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My French story: The epic quest to get a Carte Vitale

The bureaucratic expedition to get a carte vitale in France can be arduous and fraught with obstacles but it's a rite of passage for most who want to settle in the country. Adopted Parisian Jamie Gilder, 28 explains the natural highs and lows of the process.

My French story: The epic quest to get a Carte Vitale
Photo: AFP

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It’s early morning at the doctor’s surgery in Paris.

I detach myself from the other grim-faced commuters lining the waiting room as my name is called. “Can I see your health card, sir?” says the receptionist.

This is it: the moment I’ve been waiting for. Fireworks of jubilation explode inside me as I hand over my small, green “Carte Vitale”.

“Thank you” she says, “please wait over there”. I proudly take a seat, managing with difficulty to resist performing a celebratory knee slide. I’ve been accepted. I’m a normal human being. 

This might seem an unusual reaction to having a medical checkup. But it’s not uncommon among foreigners living in France who’ve spent the preceding months attempting to get themselves into the social security system. To obtain the same rights as the average citizen you must lay siege to the French administration. Show enough persistence and you can eventually claim your prize: a social security number and a ‘Carte Vitale’, which entitles you to subsidised healthcare and, just for a moment, makes you feel as though you belong.

The Carte Vitale is a relatively new innovation. Once upon a time, when you needed medical care in France you would pay for it and be given a receipt, known as a feuille des soins.

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You would then submit this to your local health authority and wait to be reimbursed. In 1998 this process was streamlined with the carte vitale, which automatically generates and submits an electronic feuille des soins each time you get treatment. If you announce at the doctor’s surgery that you don’t have a carte vitale, they look at you as though you’ve told them you enjoy collecting dog turds from the Paris pavements before giving you an old school paper feuille des soins which they've had to extract from a back room somewhere.

Even with a feuille des soins, you won’t receive any reimbursement until you’re actually registered within the social security system. This is a problem if, say, you’re living and working in France, are contributing significant chunks of your salary towards a healthcare system you’re not yet able to take advantage of, and have multiple feuilles des soins already piling up on your table. 

The process of registering is arduous and you need patience. 

Patience to a degree that most humans are not capable of. The underlying problem is that nothing happens quickly in France. It’s a country that is in some respects still dragging itself reluctantly out of the middle ages and has a deserved reputation for tedious bureaucracy. Walk into any bank, post office, or town hall and you’ll emerge no short time later clutching at least six different pieces of paper. Not just any paper either. The crispest, newest, whitest sheets of starchy manuscript you could imagine, which you then proceed to put in a draw and never look at again. 

Paper is the currency in France: the only way of getting things done. When it is difficult to accomplish everyday tasks without sacrificing at least one tree, to tackle the great behemoth of the social security system you’re going to be drowning in it.

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Healthcare in France: The essential French language you'll need if you're ill

You must first amass a hefty stack of documents (henceforth known as your dossier) before launching an assault on your local Caisse primaire d’assurances maladie or CPAM office. You can check on arrival exactly what you need to provide as it depends on your situation, but it may include: a copy of your birth certificate with certified French translation, a copy of your passport, a document certifying your bank details (a RIB), a copy of your work contract and proof of address.

After waiting in a queue of disgruntled others you meet your new adversary: the French government official.

They may change their minds randomly about what documents you need or add specifications just to annoy you. I, for example, was told at first that I needn’t have brought my birth certificate (having spent weeks getting hold of one) but was turned away for only having a printout of my RIB and not an original. When I returned they decided that in fact I did need my birth certificate and turned me away again, only for the office to be inexplicably closed for the whole afternoon when I went back a third time. 

The best way to avoid unnecessary frustration is to bring all documents you might foreseeably need, originals where possible, and expect to be rejected at least once before you get it right. I wish I could have followed my own advice but left the office each time wanting to strangle someone.

The problem, you realise with a sinking heart, is that the staff don’t really want to take on your dossier. Not only does accepting it mean more work for them to do, rejecting you gets them off. Video footage of people being told that their lovingly assembled paperwork is inadequate before scooping it up and traipsing out of the building is a niche genre of pornography consumed only by French government officials. 

READ ALSO: What to do if you have a medical emergency in France

What to do if you have a medical emergency in France

When you’ve finished dancing the administrative hokey-cokey, dutifully entering and exiting the CPAM office as many times as you’re asked to, your dossier, which by now weighs several kilos and is stained with blood and tears of frustration, is deemed worthy of consideration. This is a strange moment. You can’t decide who you hate more: the fastidious officials or yourself for the pride you felt on being told that your dossier is ‘complet’.

(You can also avoid this situation by posting your dossier to Assurance Maladie although this approach could result in a similar back and forth exchange through the post rather than face-to-face.)

Having managed to submit my dossier I relaxed, relieved to have set the process in motion.

It would surely be much easier from here. I asked a friend in a similar situation how long it had taken after he had submitted his dossier before he was able to start claiming reimbursements. “I handed it in four months ago and have heard nothing since,” he said, cheerfully.

This was not the answer I wanted. I asked another friend who told me that she had waited over six months. The CPAM office had got her address wrong twice and she’d had to call their helpline to chase it up. This is therefore what I did; as soon as six weeks – a timeframe during which it is possible to travel to another planet – had elapsed and absolutely nothing had happened, I called the helpline. The good news is there is an English-speaking helpline for the lazy or linguistically challenged. I was assured that my temporary social security number would be sent out to me in “about ten days”. Why they can’t simply give you the real one straight away is anyone’s guess.

Eventually, finally, at long last, after a few more paper-based exchanges, your Carte Vitale comes through in the post.

After dancing a jig, punching the air and whooping you run down to the doctor’s surgery you then remember that you’re supposed to be ill. In any case, with your Carte Vitale in hand, you can march through the door and be treated like anyone else. This is a beautiful moment during anyone's time in France.

REMEMBER: You can also access, a useful site through which you can follow all of your health insurance claims and access important documents. You need a special code to log in though which you can only receive… yes, you guessed it, in the post. 

Member comments

  1. What they don’t ask for, but which will help to speed up the process is to provide them document E 104 from the previous health insurance. So before leaving the previous EU country, one should already go to the previous health insurance (by the time it is still the current insurance) and ask for that document. Of course, this only helps when one moves from one EU country to another.

  2. It must have got harder – in 2002 I got mine in 3 weeks. All I had to was fill in a 3 page form which the doctor’s receptionist gave me, send it off with a photocopy of my passport and the name of my chosen GP and 3 weeks later it arrived.

  3. Just to add that, if you are a woman who has had name changes, don’t even start applying for a carte vitale without some official document that shows both your maiden and married name on the same page. Neither UK nor US passports have such a page. The mayor of the commune in which I live in France kindly signed an “attestation” to the effect that my two names were one person!

  4. I hate this! Moan moan moan. Bugger off back to the wonderful UK then! When in Rome! I got mine in a Month and received refunds for the feuille de soins a month after that. Everything is actually easy as long as you do it the french way! If you don’t like the French way, there are ferries and a tunnel. Au revoir!

  5. Well,hold tight when you hear my story. I’ve had a carte vitale since they existed having lived here longer than I care to remember. About 3 years ago I went for a blood test,and the snappy young receptionst asked for my date of birth which I duly gave only to be corrected and told it was the day before. Some crud had changed the date by one day…took two years to correct during which time bills were not reimbursed or recognised. And then suddenly it was ok again to my undying relief.

  6. When I went to the office in Perpignan (with a book and a drink as I had been warned of the long waits) I was seen within half an hour but told because of where I live I was in the wrong office. The assistant there made me an appointment at the correct office and gave me a list of the papers I would need. 3 weeks after the appointment at the correct office, where I was told I would be sent a temporary card as permanent ones were taking 3 months, i received cartes de vitale for my husband and myself. I think some regions are more efficient than others.

  7. Hello tigerssteve
    It’s not a moan, it’s a funny story; the only way to cope & leave yourself with your hair intact! If you can’t laugh at your original or your adopted country it’s, as the saying goes, a poor show, not a matter for telling someone to go elsewhere. We laugh at ourselves and our own families! You come out the other side knowing you’ve had a terrible experience but you’ll forget the suffering & remember the funny bits, thanking your lucky stars it’s over & not Kafka without end. When in Rome is one thing, but seeing the funny side is another.

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