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France is well known for having one of the most comprehensive and efficient healthcare systems in the world. But if you’re moving to France or are newly arrived, you might be wondering: what exactly does basic public healthcare cover and what’s left out?
Understanding this distinction is especially important for expats who are navigating a new system in a foreign language. In this guide, we break down what’s included under public healthcare in France (also called Assurance Maladie) and when extra insurance is recommended.
An Overview of the French Healthcare System
France operates a universal public healthcare system, primarily funded through payroll and social contributions. Once you’re registered, you’ll receive a Carte Vitale, which allows you to access care and receive automatic reimbursements for medical expenses.
Most French residents are covered under the PUMA system (Protection Universelle Maladie), which entitles them to care in both public and private settings, though only part of the cost is reimbursed by the state.
More on how the French Healthcare System works here.
What’s Covered by Basic Public Healthcare in France?
✅ General Practitioner (GP) Visits
Visits to your médecin traitant (primary care doctor/GP) are covered under the public system. The state reimburses 70% of the official consultation fee, as long as you follow the care pathway and are registered with a GP. Without registration, the reimbursement may be reduced. It's also important to know that doctors can charge more than the state-regulated fee, especially those working in the private sector.
✅ Specialist Consultations
Specialists such as dermatologists, cardiologists, gynaecologists, or orthopaedists are also covered. You’ll typically need a referral from your GP to be reimbursed at the standard rate.
The state usually reimburses 70% of the base rate consultation fee and100% for certain long-term conditions (ALDs)
✅ Hospital Care
Hospitalisation, both planned and emergency, is partially covered under the public system. In public hospitals and many private clinics working with the public system (conventionné), coverage includes surgical procedures, in-patient treatment and diagnostic tests (MRI, CT scans, blood-work).
The state generally reimburses 80% of hospital costs, but you’ll be responsible for a daily hospital fee (forfait journalier), around 20 € and private room upgrades are not covered.
✅ Prescriptions and Pharmacy Costs
Prescription medications are categorised by importance and reimbursed at different rates: 100% for life-saving treatments, 65% for essential medication, 30% or less for non-essential items, 0% for over-the-counter or comfort medicine.
Your Carte Vitale ensures that reimbursement happens automatically in most cases.
✅ Maternity and Childcare
France offers excellent maternity care. Most prenatal, birth, and postnatal costs are covered at 100% from the sixth month of pregnancy until 12 days after birth, including midwife visits, scans and tests, hospital delivery (public), postnatal follow-ups. Paediatric care and mandatory vaccinations are also largely reimbursed for children.
✅ Emergency Care
Emergency room visits are covered by the public system, though not always fully. If you are admitted to hospital from the ER, your care will typically be reimbursed like standard hospital treatment.
Ambulance services are also reimbursed, but only if deemed medically necessary and pre-authorised.
✅ Mental Health Services
Psychiatric care is partially covered by the public system, particularly when accessed through a hospital or approved mental health provider. Reimbursements are limited for independent psychologists and therapists not affiliated with the system.
New reforms introduced in 2022 allow partial reimbursement for up to eight psychologist sessions, but these must be referred by your GP and fall within a specific provider network.
What’s Not Fully Covered by the Public System?
While the basics are covered, many important areas of healthcare are either not reimbursed at all or only partially reimbursed without additional insurance.
❌ Dental Care: Check-ups are reimbursed at around 70%, fillings and simple procedures may be partly covered, crowns, implants, and orthodontics often carry high out-of-pocket costs. Without a mutuelle, dental expenses can become very expensive, especially for families.
❌ Optical Care: Standard eye exams are reimbursed at a low rate, glasses and contact lenses are only minimally covered, designer or complex lenses may not be reimbursed at all. A good mutuelle can make a significant difference in optical costs.
❌ Hearing Aids
The state reimburses a portion of hearing aid costs, but without top-up insurance, the remaining balance can reach hundreds or even thousands of euros.
❌ Alternative Therapies
Services such as osteopathy, acupuncture, or chiropody are not part of the standard public system. Some mutuelle plans include partial reimbursements for these, but they are considered “non-conventionné” services.
❌ Private Rooms and Upgrades
If you're admitted to hospital and would like a private room, the extra cost is not covered by the public system. Similarly, if you choose a private clinic or specialist with higher fees, you may pay more out of pocket.
Why Most People in France Have a Mutuelle
To bridge the gap between what’s reimbursed and what’s not, most French residents take out a mutuelle, a supplementary health insurance plan that can cover:
✅ The remaining costs of GP and specialist visits
✅ Private hospital rooms
✅ Dental and optical care
✅ Alternative therapies and more
Some employers provide mutuelles, but expats, retirees, freelancers, and self-employed individuals must usually arrange their own.
👉 Need extra cover? Get a quote for top-up health insurance
Final Thoughts: What You Can Expect from Public Healthcare in France
The basic public healthcare system in France is generous and highly effective. For essential care like doctor visits, hospital treatment, and maternity services, the system works well and is accessible to all legal residents.
However, there are important gaps in coverage, especially for dental, optical, and specialist services. That’s why many expats and locals alike rely on a mutuelle to ensure they aren’t left with unexpected bills.
Understanding the difference between what’s covered by public healthcare and what isn’t will help you plan your finances better and ensure complete peace of mind when it comes to your health.
👉 Ready to protect your health and finances? Explore our top-up insurance options today.
