L'Assurance Maladie (Sécu)

The French healthcare system is consistently ranked among the best in the world by the World Health Organization (WHO). It operates on a principle of national solidarity: everyone contributes according to their means and receives care according to their needs.

Unlike the systems in the UK or Canada, healthcare in France is not always "free" at the point of delivery. Instead, it works on a **Reimbursement System**. You typically pay the doctor upfront, and the "Sécurité Sociale" (Social Security) refunds a significant portion of the cost directly to your bank account within a few days.

PUMA: Protection Universelle Maladie

Since 2016, a system called **PUMA** guarantees that anyone who works or resides in France in a stable and regular manner has a right to have their healthcare expenses covered.

• Residence Requirement: You must live in France for at least 3 months to apply (if you are non-EU and unemployed).
• Employment Requirement: If you work in France, you are covered from your first hour of work.
• EU Citizens: Can use their EHIC card for temporary stays or S1 form for pensioners.

The "Carte Vitale" (Green Card)

This small green plastic card with a chip is your key to the French health system. It does not contain clinical medical records but holds all the administrative information needed to reimburse you.

*Note: If you don't have your card yet, the doctor will give you a paper form (Feuille de Soins) which you must mail to your local CPAM office.*

The 70% / 30% Rule (Reimbursement Explained)

Understanding the math is crucial for your budget. The Assurance Maladie sets a "Convention Rate" (Base Cost) for every medical act.

Example: Visiting a GP (General Practitioner)

The standard fee for a General Practitioner (Sector 1) is approx €26.50.

• Social Security Pays (70%): €18.55
• Less Mandatory Contribution: -€1.00 (Participation Forfaitaire)
• Total Refund to You: €17.55
• Remaining Cost (Ticket Modérateur): €8.95

This remaining €8.95 is either paid by you or covered by your private top-up insurance (Mutuelle).

La Mutuelle (Top-Up Insurance)

Because the state only covers about 70% of routine costs (and much less for glasses or dental crowns), almost everyone in France has a "Mutuelle".

• For Employees: It is mandatory for employers to offer a Mutuelle and pay at least 50% of the cost.
• For Students/Unemployed: You can buy an individual plan or apply for "Complémentaire Santé Solidaire" (CSS) if you have a low income.

Le Médecin Traitant (Declared GP)

Critical Rule: You must declare a primary care doctor ("Médecin Traitant") to the Social Security.

This doctor acts as the gatekeeper to the healthcare system (Parcours de Soins Coordonnés). If you go to a specialist directly without a referral from your declared GP, or if you haven't declared a GP, the Social Security will only reimburse 30% of the cost instead of 70%.

Exceptions: You can see Gynecologists, Ophthalmologists, Psychiatrists (under 26), and Dentists directly without a referral.

How to Find a Doctor or Hospital?

In France, you can choose any doctor you want (public or private). To find a doctor, verify their rates (Sector 1 vs Sector 2), and check if they accept the Carte Vitale, use the official government directory.