Legal residents can join France's state health system after 3 months — no age limits, no medical questionnaire. The state reimburses 70% of standard tariffs; a top-up policy (mutuelle) covers most of the rest. Here are the real numbers.
Figures verified 8 July 2026France's protection universelle maladie (PUMa) covers anyone who lives in France in a stable, regular way — including visitor-visa retirees. After 3 months of residence, you apply through your local CPAM office with your visa/permit, proof of address, and civil documents. Approval brings a social security number, then the carte Vitale — the card that makes reimbursements automatic. The step-by-step guide →
France runs on co-payments, not free-at-point-of-use. The state reimburses a percentage of official tariffs — 70% for doctors, around 80% for hospital stays, 100% for listed chronic conditions — and your mutuelle picks up most of the rest. A GP visit costs €30 up front; with carte Vitale plus a standard mutuelle your net cost is the €2 participation. Sector-2 doctors (common in Paris and Nice) charge above tariff; the excess is only covered if your mutuelle includes it.
Good news versus most countries: mutuelles are open-enrolment — no medical questionnaire, no age cut-off for standard contracts. Premiums are age-rated: plan on roughly €80–160 per person per month in your 60s depending on the level of cover (market estimates). Before your PUMa acceptance, you'll rely on the private travel/expat policy your visa required — keep it active until the carte Vitale actually arrives.
| Stage | What you need |
|---|---|
| Visa application | Private insurance covering the full stay, incl. hospitalisation and repatriation. |
| First months in France | Keep the private policy running; apply to PUMa after month 3. |
| Settled resident | PUMa + carte Vitale as the backbone; a mutuelle for the co-payments. Most residents carry both. |
The 3-month rule, the CPAM application, the carte Vitale, and the "PUMa tax" some early retirees owe.
Read the guide →Cover levels, sector-2 top-ups, and what the price bands actually buy.
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