), an annual healthcare cost contribution. Here’s a quick breakdown:

  • Exemptions from CSM:
    • Individuals with modest incomes (less than 50% of the PASS, which is €46,368 in 2024 or €3,864 net per month)
    • Married or PACSed partners with a low combined income (under 1 x PASS)
    • Minors
    • Recipients of French or EU retirement, invalidity, or unemployment pensions, including British retirees
  • CSM Calculation: If your income exceeds 0.5 times the PASS (€23,184 in 2024), you might need to pay the CSM. For example:
    • A single person earning €50,000: (€50,000 – €23,184) * 6.5% = €1,743
    • A couple earning the same: (€50,000 – €46,368) * 6.5% = €236.08

Applying for “La Sécu”

To register for the French social security system, you’ll need to file a form called an “ouverture de droits” with CPAM. This process typically takes about 6-7 months, depending on your location. Once approved, you’ll receive an “attestation de droits,” allowing you to apply for a Carte Vitale and supplementary health insurance (Mutuelle).

What is a Mutuelle?

A Mutuelle is supplementary health insurance that covers healthcare costs not paid by Social Security. Even French natives often opt for a Mutuelle to minimize out-of-pocket expenses. For non-EU citizens residing permanently in France, having a Mutuelle is crucial to ensure full coverage. While there’s a small 2€ deductible on every claim, a Mutuelle ensures that you can enjoy excellent medical care without worrying about excessive bills.


Navigating the French healthcare system might seem daunting, but enrolling in PUMA and securing a Mutuelle ensures you receive comprehensive coverage and peace of mind. By following these steps, you can fully enjoy the high standard of medical care available in France, leaving you free to savor all the other wonderful aspects of French life.

At “Moving to France,” we’re here to help you every step of the way. From understanding how to get your Carte Vitale to choosing the right Mutuelle, we provide the information and support you need for a healthy and happy life in France. So, pack your bags, get ready to explore, and bienvenue en France!

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