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Moving to France as an expat comes with many exciting opportunities, but navigating the French healthcare system can be overwhelming. While France offers one of the best public healthcare systems in the world, newcomers often make mistakes that lead to unnecessary stress, delays, and unexpected expenses.
Understanding expat healthcare mistakes in France is crucial to ensuring smooth access to medical care. Below, we outline the top five healthcare pitfalls expats face and provide practical solutions to avoid them.
1. Overlooking Registration Deadlines
The Mistake:
Many expats assume that healthcare access in France is automatic upon arrival. However, you must actively register with the Assurance Maladie (French public health insurance) to receive coverage. Some expats delay their application, only to find themselves without coverage for months when they need medical care.
Why This is a Problem:
🔹 Waiting periods: It can take several months to receive a social security number and a few extra months to get the Carte Vitale (health insurance card).
🔹 Out-of-pocket expenses: Without registration, you’ll pay full price for medical care and prescriptions (not considering private medical insurance). Get an estimate for health insurance here.
🔹 Limited reimbursement options: If you don’t register on time, retroactive reimbursement may not be possible.
How to Avoid It:
🔹 In most cases it means you should apply for PUMA (Protection Universelle Maladie) as soon as you’ve lived in France for three months.
🔹 If employed, ensure your employer registers you with the social security system immediately.
🔹 If a French business owner or self-employed in France (micro entreprise) make sure to apply for French healthcare as you’re creating/incorporating the business.
🔹 Submit all required documents correctly, including proof of residence, ID, birth certificate, and employment status.
2. Misunderstanding Reimbursement Rates
The Mistake:
Expats often assume that French healthcare is completely free. While Assurance Maladie covers a large portion of medical costs, patients still pay a percentage of consultations, hospital stays, and prescriptions. The French healthcare system operates on a reimbursement system, where patients initially pay for their treatment and later receive partial or full refunds from Sécurité Sociale based on standardised rates similar to an index called the BRSS (base de remboursement de la Sécurité sociale). The Sécurité Sociale applies a fixed reimbursement percentage to the official index for each medical act.
Why This is a Problem:
🔹The Assurance Maladie reimbursement rate varies, and many new expats miscalculate their out-of-pocket costs.
🔹Reimbursements are based on standardised government rates, not the actual amount billed by the doctor.
🔹If you see a private doctor, expect lower reimbursements than with a state-approved practitioner.
How to Avoid It:
🔹Understand reimbursement rates: 70% for standard doctor visits, 80% for hospital stays (100% after 30 days), 15% to 100% for medications, depending on necessity. More on this here.
🔹Always check if your doctor follows state-regulated fees (Secteur 1) to avoid surprise charges.
🔹Consider getting a Mutuelle (top-up insurance) to cover the remaining costs (more on this below).
3. Language Barriers at Appointments
The Mistake:
Many expats struggle with medical appointments because they don’t speak French fluently. Medical terminology can be difficult to understand, leading to miscommunication, incorrect diagnoses, or misunderstandings about treatments and prescriptions.
Why This is a Problem:
🔹Doctors may not speak English, particularly outside major cities.
🔹 Miscommunication can lead to incorrect treatments or missed instructions.
🔹If you don’t understand French medical paperwork, you may struggle with reimbursements.
How to Avoid It:
🔹Prepare in advance: Learn basic medical terms in French or use translation apps.
🔹Bring a bilingual friend or interpreter to your first few appointments.
🔹Ask if your doctor offers tele consultations—some English-speaking doctors provide remote consultations for expats.
🔹 Use online resources like Doctolib to find English-speaking doctors in your area.
4. Not Having a Mutuelle & Paying High Out-of-Pocket Costs
The Mistake:
Expats often skip getting a mutuelle (private top-up insurance), thinking they won’t need it. However, Assurance Maladie does not cover 100% of medical expenses, and without a mutuelle, you’ll be left paying significant out-of-pocket costs for treatments, hospital stays, and medications.
Why This is a Problem:
🔹Specialist visits can have low reimbursement rates, leaving you with high medical bills.
🔹 Hospital stays require a daily fee (€20 per day), which a mutuelle can cover.
🔹 Dental and vision care are only partially reimbursed by Assurance Maladie, meaning without a mutuelle, you could pay hundreds or even thousands of euros for treatment.
How to Avoid It:
🔹Compare different mutuelle plans based on your needs (e.g., dental, vision, hospitalisation).
🔹Consider employer-sponsored mutuelles, as companies in France must offer health insurance to employees.
🔹If self-employed or unemployed, look for a private mutuelle provider that fits your budget and medical needs.
🔹 Read our article on the benefits of having a mutuelle in France here.
Get a estimate for a top-up insurance here.
5. Missing Important Documents for Healthcare Registration
The Mistake:
French bureaucracy is notorious for requiring extensive paperwork. Expats often submit incomplete healthcare applications, causing delays in processing their registration for Assurance Maladie.
Why This is a Problem:
🔹Delays in getting a Carte Vitale mean you must pay full price for medical care upfront.
🔹 Missing documents lead to rejected applications, forcing you to start over.
🔹 Incorrect paperwork can cause delays in getting reimbursements for medical expenses.
How to Avoid It:
Before applying for public health insurance in France, ensure you have:
🔹Valid passport or residence permit.
🔹Proof of address (utility bill, rental contract).
🔹Proof of three months of residence (bank statements, rent receipts).
🔹Birth certificate (officially translated into French).
🔹Employment contract or proof of financial resources.
🔹RIB (French bank account details) for reimbursements.
Make sure your documents are correctly formatted and translated if required to avoid unnecessary delays.
To wrap it all up
Navigating healthcare in France for expats requires preparation and knowledge. By registering on time, understanding reimbursement rates, overcoming language barriers, getting a mutuelle, and ensuring correct paperwork, you can avoid common healthcare pitfalls and access one of the best medical systems in the world with ease.
If you’re new to France, take proactive steps to set up your healthcare coverage properly so you can focus on enjoying your new life—without unexpected medical headaches.
