France is highly regarded as having one of the best healthcare systems in the world, so if you’re planning to move over in your golden years, that’s certainly an added bonus.
Gaining access to this coveted medical network is a necessity if you’re making France your new home, and one that requires adding a few steps to your retirement plan.
When you first arrive in France:
If you’re a retiree from another European Union country (EEA+Switzerland) you may already have an EHIC card (European Health Insurance Card) that will cover you initially while you’re scouting for a place to live in France.
If you’re not familiar with the EHIC scheme know that it basically ensures that anyone covered by an EU country’s social security scheme can receive medical treatment in another member state free or at a reduced cost.
It’s meant mainly for emergencies but does cover pre-existing conditions too (here's how to apply if you're British).
However, an EHIC card doesn’t cover people who are in France for the specific purpose of obtaining medical care. If that were your goal or if you’ve decided you’re going to be living in France for more than a few weeks, then scroll down to the next section.
If you’re a non-EU pensioner heading to France on a short-stay visa you’ll need to buy international medical cover for the duration of your stay for your entry paperwork to be processed successfully.
In the following section, you can find out if you’ll be entitled to receive subsidized healthcare from the French State as a non-EU retiree resident of France.
You’ve decided you’re definitely retiring in France. What next?
French law states that if you want to live in France, you have to have health insurance. That’s regardless of where you’re from, whether it’s public or private medical cover, or both.
If you’re an EU citizen the first thing to do is to join Assurance Maladie, which is mandatory for anyone who’s living in France on a regular ongoing basis, including pensioners who are settling in France.
Go to your local health insurance office (caisse primaire d’assurance maladie) in the department you’ve chosen to live in and you’ll be assigned a health insurance scheme in accordance with your situation.
You can find out which caisse primaire d'assurance maladie you are assigned to here.
You will receive a registration number that’s a prior requirement for obtaining your carte vitale healthcard. This smart card contains the administrative information required to provide you with medical care.
Previously, EU pensioners received much less medical cover from the French State as they were required to show social security contributions via paid employment or pension first.
Now under the new universal health protection plan (PUMA - Protection Universelle Maladie) the main condition is that you spend more than 183 days a year in France to have access to the country’s lauded healthcare system.
You can still transfer your EU pension over to France and make social security contributions, which in turn are likely to lessen your medical costs, and as we will cover later adding private medical cover is also recommended.
What about healthcare cover if I’m a retiree who isn’t from the EU?
If your residency papers are in order - a whole different kettle of fish with its own set of complexities - you will also have access to France’s PUMA system.
Before being accepted as a long-term resident in France you will however have to show proof of a comprehensive private medical plan, capable of covering €30,000 in expenses some sources say.
The registration process for PUMA and your carte vitale pretty much the same as that mentioned above for EU pensioners.
And just because you’re from outside the EU doesn’t mean you can’t make social security contributions via your pension back home. In fact the French government has set up a pension transfer scheme with a number of non-EU countries (including the US and Canada but not Australia) that may allow you to get discounted medical treatment through your contributions.
It’s important to remember that as a non-EU pensioner your right to live in France is closely linked to your financial means and proof that you won’t be a burden to the state. So having a comprehensive private medical plan may still be a requirement when processing and renewing your residency papers.
So it’s recommended (if not necessary) as a pensioner in France to have private healthcare as well?
It’s important to remember that public health cover in France isn’t usually completely free. Basically any medical certificate issued by a doctor, hospital or pharmacy in France is subject to a fee.
Your medical costs may be mostly covered by your social security contributions as a pensioner but for those extra costs it’s wise to get some supplementary health insurance.
If you’re not putting money into public coffers then the likelihood of you needing a private plan that covers all or part of the costs that Assurance maladie does not reimburse (medicine, drugs, hospitalisation, care) is even greater.
Even as an EU pensioner you are in theory subject to having to prove that you’re not ‘milking’ the system and private health insurance is quite probably the best way to do that in the eyes of the French government.
To subscribe to supplementary health insurance, you must already be a member of Assurance Maladie.
Depending on your financial means, you may be able to receive supplementary coverage free of charge (referred to as CMU-c in French) or support for the payment of supplementary health insurance (referred to as ACS in French) in order to reduce its cost.
Remember to also inform your local health insurance office of the name of the doctor you’ve chosen in order to receive medical care (treating doctor) and receive some if not all reimbursement for your costs.
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Anything else I should know?
In June 2018, the country's Ministry of Health announced details of a plan called "100% Health" (100% Santé) which is designed to help cover the costs of healthcare in three areas: the costs of glasses, dental treatment and hearing aids. It is supposed to come into effect in the next two or three years.