Guidance

Healthcare in France

Healthcare information for UK nationals visiting, living in or moving to France.

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This content was originally published on the NHS website.

Healthcare after Brexit

You should be ready for possible changes to your access to healthcare if there is a no-deal Brexit and you are a UK national living in or visiting France.

You should review your access to healthcare now. There may be a gap or permanent change in how you access healthcare if there is no deal and no arrangements with France in place.

For example, if you are a posted worker or student using a European Health Insurance Card (EHIC), you will not be able to rely on this to access your healthcare as you do now.

If you live in France

You need to make the best decisions for your circumstances and consider:

  • registering to live in France
  • registering for healthcare under the local rules and legislation of France
  • buying comprehensive health insurance while you are applying for residency or if you are not eligible for local schemes – complementary or top-up insurance (mutuelle) can also cover part or all patient contributions you make for your healthcare

Make sure you have all the right documentation and it is up to date.

If you are employed in France

Your access to healthcare should not change if you are employed in France and you are making social security contributions (cotisations) through your employer.

S1 certificate holders

If you are already an S1 holder, make sure you register your S1 at your local CPAM office.

UK nationals without an S1 can apply to be covered by the French healthcare system (PUMA) if you work in or have been resident in France for at least 3 months. PUMA gives you the same access to healthcare as French nationals.

S1 arrangement in France if there is a no-deal Brexit

Following new legislation, the French government have indicated that UK pensioners with an S1 who are resident in France before Brexit would continue to be entitled to healthcare for up to 2 years on equal terms to local healthcare users.

Make sure you register your S1 at your local CPAM office.

Studying in France

Your EHIC may not be valid after exit day if there is a no-deal Brexit.

This will depend on whether the UK has an arrangement with France and might mean you need to pay for treatment.

If you’re already studying in France before the UK leaves the EU, the UK will cover your healthcare costs for the duration of your course.

Students starting courses after the UK leaves the EU should ensure they have comprehensive healthcare cover in place.

Get help paying for medical treatment after Brexit

During the first 6 months after Brexit, if you need medical treatment and you’re being asked to pay for it, the UK can help.

This may be through arrangements with the country you live in, or by paying your healthcare provider directly.

To organise a payment, you’ll need to give your healthcare provider’s details to the NHS Business Services Authority’s Overseas Healthcare Services.

Call the NHS Business Services Authority on +44 (0)191 218 1999 for more information. Lines are open Monday to Friday 8am to 6pm and Saturday 9am to 3pm (UK time).

Using NHS services when visiting the UK

You should not expect to be able to use NHS services for free if you are living in France and are not currently eligible for a UK-issued S1 form or EHIC.

Take out appropriate travel insurance when visiting the UK, as you would when visiting any other country.

If you are living in France before Brexit, you can use NHS services in England, Scotland and Wales without charge after exit day if you:

  • have a UK-issued S1 form
  • have a UK-issued EHIC
  • would have been eligible for the UK to fund your healthcare access, if exit day had not occurred

Returning to the UK permanently

If you return to the UK permanently and meet the ordinarily resident test you will be able to access NHS care without charge.

European Health Insurance Cards (EHIC)

Your EHIC may not be valid if there is a no-deal Brexit. This will depend on whether the UK has an arrangement with France and might mean you need to pay in full for treatment.

Make sure you have comprehensive travel insurance if you’re planning to visit France.

Check your insurance has the necessary healthcare cover to ensure you can get any treatment you might need.

If you have any pre-existing conditions, talk to your insurer about how to get the right cover, and how this affects your travel.

Your EHIC can be used to access UK-funded treatment if your visit or treatment started before exit day until you return to the UK.

To organise a payment, you’ll need to give your healthcare provider’s details to the NHS Business Services Authority’s Overseas Healthcare Services.

Call the NHS Business Services Authority on +44 (0)191 218 1999 for more information. Lines are open Monday to Friday 8am to 6pm and Saturday 9am to 3pm (UK time).

Living in France

This information is for healthcare in France before Brexit. Find out about healthcare for UK nationals living in France after Brexit.

How to register for the French healthcare system

You can apply to be covered by the French healthcare system (known as PUMA) if you have been a resident in France for at least 3 months. This gives you the same access to healthcare as French nationals.

You can apply for the PUMA through your local sickness insurance fund. This is called ‘Caisse Primaire d’Assurance Maladie’ (CPAM) in French. They can tell you which documents you’ll need to register.

Once registered, you will receive a French social security card, called a ‘Carte Vitale’.

You will need to present this card at any medical consultation, hospital visit or pharmacy.

Paying for healthcare

In France, healthcare costs are covered by both the state and through patient contributions. These are known as co-payments.

The social security card will not cover all medical fees and the patient must pay a contribution.

If you are employed in France, you will pay for PUMA through social security contributions (cotisations).

If you are not employed, you may need to pay contributions to access healthcare. Contact your local CPAM for more information.

It is important to choose and declare a ‘medécin traitant’ (this is a type of general practitioner) to your CPAM office. By doing so, you will be reimbursed at a higher rate than if you have not declared one.

If you need to go to hospital, you can choose which hospital you receive treatment in.

Ask about the details about any treatment costs before you go to a hospital. Some medical facilities apply fees that are not covered by CPAM.

You can choose to take out a complementary or top-up insurance policy (a mutuelle) to cover part or all of the patient contribution.

For more information about the breakdown of reimbursements and the patient contribution, please see the l’Assurance Maladie reimbursement page (available in French only).

UK posted workers

If you are a worker posted by a UK company to France, you may be entitled to health cover funded by the UK in France.

You can find out more from HM Revenue and Customs (HMRC):

S1 certificate

You may be entitled to state healthcare paid for by the UK if you live in France and receive:

  • an exportable UK State Pension
  • a contribution-based Employment Support Allowance
  • another exportable benefit

You will need to apply for a certificate of entitlement known as an S1 certificate.

An S1 certificate helps you and your dependants access healthcare in France. If you have an S1 certificate, it will be valid until the UK leaves the EU.

You may be eligible for an S1 certificate, if you:

  • receive certain UK benefits, such as a UK State Pension
  • are employed by a UK body or firm (you are a posted or frontier worker)
  • are a dependant of someone who has an S1 certificate

You can apply for an S1 certificate through the Business Services Authority.

If you receive a UK State Pension, you can apply for your certificate via the Overseas Healthcare Service on +44 (0) 191 218 1999 (option 5).

Your S1 certificate may not be valid if there is a no-deal Brexit. This will depend on whether the UK has an arrangement with France and might mean you have to pay in full for treatment.

You can register your S1 form by sending it to your local CPAM office.

You will be issued with a Carte Vitale, which confirms your right to access healthcare on the same basis as a French national.

For other exportable benefits, you may need to contact a different team depending on the exportable benefit.

Read about claiming benefits if you live, move or travel abroad for more information. Please note that different exportable benefits can have different rules in terms of healthcare cover.

Studying in France

This information is for healthcare in France before Brexit. Find out about healthcare for UK nationals studying in France after Brexit.

The government always advises UK nationals to take out comprehensive insurance when going overseas.

Your EHIC is not an alternative to insurance and you should have both when you travel abroad.

If you are a UK resident studying in France, your EHIC will be valid until the UK leaves the EU.

Read more about healthcare when studying abroad on the NHS website.

For more information about healthcare when living abroad, read the NHS guide on planning your healthcare when moving abroad.

Visiting France

This information is for people visiting before Brexit. Find out about healthcare for UK nationals visiting after Brexit.

UK-issued EHICs will still be valid until the UK leaves the EU.

Make sure you have comprehensive travel insurance if you’re planning to visit France.The government always advises UK nationals to take out comprehensive travel insurance when going overseas.

Your European Health Insurance Card (EHIC) is not an alternative to travel insurance and you should have both when you travel abroad.

Emergency medical care is provided to anyone requiring urgent attention. You can expect to be charged in full for any care provided without an EHIC. Your EHIC enables you to access necessary state-provided healthcare in France at a reduced cost, or sometimes for free, if you are staying there temporarily.

Make sure you’re treated by a healthcare provider in the state system. This is known as ‘conventionné’ in France. Your EHIC will not cover you for private healthcare.

State practitioners, called ‘conventionnés’, can either be:

  • Secteur 1: practitioners who charge the official social security rate
  • Secteur 2: practitioners who charge an extra fee on top of the official rate

Remember to keep all receipts and any paperwork.

Pre-existing health conditions

You should buy medical travel insurance before visiting France if you have a pre-existing health condition.

You must tell the insurance company about any pre-existing health conditions to ensure you get the cover you need.

The Money and Pensions Advice Service has information about buying travel insurance for people with pre-existing medical conditions.

If you have a pre-existing condition that will need treatment while abroad, ask your doctor in the UK for advice before you travel.

Take any documents about your health condition or medicine with you.

If you are travelling to have planned medical treatment, read the NHS guide to seeking medical treatment in Europe.

Healthcare services in France

Finding help in an emergency

If you have a serious, life-threatening emergency, you should go to the A&E unit (les urgences) of your nearest hospital.

Call 112 or 114 (for hearing assisted) if you need an ambulance. The is free of charge.

In France, a doctor must confirm that you are really in need of an ambulance service, otherwise you will be charged.

Alternatively, you could use a light medical vehicle to get to hospital. This is called a ‘véhicule sanitaire léger’ (VSL).

Dentists

You must pay the dentist directly. They will fill out a treatment certificate, called a ‘feuille de soins’.

You need the treatment certificate to claim any refunds in France. You can claim back around 70% of the standard treatment cost.

You can search for health professionals for the area you are staying in via l’Assurance Maladie website (information in French only).

Hospitals

Make sure you present your EHIC if you are admitted to hospital. This will ensure you only pay the patient contribution.

If you are admitted to a private hospital or clinic, check if it is also registered to provide state healthcare.

Generally, you will only have to pay a 20% co-payment towards your treatment. Sometimes it will be free. Inpatients will have to pay a daily hospital charge of €20.

If you are admitted to hospital and receive any major medical treatment, you will need to pay the daily hospital charge.

This is a flat-rate contribution of €20, in addition to the 20% co-payment.

Find out about treatment costs and reimbursement rates in advance if possible.

Some facilities apply a surcharge (dépassement d’honoraires) that is not covered by the French healthcare system.

A few clinics are ‘non conventionnées’, meaning that their rates are not government regulated.

Find your nearest hospital in France

Prescriptions

You can get your medicines from any pharmacy (pharmacie) on presenting the treatment certificate (called ‘feuille de soins’) and the doctor’s prescription.

The price of the medicine is printed on a treatment certificate that the chemist will give back to you with the prescription. You pay the chemist directly.

Prescribed medicines are only reimbursable if they are listed as reimbursable pharmaceutical products. Reimbursement rates vary between 15% and 100% of the sale price.

You can call 3237 for information about duty pharmacies. It’s a 24-hour phone service to help you find pharmacies in your area.

You can also use their online service and search for pharmacies via postcode (information in French only).

Bringing your own medicines to France

Some prescribed medicines contain drugs that are controlled under the Misuse of Drugs legislation in the UK. This means that extra legal controls apply to these medicines.

You may need a personal licence to take controlled medicines abroad.

Specific requirements also apply to:

  • the information that you must take with you
  • how you carry your controlled medicines

Read more about travelling with controlled medicines.

Published 23 September 2019