This guide is for you if you live or work in France – or are just moving there – and want to understand how the public healthcare system works: Assurance Maladie, carte Vitale, médecin traitant, mutuelle, and reimbursements. At the end, you will also find a brief section for those visiting France only for vacation or visits.
Last verification: October 21, 2026. Informational material – not legal or medical advice. Amounts and rules in France change frequently (several changed in 2026); confirm them with an official source or your CPAM before making decisions.
In Brief
- If you work in France, you are entitled to reimbursement for medical expenses from the first hour of work; without work, the right to PUMa opens after 3 months of stable residence.
- A visit to a general practitioner in sector 1 costs €30 in 2026 and is reimbursed at 70% – provided you are in the “parcours de soins” with a declared médecin traitant.
- From each visit, €2 is deducted (participation forfaitaire), and €1 per package for medications (franchise). From October 1, 2026, the annual limits for these deductions increased from €50 to €70 each – totaling €140 per year.
- A private sector employer must provide all employees with group mutuelle (complémentaire santé) – regardless of tenure.
- In the Mon soutien psy program, you have up to 12 sessions with a psychologist per year for €50, of which Assurance Maladie reimburses 60%.
- In emergencies, call 15 (SAMU) or 112.
Structure of the French System – Key Concepts
The French healthcare system operates in two layers. The first is public insurance (Assurance Maladie, commonly referred to as “la Sécu”), which reimburses a certain percentage of the so-called base rate. The second is complementary insurance (complémentaire santé, commonly mutuelle), which covers part or all of the remaining costs. Without mutuelle, you pay the difference yourself.
CPAM (Caisse primaire d'assurance maladie) – the local health insurance fund in the metropolitan area; this is where you register and submit documents. In overseas departments, this role is fulfilled by CGSS.
PUMa (Protection universelle maladie) – the principle that anyone who works or resides in France in a stable and regular manner is entitled to reimbursement for medical expenses, even after losing a job or divorce.
Numéro de sécurité sociale – your insurance number. Without it, you will not receive a carte Vitale. Initially, you may have a temporary number; you can order the card after receiving the final number (définitif).
Ticket modérateur – the part of the base rate that Assurance Maladie does not reimburse (e.g., 30% for a visit to the doctor). This part is usually covered by mutuelle.
Tiers payant – a system where you do not pay upfront, as the fund (and possibly mutuelle) settles directly with the doctor or pharmacy.
Who and When Gets Insured
As a Polish citizen (EU), you have the right to reside freely in France – to prove “regularity” of residence, an ID card or passport is sufficient. Everything else depends on your situation:
| Your Situation | What Happens with Insurance |
|---|---|
| You work in France on a French contract | Entitled to reimbursement from the first hour of work, with no waiting period. Your employer registers you (DPAE), but you must complete the registration at the CPAM of your residence. |
| You live in France, do not work | Entitled to PUMa after 3 months of residence; you maintain it if you live in France for at least 6 months a year. For those not professionally active, this is not automatic – CPAM also assesses the right to residence. |
| Employee delegated by a Polish company | You remain in the Polish system (delegation for up to 24 months, with exceptions). Before leaving, you take the S1 form from NFZ and submit it to CPAM – then you can receive treatment in France like a French person. |
| Pensioner with a Polish pension | You request the institution paying your pension for an S1 form, which transfers your right to treatment to France. Family members also need S1. |
| Unemployed with exported Polish benefits (U2) | While receiving benefits, you use EKUZ. |
| Family of an employee | Family members living with you in France for more than 3 months are covered by French insurance. Children under 18 are “ayant droit” of the parent; adults are insured in their own name. |
Note the new regulation: the law on financing Sécurité sociale for 2026 provides for a fee for some PUMa beneficiaries who do not work and do not pay CSG or contributions. According to service-public (as of May 13, 2026), the decree on the fee amount was only announced. Individuals with high capital income and low work income may also pay cotisation subsidiaire maladie (6.5%).
Registration Step by Step
- Apply for Opening Rights
At the CPAM of your residence, fill out the “Demander l'ouverture des droits à l'Assurance maladie” form and attach the documents listed in the form. If you have S1 – attach it. Refusal or persistent avoidance of mandatory registration is a crime.
- Receive Your Insurance Number and Create an Ameli Account
After receiving your number, create an account on ameli.fr (or in the “Compte ameli” app). You will download the attestation de droits – proof of insurance, which various offices often require.
- Order Your Carte Vitale
The card is free. Ordered through your ameli account, it arrives in about 2 weeks by mail – in about 3 weeks. Prepare a photo and an identity document.
- Activate the Carte Vitale App
The digital carte Vitale on your smartphone works throughout France since November 2025. With a French biometric ID (CNIe), you activate it through the France Identité app; without it, there is a separate activation path. Not all doctors and pharmacies have readers yet, so also carry the physical card.
- Declare Your Médecin Traitant
Choose a doctor and ask them to declare you – usually done online using your carte Vitale, without paperwork. Do this as soon as possible, as it affects the reimbursement amounts.
- Join a Mutuelle
If you work – sign up for the company mutuelle. If not – consider an individual policy or check if you qualify for C2S (below).
Médecin Traitant and “Parcours de Soins”
The médecin traitant is your primary care physician – the first contact for health issues, who refers you to specialists. This can be a general practitioner or a specialist, working alone, in a group practice, health center, or hospital – close to home or work. The doctor must agree; you cannot designate a substitute doctor (remplaçant). You can change doctors at any time, without giving a reason – the new declaration cancels the previous one.
If you go to a doctor who is not your médecin traitant (or you do not have one), the reimbursement is lower. Without a referral, with normal reimbursement, you can go to:
- a gynecologist, ophthalmologist, dentist, and also a psychiatrist if you are under 26 (provided you have a declared médecin traitant),
- dentist and midwife,
- any doctor in an emergency when your doctor is unavailable or when you are far from home (e.g., on vacation).
Children under 16 do not lose reimbursement, even without a médecin traitant. If you cannot find a doctor who will accept you as a regular patient, service-public advises contacting a local coordinating organization (organisation coordonnée territoriale), and in case of difficulties – CPAM.
How Much You Will Pay – Reimbursements, Deductions, and Limits (2026)
Visit to a General Practitioner
In 2026, the rate for a consultation with a general practitioner is €30, and Assurance Maladie reimburses 70% within the parcours de soins, after a deduction of €2. In practice: €30 × 70% = €21, minus €2 = €19 reimbursement. The remaining €9 (ticket modérateur) is usually covered by mutuelle; €2 remains your responsibility.
Participation Forfaitaire and Medical Franchises
| Deduction | Unit Amount | Daily Limit | Annual Limit |
|---|---|---|---|
| Participation forfaitaire (doctor visit, laboratory test, X-ray) | €2 | €8 with the same doctor/laboratory | €50 until September 30, 2026; €70 from October 1, 2026 |
| Franchise – medication package | €1 | – | total €50 until September 30, 2026; €70 from October 1, 2026 |
| Franchise – paramedical procedure (nurse, physiotherapist) | €1 | €4 | |
| Franchise – medical transport | €4 | €8 |
Source: service-public.gouv.fr, article from September 16, 2026 (decree no. 2026-858 from September 11, 2026). Unit amounts have not changed – only annual limits have increased. From January 1, 2028, limits are to be indexed annually for inflation. Deductions are not paid by, among others, individuals under 18, C2S beneficiaries, and pregnant women from the 6th month to 12 days postpartum.
Medications, Hospital, Equipment
- Medications: reimbursement 100%, 65%, or 30% depending on the therapeutic value of the medication, minus €1 per package.
- Hospital: the fund covers 80% of costs; in addition, there is a daily fee (forfait journalier) of €23, and for major procedures, a one-time fee of €32.
- Glasses, hearing aids, and dental prostheses from the “100% Santé” basket are fully covered if you have “responsible” mutuelle or C2S.
Sector 1, Sector 2, and Additional Fees (Dépassements d'honoraires)
The doctor applies official rates. Reimbursement of 70% is calculated from the total amount. An additional fee may be charged, among others, outside the parcours de soins, during home visits, or outside regular hours.
The doctor can charge more but has a contract for “controlled” prices. The basis for reimbursement is the same as in sector 1; the excess is not reimbursed by the fund.
Free pricing, and 70% is calculated from a lower rate than in sector 1. Highest out-of-pocket cost – check how much your mutuelle covers.
You can check the doctor's sector in the official Annuaire santé search engine on ameli.fr, which service-public refers to. C2S beneficiaries are protected from additional fees – the doctor cannot charge them.
Mutuelle and Complémentaire Santé Solidaire (C2S)
Company Mutuelle
Every company must provide all employees with group complémentaire santé, regardless of tenure. This obligation does not apply to private individuals employing, for example, domestic help. The employer negotiates the contract – you do not have to arrange anything. In some situations, you may be exempt from joining. The contract must cover a minimum basket of benefits: ticket modérateur (with exceptions), the entire forfait journalier in the hospital, prostheses and orthodontics up to 125% of the rate, and a flat rate for glasses (at least €100 for simple correction every 2 years). If the employer has not provided mutuelle, you can appeal to the labor court (conseil des prud'hommes).
C2S – for Low-Income Individuals
C2S (formerly CMU-C) covers the complementary part – that is, what Assurance Maladie does not reimburse – up to the amounts of Sécurité sociale. Additionally: no fees at doctors, no €2 deductions and franchises, tiers payant (without paying upfront if you are in parcours de soins), and coverage of forfait journalier in the hospital. The thresholds in the metropolitan area (as of July 1, 2026):
| People in Household | C2S Free – Annual Income Up To | C2S With Fee – Annual Income |
|---|---|---|
| 1 | €10,421 | €10,421–€14,069 |
| 2 | €15,632 | €15,632–€21,103 |
| 3 | €18,758 | €18,758–€25,324 |
| 4 | €21,885 | €21,885–€29,544 |
Individuals receiving RSA automatically receive free C2S automatically. The thresholds change annually – check the current ones before applying.
Dentist, Pharmacy, and Tiers Payant
You can visit the dentist without a referral, and the reimbursement is normal. Prostheses from the “100% Santé” basket are fully covered with “responsible” mutuelle – since 2022, these contracts must also accept tiers payant for this basket.
At the pharmacy, upon presenting your carte Vitale, the pharmacist can apply tiers payant – provided you accept the proposed generic medication. Since June 2025, to use tiers payant, you must show your carte Vitale (physical or in the app); without it, you will pay upfront. Medications needed at night or on weekends can be purchased at the on-call pharmacy – your mairie has the on-call list.
Emergency Numbers and Help Outside Hours
Number 15 currently serves two roles: it is used for emergency calls and is also the Service d'accès aux soins (SAS) number – call if you need quick advice and your doctor is unavailable. In the emergency room (urgences) without hospitalization, a flat fee is charged – according to Cleiss €23.
Mental Health – Mon Soutien Psy
You can see a psychologist without the consent of a médecin traitant. In the Mon soutien psy program:
- a session costs €50 (the first is an assessment interview, then up to 11 sessions),
- Assurance Maladie reimburses 60% (€30), “responsible” mutuelle covers the remaining 40%,
- the limit is 12 sessions in a calendar year (no limit for a child in ALD),
- the psychologist must have a contract with CPAM – you can find a list through the “Trouver un psychologue conventionné” search engine, linked by service-public,
- without paying upfront (100%) for C2S, AME, pregnancy from the 6th month, or work accidents.
The law on financing Sécurité sociale for 2026 widens tiers payant for psychologists in this program, but details are to be specified by decree (page status: July 3, 2026). Visits to psychiatrists are reimbursed like visits to doctors; consultations in medical-psychological centers (CMP) are also covered by Assurance Maladie.
How to Find a Polish-Speaking Doctor
We do not provide names – instead, we suggest how to search independently:
- Annuaire santé (ameli.fr) – the official directory of doctors with sectors and rates. We could not confirm if it has a language filter; search for doctors in your area and call to ask “Parlez-vous polonais ?”.
- Consulate of the Republic of Poland / Embassy of the Republic of Poland in Paris – ask (on the embassy's website on gov.pl or by phone) if the office provides a list of Polish-speaking doctors. We have not checked if such a list is currently available.
- Parishes and Polish community organizations – in practice, a good source of recommendations, but check in Annuaire santé if the doctor has a contract with the fund and in which sector they are.
If You Are Coming for a Short Visit: EKUZ
For vacation or visits, bring EKUZ – the European Health Insurance Card. It is free and issued to each person separately (there is no family card). From January 1, 2026, you can submit an electronic application only through the Internet Patient Account or the mojeIKP app; you can also go to the NFZ branch or send the application by mail. EKUZ covers only necessary and unplanned treatment, in the public system and under the same conditions as the French – meaning also with their deductions. It usually does not cover rescue operations or return to Poland due to illness, so NFZ advises considering additional commercial insurance.
What about NFZ if you move permanently? If you work in France on a French contract, you are insured by France. EKUZ from NFZ applies to temporary stays, so it is not a solution for someone living there. The exception is delegated workers and pensioners with a Polish pension – they remain in NFZ and use the S1 form in France.
Common Mistakes
- Delaying the declaration of médecin traitant – during this time, you receive lower reimbursements.
- Lack of mutuelle – without it, you cover the ticket modérateur and additional fees in sector 2 yourself.
- Giving up company mutuelle without checking if you qualify for an exemption.
- Going to the pharmacy without a carte Vitale – then you pay upfront.
- Visiting a sector 2 doctor without OPTAM without checking the price – additional fees are not reimbursed by the fund.
- Treating yourself with a Polish EKUZ when you already live and work in France.
- Not reporting departure from France – PUMa may be revoked, and departure must be reported by yourself.
- Paying someone for replacing a lost carte Vitale – this is always free (a fee of €5 only from the 4th replacement in a year); asking for money is fraud.
This guide does not replace advice from a doctor or CPAM. Amounts from 2026 (deduction limits, C2S thresholds, psychologist rates) have changed throughout the year and may change again. In an emergency, do not seek information – call 15 or 112.
Frequently Asked Questions
Do I have to wait 3 months if I start working?
No. When working in France, you have the right to reimbursements from the first hour. Three months apply to those who do not work.
What is my actual cost for a visit to a general practitioner?
In sector 1, in parcours de soins: from €30, the fund reimburses €19. If mutuelle covers the ticket modérateur, you are left with €2 participation forfaitaire – up to the annual limit of €70 (from October 1, 2026).
Can I have a primary care doctor far from home?
Yes – they can see you wherever is convenient for you, e.g., near work.
Will the carte Vitale app replace the physical card?
It serves the same function, but not every office has a reader. For now, carry both.
Do children have their own carte Vitale?
From 16 years old, a child can have their own card with parental consent; parents can also apply for a separate card for a child aged 12–16.
Fact-Check Summary
- Definitely true: limits for participation forfaitaire and franchises increased from October 1, 2026, to €70 each (decree 2026-858); consultation with a general practitioner is €30 in 2026, reimbursed at 70% in parcours de soins; Mon soutien psy – 12 sessions at €50, 60% reimbursement; work provides insurance from the first hour, and residence without work – after 3 months; from January 1, 2026, the EKUZ application online is only through IKP/mojeIKP.
- Probably true: outside parcours de soins, reimbursement drops from 70% to about 30% of the rate – service-public only mentions “lower reimbursement,” and insurers state the number 30%; the employer must cover at least half of the premium for company mutuelle (this has not been verified in an official source).
- What is uncertain: the amount of the new fee for non-working PUMa beneficiaries and the timing of the introduction of tiers payant for psychologists – both depend on decrees that were not yet described on service-public at the time of verification; the availability of number 116 117 (medical on-call) in your region; whether Annuaire santé allows filtering by language.
- Common myth: “With EKUZ, I get treatment in France for free” – no, you pay the same deductions as the French. “Mutuelle is mandatory state insurance” – no, it is complementary insurance, mandatorily offered by the employer.
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