International Health Insurance in France for Expats

Yes – proof of comprehensive private health insurance is a mandatory requirement for all long-stay visa applications in France, including the long-stay visitor visa, the student visa and work visas. The policy must cover medical expenses and hospitalisation in France for the full duration of the visa, and standard travel insurance is not accepted. The policy must be a long-term residency health insurance plan. Americans on visitor visas should ensure their policy covers the entire Schengen Area and the full duration of their intended stay. ExpatInsure can help you find a plan that meets French visa requirements and provides the documentation needed for your application.

France’s public healthcare system – the Protection Universelle Maladie, or PUMa – provides coverage to all legal residents after three months of continuous residency in France. Once eligible, you register with the Caisse Primaire d’Assurance Maladie (CPAM), France’s national health insurance fund, and receive a Carte Vitale – a health insurance card that entitles you to reimbursements for medical costs. The public system typically covers around 70% of medical costs, which is why over 92% of residents in France also hold a mutuelle – a supplemental private insurance policy – to cover the remaining costs. During the initial three-month period before PUMa eligibility, private health insurance is essential.

In late 2025, French lawmakers approved a significant change to the rules for non-EU visitor visa holders, including Americans. Previously, Americans on long-stay visitor visas could access PUMa public healthcare coverage for free after three months of residency if they had no professional income in France. From 2026, a new minimum healthcare contribution is required before affiliation with the public system can be granted. Without paying this contribution, private health insurance remains mandatory. This is a material change for American retirees and others living in France on visitor visas. ExpatInsure recommends that anyone planning a move to France in 2026 or later stays informed about this requirement and factors it into their planning. We can help you find the right private health insurance plan for your situation.

A mutuelle is a supplemental private health insurance policy that covers the costs not reimbursed by the French public system – typically around 30% of medical costs. Over 92% of French residents hold a mutuelle alongside their public coverage. For Americans who have joined PUMa, a mutuelle is not legally mandatory but is strongly recommended given the out-of-pocket costs that can accumulate without it. Dental care, optical care and specialist consultations in particular can involve significant costs without supplemental cover. International health insurance plans available through ExpatInsure may cover both the public system gap and broader international coverage in a single policy. ExpatInsure can help you find the right option for your situation in France.

No. US Medicare does not provide coverage outside the United States in most circumstances. Some Medicare Advantage plans offer limited emergency cover abroad and certain Medigap policies include emergency foreign travel coverage, but these are designed for short trips rather than long-term living abroad. Americans planning to live in France should arrange international health insurance as a separate plan to cover their healthcare needs. This is particularly important during the initial period before PUMa eligibility begins, and for those on visitor visas navigating the new 2026 contribution requirements. ExpatInsure can help you find options suited to your age, health needs and length of stay in France.