Health Insurance for Retirees in France: What’s Covered and What’s Not

If you’re planning on retiring in France, you’re not alone. France is a top destination for retirees worldwide, offering a high quality of life, beautiful scenery, and one of the most respected healthcare systems in the world.

But what exactly does health insurance for retired expats in France include? Will your medical care be free? Do you need additional coverage? This article walks you through the essentials of healthcare for retired expats, clarifying what’s covered under the public system and what requires extra protection.

Why Retirees Are Choosing France

Before diving into the details of health insurance, it’s worth noting why so many retirees are drawn to France in the first place.

✅ World-class healthcare system
✅ Affordable cost of living outside major cities
✅ Excellent public transport and infrastructure
✅ Beautiful countryside, culture, and climate
✅ Accessible residency options for retirees

France is particularly attractive to those looking to stretch their retirement income while enjoying a safe, comfortable, and healthcare-secure environment.

Step 1: Getting Health Insurance When You First Arrive

As a retired expat moving to France, you’ll most likely enter on a long-stay visitor visa. One of the key requirements for that visa is having private health insurance that covers you as a resident, not just as a tourist.

This private insurance must:

👉 Cover you for your full stay in France
👉 Offer comprehensive medical care (GPs, specialists, hospitals)
👉 Meet visa and residency compliance
👉 Include at least 30,000 € in medical coverage

This insurance is crucial during your first three months, before you become eligible for the public system.

Step 2: Applying for PUMA (Public Health Cover)

Once you’ve been living in France for three consecutive months, you can apply to join the PUMA system (Protection Universelle Maladie), which provides access to public healthcare for legal residents.

To apply, you must:
✅ Prove legal residency (e.g. rental contracts, utility bills)
✅ Show proof of income (including pension statements)
✅ Submit your application to your local CPAM office

Once approved, you’ll receive a Carte Vitale, the green card that allows for direct billing and reimbursement. Under PUMA, the French state generally reimburses around 70% of the base rate of healthcare costs. The remaining cost is your responsibility unless you have a mutuelle (top-up health insurance).

What the Public System Covers

Public healthcare in France is comprehensive and includes a wide range of services, including:

✅ General Practitioners and Specialists: You can see both GPs and specialists. You’ll often need a referral to get the best reimbursement rate, but the quality of care is excellent.

✅ Hospital Care: Public hospitals are well-regarded and most services are reimbursed at 80%, sometimes 100% for long-term or serious illnesses.

✅ Prescriptions: Medication is generally affordable, and many essential drugs are heavily subsidised.

✅ Emergency Services: Emergency care at public hospitals is covered, although you may be billed a portion of the cost unless fully covered by a mutuelle.

What’s Not Covered Without a Mutuelle

While the French public system is generous, it doesn’t cover everything, which is why a top-up health insurance policy (mutuelle) is highly recommended, especially for retirees who may have regular medical needs.

Here’s what you may have to pay out of pocket without a mutuelle:

❌ The Remaining 30% of GP or Specialist Fees: That’s right, even a routine visit to the doctor leaves you with a balance unless topped up.

❌ Private Room Fees in Hospital: Want a private room for recovery? You’ll need to pay extra or have a mutuelle that includes hospital room cover.

❌ Dental and Optical Care: Routine dental and eye care are only partially covered by the public system. Dentures, crowns, glasses, and lenses can be costly without extra cover.

❌ Alternative Therapies: Things like osteopathy, acupuncture, or podiatry are not always covered unless specified in your mutuelle policy.

❌ Hearing Aids and Prosthetics: Reimbursement is limited, making a mutuelle essential if these services are part of your healthcare needs.

The Role of the Mutuelle for Retired Expats in France

A mutuelle is a private top-up insurance policy that covers all or part of the expenses left behind by the public system. You can tailor your mutuelle to your needs:
Basic plans for just the essentials
Mid-range plans including dental and optical
Premium plans covering private rooms, therapies, and more

Retired expats in France commonly choose mutuelle plans to ensure full coverage without surprise costs. Given the increased frequency of healthcare use in retirement, this added protection is both practical and cost-effective.

👉 Get a Quote: Top-Up Health Insurance for Retired Expats in France

How Much Does Health Insurance Cost for Retirees in France?

PUMA (public cover):

Costs are based on your income. If your annual income is below a certain threshold, public coverage is free. Above that, you may pay a small contribution (usually around 8% of your pension income above 10,000 €).

Mutuelle (top-up cover):

Prices vary widely depending on age and coverage level:
👉Basic: 30 € – 50 €/month
👉Comprehensive: 70 € – 120 €/month
👉Premium (with dental, optical, private rooms): 120 € – 200 €/month+

For couples retiring together, family policies can offer good value.

Common Questions from Retired Expats

Can I just rely on the public system without a mutuelle?

You can, but you’ll be liable for co-payments and non-reimbursed expenses. Over time, these can add up, especially for dental, optical, or hospital stays. Read our article Why Most Expats Overpay for French Healthcare (and the 3 Steps to Fix It) to find out more.

Is my UK NHS or foreign health insurance enough?

No. The NHS does not cover long-term residency abroad. Foreign travel insurance also won’t satisfy French legal requirements if you are applying for a French long-stay visa. You need resident-level private cover, then transition to PUMA + mutuelle.

Do mutuelles cover pre-existing conditions?

Yes. Mutuelle policies in France generally do not exclude pre-existing conditions. However, private international insurance for the visa stage may have exclusions, so check carefully.

Final Thoughts: Secure Your Health in Retirement

Healthcare for retired expats in France is accessible, high quality, and reasonably priced, but only if you understand how the system works. While retiring in France is a dream for many, navigating the public and private systems requires careful planning.

Start with the right private insurance for your visa. Then move to PUMA after three months and choose a mutuelle that meets your long-term health needs.

FAB French Insurance is here to make this process simple, clear, and stress-free. 👉 Get expert help and a personalised quote today: Top-Up Health Insurance for Retired Expats in France