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.
What happens to your US Medicare when you leave, and why most people keep Part A.
Most visas require proof of cover before you apply. We'll match you with an expat health insurance specialist we've independently vetted for France. Free, no obligation.