Guidance

Healthcare for UK nationals living in France

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

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This guidance will be updated if anything changes to how you get state healthcare in France.

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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 treatments. The French national insurance fund, Caisse Primaire d’Assurance Maladie (CPAM), will then repay you for part of the costs later.

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
  • using a European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) for temporary stays when studying, or as a ‘posted’ (detached) worker
  • registering a UK-issued S1 form with the local CPAM office (see ‘UK-funded healthcare: getting and using an S1 form in France’ below)

Healthcare if you live and work in France

If you are planning on moving to France, see the guidance on Living in France for more information about visa and residency requirements.

You must show proof of healthcare cover:

  • before you can register as a resident
  • when you apply for a visa

For details about the healthcare cover required for residency applications, contact local authorities in France or the appropriate French embassy or consulate in the UK.

You can apply to be covered by the French healthcare system (Protection Universelle Maladie or ‘PUMa’) if you’ve 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.

You’ll 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’s more information on the CPAM website (in French).

You may be entitled to a French EHIC for travel, including visits to the UK.

You may also have the right to apply for a UK S1 if you start drawing a UK State Pension (see ‘UK-funded healthcare: getting and using an S1 form in France’ below).

How to register for healthcare

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

Once registered, you’ll get a temporary social security number by post after 1 to 3 months.

You’ll then receive a document called an ‘attestation de droits à l’assurance maladie’. This confirms your right to French state healthcare and your French social security number.

Once you’ve got that document, you can apply for your French state healthcare card, the ‘carte vitale’. Take it with you whenever you visit a doctor, pharmacy or specialist provider.

It can take 6 months or longer to get a carte vitale. If you have questions about your application, contact your local CPAM office.

If you need healthcare before you receive your card, use your social security number. Ask your healthcare provider for a ‘feuille de soins’ and send it to your CPAM office to be refunded for any treatment you’ve paid for.

How to access healthcare services

Find your nearest hospital or clinic on the Hopital.fr website (in French).

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’ll get back through state healthcare cover. There’s 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 not covered by the state.

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

A posted worker, also known as a ‘detached worker’, is someone who is employed or self-employed in the UK, but temporarily sent to a European Economic Area (EEA) country.

UK posted workers can access healthcare in France using an EHIC, GHIC or S1 form.

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 your local 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 or GHIC, you’ll need to show the card when you go to your appointment.

UK-funded healthcare: getting and using an S1 form in France

There’s different guidance if you have an S1 as a ‘posted worker’ (see ‘If your UK employer has sent you to France temporarily (‘posted workers’)’ above).

You may be entitled to state healthcare paid for by the UK if you’re a resident in France and receive a UK State Pension or an exportable benefit. See Planning your healthcare abroad on the NHS website for more information about eligibility.

You may also be entitled to an S1 form if you’re a frontier worker (someone who works in one state and lives in another). You must contact HMRC National Insurance enquiries to find out if you’re eligible.

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.

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

This will mean you and your dependants will be entitled to healthcare in France 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.

You’ll also get:

Dependants and family members may be classified differently in France than the UK.

Check with the local authorities when you register your S1 form.

If you’re entitled to an S1 form as a dependant of a State Pensioner, your health cover will be cancelled once you begin claiming your UK State Pension.

You will be sent a new S1 form to your registered address from NHS Overseas Healthcare Services. You must register this form to ensure continuation of healthcare cover.

You are responsible for informing NHS Overseas Healthcare Services if you change your address or your circumstances change.

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

How to get an S1 form

If you have a UK State Pension or another qualifying exportable benefit, you must request an application form by phone from NHS Overseas Healthcare Services (see contact details above).

How to use an S1 form in France

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

Once registered, you’ll get a temporary social security number by post after 1 to 3 months.

You’ll then receive a document called an ‘attestation de droits à l’assurance maladie’. This confirms your right to French state healthcare and your French social security number.

Once you’ve got that document, you can apply for your French state healthcare card, the ‘carte vitale’. Take it with you whenever you visit a doctor, pharmacy or specialist provider.

It can take 6 months or longer to get a carte vitale. If you have questions about your application, contact your local CPAM office.

If you need healthcare before you receive your card, use your social security number. Ask your healthcare provider for a ‘feuille de soins’ and send it to your CPAM office to be refunded for any treatment you’ve paid for.

If you are experiencing delays registering your S1 with local authorities and require emergency or urgent treatment, contact the Overseas Healthcare Services on 0044 191 218 1999.

Studying in France

You should apply for a Student GHIC to get medically necessary, state-provided healthcare for the duration of your study period in France, whether this is for part or all of your course. This means that you’ll get necessary healthcare services on the same basis as a French citizen either for free or at a reduced cost.

If you already hold a valid Student EHIC you can use this until the card expires.

Read more about eligibility and how to apply

Getting treatment in the UK

Because the NHS is a residency-based system, under NHS rules UK nationals who move abroad on a permanent basis may lose their entitlement to free NHS healthcare.

If you are a UK national and move to the EU, you should not expect to be able to use NHS services for free when visiting the UK unless you have an EHIC, PRC or S2 to show your healthcare costs are funded by the EU country in which you now live, or another exemption applies.

Some former UK residents do not have to pay for NHS treatment when visiting England. This includes:

  • UK war pensioners
  • UK government employees
  • UK nationals living in the EU on or before 31 December 2020, once they have a registered, UK-issued S1

Read more about using the NHS when you no longer live in the UK (see ‘UK nationals who no longer live in the UK’ in Healthcare for visitors to the UK from the EU).

If you return to live in the UK 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.

Published 23 September 2019
Last updated 14 October 2021 + show all updates
  1. Updated 'Healthcare if you live and work in France' to include information about how to find your nearest hospital or clinic. Updated 'UK-funded healthcare' to include information for S1 dependants who begin claiming a UK State Pension, and guidance for S1 holders who are experiencing delays in registering their S1. Updated 'Studying in France' to include more information on Student GHIC and Student EHIC cards. Updated 'Getting treatment in the UK' to provide additional detail about NHS access when visiting the UK.

  2. Updated 'posted worker' section to reflect that posted workers can continue working and accessing state healthcare in France, and added detail to ‘getting treatment in the UK’ section about healthcare when you no longer live in the UK.

  3. Updated sections on living and working in France, using an S1 form in France, posted workers and studying in France. Changes reflect healthcare arrangements for people moving to France under the new rules of the UK’s deal with the EU.

  4. Updated 2 sections: ‘Healthcare if you’re using an S1 form in France and ‘Healthcare if you’re studying in France’. Students and people with a registered S1 in France can now apply for a new UK European Health Insurance Card (EHIC) that will remain valid from 1 January 2021.

  5. 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

  6. First published.