Guidance

Healthcare for UK nationals living in France

How to get state healthcare if you live, work or study in France.

This information is about living in France. There’s different guidance if you’re visiting France.

You must have health insurance cover to live in France.

State healthcare in France is not free. Healthcare costs are covered by both the state and through patient contributions. These are known as co-payments.

You may have to pay upfront for some treatment. The French national insurance fund, Caisse Primaire d’Assurance Maladie (CPAM), will then repay you for part of the costs later.

At the moment, UK nationals usually access the French healthcare system in one of these ways:

  • making French social security contributions through their employer or as a self-employed person
  • registering a UK-issued S1 certificate with the local CPAM office

The S1 certificate entitles UK nationals access to state healthcare on the same basis as a French citizen. You’re entitled to an S1 if you receive a UK State Pension or certain other benefits. Find out more about the S1.

Healthcare during the transition period

There will be no changes to healthcare access for UK nationals visiting or living in the EU, Iceland, Liechtenstein, Norway and Switzerland before the end of 2020.

You can continue to use your EHIC during this time, as you did before.

If you’re living in France or move there permanently before the end of 2020, you’ll have life-long healthcare rights in France as you do now, provided you remain legally resident.

You may need to register or apply for residency. This guidance explains what you need to do in France depending on your circumstances.

Healthcare if you live and work in France

You can apply to be covered by the French healthcare system (‘PUMa’) if you have been a resident in France for at least 3 months. If you’re employed in France, you can apply as soon as you start work. You’ll have access to state healthcare on the same basis as a French citizen.

Find out more about becoming resident in France.

You will pay for PUMa through social security contributions if you are employed or self-employed in France.

If you are not employed you may have to pay into PUMa yourself. There is more information on the CPAM website (in French).

How to register

You can apply for PUMa through your local CPAM office. There is information about how to register online.

You’ll get a French social security number and once registered, you’ll get a social security card, called a ‘Carte Vitale’. Take it with you whenever you visit a doctor, pharmacy or specialist provider.

How much you’ll pay

State healthcare in France is not free. You may have to pay some of the cost of any treatment.

Make sure you understand what you’ll be charged and how much of that you will get back through insurance. There is information (in French) about reimbursements online.

You can also get top-up insurance called a ‘mutuelle’. This will cover all or part of your medical costs.

Healthcare during the transition period if you live and work in France

There will be no changes to healthcare access for UK nationals in the EU, Iceland, Liechtenstein, Norway and Switzerland before the end of 2020.

If you’re living in France or move there permanently before the end of 2020, you’ll have life-long healthcare rights in France as you do now, provided you remain legally resident.

This means you’ll also have the right to apply for a UK S1 if you start drawing a UK State Pension.

You may need to register or apply for residency depending on your circumstances.

If your UK employer has sent you to France temporarily (‘posted workers’)

A posted worker is someone who is employed or self-employed in the UK, but temporarily sent to another European Economic Area (EEA) country.

Currently, posted workers can use an EHIC or an S1 certificate to access French healthcare. HMRC has a helpline for National Insurance enquiries from non-UK residents. They can answer questions about posted worker status and explain which documents you will need to get healthcare while posted.

You should register your S1 with CPAM.

You may also need a UK-issued A1 certificate to show that you pay national insurance in the UK. You can get this from HMRC.

If you’re using an EHIC, you’ll need to show the card when you go to your appointment.

Healthcare during the transition period if you’re a posted worker

There will be no changes to healthcare access for UK nationals in the EU, Iceland, Liechtenstein, Norway and Switzerland before the end of 2020.

You can continue to use your EHIC or S1 during this time, as you did before.

UK-funded healthcare: using an S1 in France

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

  • a UK State Pension
  • some other ‘exportable benefits’

Not all UK benefits that can be claimed while abroad entitle you to UK-funded healthcare. Read more about claiming benefits if you move abroad or contact Jobcentre Plus to ask about a benefit.

You may also be entitled to an S1 if you’re a posted worker or frontier worker. You must contact HMRC National Insurance enquiries to find out if you’re eligible.

Once you have an S1 certificate, you must register it at your local CPAM office.

This will mean you and your dependants will be entitled to healthcare on the same basis as a French citizen.

You’ll still have to pay part of your medical costs, just like other French residents.

You can also get top-up insurance called a ‘mutuelle’. This will cover all or part of your medical costs that are not covered by state repayments.

How to get an S1

If you have a UK State Pension, you must request an application form by phone from NHS Overseas Healthcare Services.

NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
Monday to Friday, 8am to 6pm
Saturday, 9am to 3pm

How to use an S1 in France

You must register your S1 with your local CPAM office. There is information about how to register online.

You’ll get a French social security number and once registered, you’ll get a social security card, called a ‘Carte Vitale’. Take it with you whenever you visit a doctor, pharmacy or specialist provider.

This will mean you’re entitled to healthcare on the same basis as French citizen.

Healthcare during the transition period if you use an S1

There is different guidance if you have an S1 as a posted worker.

There will be no changes to healthcare access for UK S1 holders in the EU, Iceland, Liechtenstein, Norway and Switzerland before the end of 2020 if you’re either:

  • someone with an exportable UK State Pension
  • someone with another ‘exportable benefit’
  • a frontier worker (someone who works in one state and lives in another)

If you’re living in France or move there permanently before the end of 2020, you’ll have life-long healthcare rights in France as you do now, provided you remain legally resident.

This means that you’ll get:

  • continued access to healthcare in France using your UK-issued S1
  • a UK-issued EHIC for travelling to other countries in the EU
  • planned treatments in other EU countries via the S2 route

You may need to register or apply for residency depending on your circumstances.

Moving back to the UK

If you return to the UK permanently you’ll be able to use the NHS like any other UK resident.

Read more about using the NHS when you return to live in the UK.

Studying in France

You can apply for a student EHIC. This is different from a normal EHIC, and entitles you to cover for longer.

Your student EHIC should be valid until at least the end of the academic year.

Your EHIC gives you access to emergency or necessary state healthcare for the same cost as a French resident.

An EHIC is not a replacement for health insurance. You should also have insurance to cover the duration of your course.

Healthcare during the transition period if you’re studying in France

There will be no changes to healthcare access for UK nationals in the EU, Iceland, Liechtenstein, Norway and Switzerland before the end of 2020.

You can continue to use your EHIC during this time, as you did before.

If you started studying in France before the end of 2020, your student EHIC will be valid for the rest of the time you study there.

Published 23 September 2019
Last updated 31 January 2020 + show all updates
  1. Details on the ways that you access healthcare have been updated. The guidance now only covers living, working and studying. Information on visiting has been moved to: https://www.gov.uk/guidance/uk-residents-visiting-the-eueea-and-switzerland-healthcare

  2. First published.