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Universal health protection (PUMa), a system available to expats residing in France
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Are you about to move, or move back, to France? If so, you may be wondering how your health costs will be paid in your new country of residence. Fortunately, the universal health protection scheme (PUMa - ‘Protection universelle maladie’) means there is no reason to be concerned. You’ll be covered by France’s Social Security system, whatever your employment status may be.

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PUMa: universal health insurance in France

PUMa applies to all people working in France, or who are resident in France on a stable and regular basis. PUMa offers health care cover in the event of sickness or pregnancy without any extra paperwork.

This system replaced the universal health cover scheme (CMU) in 2016, making cover simpler to obtain. PUMa is accessible to:

  • all persons working on a regular basis in France, from the very start of their employment;

  • all persons residing in France on a stable and regular basis (regardless of employment, and provided they are not covered by the social protection system of another State). However, they must prove that they have been resident in French territory on an uninterrupted basis for at least 3 months, and that they reside there for at least 6 months per year (in mainland France, Guadeloupe, French Guyana, Martinique, La Réunion, Saint-Barthélemy or Saint Martin). NB: There is no obligation to meet this condition if it relates to certain specific categories, for example a return to France following a VIE [international volunteers in business] programme, moving to France to join family members, etc.

> Find out more: PUMa in brief

How to benefit from PUMa as an expat

Obtaining French health insurance is a three-step process:

When you get your Carte Vitale (France’s health insurance card – for over 16s only), your repayment forms will be automatically sent to France's Social Security system. In certain cases ('tiers payant'), you'll be reimbursed directly (meaning that you will not have to pay in advance).

> To learn more, you can contact France’s health insurance system on 3646 (from a French landline) or by visiting www.ameli.fr.

Expats in France: buying a top-up health insurance policy

PUMa repays your healthcare costs on a continuous basis, even if your professional or family situation changes, or if you change your place of residence.

However, it’s important to know that standard state French health insurance only covers part of your costs.

How much you’ll be reimbursed may change, and is calculated according to:

  • the cost of your consultation, procedure, treatment or service (‘tarifs de base officiels’). Determined by France’s Social Security system, these are the standard fees charged by doctors operating under “Sector 1”. These are doctors who do not apply additional fees, unlike "Sector 2" doctors;

  • the repayment rate (‘taux de remboursement’). These are also determined by Social Security, and vary according to the type of care. For example, you’ll be reimbursed 70% of the flat fee for a consultation, 65% for medicines for significant medical services, etc.

It’s important to sign up for a top-up health insurance policy to guarantee you’ll have all your costs covered, for example optical care, dental care and auditory prostheses. A complementary policy will also repay any additional medical fees (‘dépassements d’honoraires médicaux’) you may incur, as these are only partially covered by French Social Security.

> Find out more: The French healthcare system

A stress-free move to France with APRIL International

Are you planning to move to France, or even retire there? APRIL International's MyHealth France solution is designed for you! The scheme guarantees flexible and global cover for healthcare costs incurred throughout your time in France (on top of French Social Security repayments), and also temporarily throughout the world. Our team of bilingual healthcare managers will be on hand to guide you.

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