Detailed guide: Healthcare for UK nationals living in France

You must have health insurance cover to live in France.

State healthcare in France is not free. Healthcare costs are covered by both the state and through patient contributions. These are known as co-payments.

You may have to pay upfront for some treatments. The French national insurance fund, Caisse Primaire d’Assurance Maladie (CPAM), will then repay you for part of the costs later.

UK nationals usually access the French healthcare system in one of these ways:

• making French social security contributions through their employer or as a self-employed person
• registering a UK-issued S1 form with the local CPAM office
• using a European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) for temporary stays

Healthcare if you live and work in France

You can apply to be covered by the French healthcare system (Protection Universelle Maladie or ‘PUMa’) if you’ve been a resident in France for at least 3 months. If you’re employed in France, you can apply as soon as you start work. You’ll have access to state healthcare on the same basis as a French citizen.

Find out more about becoming resident in France

You’ll pay for PUMa through social security contributions if you are employed or self-employed in France.

If you are not employed you may have to pay into PUMa yourself. There’s more information on the CPAM website (in French).

You may be entitled to a French EHIC for travel, including visits to the UK.

You may also have the right to apply for a UK S1 if you start drawing a UK State Pension.

How to register

You can apply for PUMa through your local CPAM office. There’s information about how to register online.

Once registered, you’ll get a temporary social security number by post after 1 to 3 months.

You’ll then receive a document called an ‘attestation de droits à l’assurance maladie’. This confirms your right to French state healthcare and your French social security number.

Once you’ve got that document, you can apply for your French state healthcare card, the ‘carte vitale’. Take it with you whenever you visit a doctor, pharmacy or specialist provider.

It can take 6 months or longer to get a carte vitale. If you have questions about your application, contact your local CPAM office.

If you need healthcare before you receive your card, use your social security number. Ask your healthcare provider for a ‘feuille de soins’ and send it to your CPAM office to be refunded for any treatment you’ve paid for.

How much you’ll pay

State healthcare in France is not free. You may have to pay some of the cost of any treatment.

Make sure you understand what you’ll be charged and how much of that you’ll get back through state healthcare cover. There’s information (in French) about reimbursements online.

You can also get top-up insurance called a ‘mutuelle’. This will cover all or part of your medical costs not covered by the state.

If your UK employer has sent you to France temporarily (‘posted workers’)

A posted worker, also known as a ‘detached worker’, is someone who is employed or self-employed in the UK, but temporarily sent to a European Economic Area (EEA) country.

UK posted workers can access healthcare in France using an EHIC, GHIC or S1 form.

HMRC has a helpline for National Insurance enquiries from non-UK residents. This can answer questions about posted worker status and explain which documents you will need to get healthcare while posted.

You should register your S1 with your local CPAM.

You may also need a UK-issued A1 certificate to show that you pay national insurance in the UK. You can get this from HMRC.

If you’re using an EHIC or GHIC, you’ll need to show the card when you go to your appointment.

UK-funded healthcare: using an S1 form in France

There’s different guidance if you have an S1 as a posted worker.

You may be entitled to state healthcare paid for by the UK if you’re a French resident and receive a UK State Pension.

You may also be entitled to an S1 form if you’re a frontier worker (someone who works in one state and lives in another). You must contact HMRC National Insurance enquiries to find out if you’re eligible.

If you started living France before 1 January 2021, you may also be entitled to an S1 if you receive some other ‘exportable benefits’.

Once you have an S1 form, you must register it at your local CPAM office.

This will mean you and your dependants will be entitled to healthcare in France on the same basis as a French citizen.

You’ll still have to pay part of your medical costs, just like other French residents.

You can also get top-up insurance called a ‘mutuelle’. This will cover all or part of your medical costs that are not covered by state repayments.

You’ll also get:

Dependants and family members may be classified differently in France than the UK.

Check with the local authorities when you register your S1 form.

How to get an S1 form

If you have a UK State Pension, you must request an application form by phone from NHS Overseas Healthcare Services.

How to use an S1 form in France

You must register your S1 with your local CPAM office. There’s information about how to register online.

Once registered, you’ll get a temporary social security number by post after 1 to 3 months.

You’ll then receive a document called an ‘attestation de droits à l’assurance maladie’. This confirms your right to French state healthcare and your French social security number.

Once you’ve got that document, you can apply for your French state healthcare card, the ‘carte vitale’. Take it with you whenever you visit a doctor, pharmacy or specialist provider.

It can take 6 months or longer to get a carte vitale. If you have questions about your application, contact your local CPAM office.

If you need healthcare before you receive your card, use your social security number. Ask your healthcare provider for a ‘feuille de soins’ and send it to your CPAM office to be refunded for any treatment you’ve paid for.

Studying in France

You can use an EHIC or a GHIC to get medically necessary healthcare until the end of your study period in France.

Getting treatment in the UK

Some former UK residents do not have to pay for NHS treatment when visiting England. This includes UK nationals who started living in the EU before 1 January 2021.

Read more about healthcare when you no longer live in the UK.

If you return to live in the UK you’ll be able to use the NHS like any other UK resident.

Read more about using the NHS when you return to live in the UK.

Source