🛡️ Who Is Covered (PUMa)

If you live and work in France, you are covered automatically under the national health insurance system:
Protection Universelle Maladie (PUMa).

✔ Near-universal coverage
✔ Administered by Assurance Maladie (Ameli)
✔ Includes access to public & private healthcare providers

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💳 Proving Your Coverage: The Carte Vitale

Your Carte Vitale is your digital health insurance card.
It stores your social security details and allows automatic reimbursements directly to your bank account.

Show it at:

• Doctors' offices

• Labs & radiology centers

• Pharmacies

• Hospitals

If you forget it, you’ll get a paper form (feuille de soins) for reimbursement.

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💶 How Payments & Reimbursements Work

France uses a regulated fee system:

• Example: Standard GP consultation = €30

• National insurance reimburses ~70% of the regulated rate

• Small mandatory patient contribution: €2 participation forfaitaire

👉 You pay the doctor → insurance refunds you automatically (if using Carte Vitale).

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📌 Coordinated Care Pathway

If you declare a médecin traitant (regular GP), you get the highest reimbursement rates.
If not, reimbursement drops significantly.

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➕ Complementary Insurance (Mutuelle)

National insurance rarely covers 100%.
Most residents have a mutuelle (top-up insurance) to cover the remaining portion — especially for:

• Dental care

• Glasses & vision

• Hospital stays

• Specialist consultations

• Private clinics

People with low income may qualify for Complémentaire Santé Solidaire (CSS), which reduces or eliminates costs.

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❤️‍🩹 Special Rules & Long-Term Conditions (ALD)

Certain long-term illnesses (ALD — Affection de Longue Durée) are reimbursed at 100%, including:

• Diabetes

• Cancer

• Severe hypertension

• Chronic heart disease

• Severe mental illnesses

Emergency care is always covered under the same rules.

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🌍 Important Notes for Visitors & Expats

• EU visitors: Use the EHIC for emergency and medically necessary treatment.

• Non-EU residents: Register for PUMa after settling in France.

• Always keep receipts and medical documents if you need reimbursement later.

🏥 Healthcare Services in France

France offers a wide network of public and private healthcare services:

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Primary Care

• General practitioners

• Pediatricians

• Gynecologists

• Midwives

• Psychologists (partially reimbursed)

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Specialist Care

• Cardiologists

• Dermatologists

• Orthopedics

• Neurologists

• ENT specialists

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Emergency Services

• Samu (15) – Medical emergency

• Pompiers (18) – Firefighters for injury/emergency

• 112 – EU-wide emergency number

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Pharmacies

• Very common, open late in cities

• Green cross sign (flashing)

• “Garde” pharmacies available overnight/weekends