Moving to France: Health Insurance for UK Expats Explained

"You must have health insurance cover to live in France." That line from the UK government's guidance is the starting point for anyone planning a move. Health cover isn't an optional extra you sort out once you've settled in. It's part of your visa application, and it's a condition of living in France.

The cover you need changes over your first year. Here's how it works for UK nationals, stage by stage.

Stage 1: Health Insurance For Your Visa Application

The cover the French authorities expect depends on the visa you apply for. FrenchEntrée's guide to long stay visa insurance sets out the main distinction.

For a temporary long stay visitor visa (VLS T), which covers stays of four to six months, travel insurance that meets the requirements will usually do. FrenchEntrée reports that the French Embassy in the UK has confirmed a UK Global Health Insurance Card (GHIC) is accepted for this visa.

For a long stay visa that works as a residence permit (VLS TS), the usual route for people moving permanently, standard travel insurance won't be enough. You'll need private medical insurance that meets French national requirements, not just Schengen travel requirements, covering the period required. FrenchEntrée lists non compliant medical insurance as one of the most common reasons long stay visa applications are refused.

If you're a UK State Pensioner, FrenchEntrée notes that a valid S1 certificate can be provided with your visa application as an alternative to private insurance.

The S1 route for UK State Pensioners

If you live in France and receive a UK State Pension or certain exportable benefits, GOV.UK says you may be entitled to state healthcare in France paid for by the UK. This is the S1 form. Your dependants may also qualify, though their cover ends once they start claiming a UK State Pension themselves.

To request an S1, GOV.UK directs you to NHS Overseas Healthcare Services on +44 (0)191 218 1999. Once you're in France, you register the S1 with your local CPAM, the French health insurance office. You and your dependants then receive healthcare on the same basis as French residents, which includes paying your share of the costs.

Stage 2: Joining PUMa after three months

Other residents can join the French state system, known as PUMa, after living in France for at least three months. GOV.UK sets out the process:

1. Apply to your local CPAM office. The ameli.fr website has English pages explaining what to send.
2. You receive a temporary social security number by post, usually after one to three months, followed by your attestation of rights.
3. Apply for your carte Vitale. GOV.UK warns this "can take 6 months or longer".
4. Until the card arrives, use your social security number and a paper feuille de soins to claim refunds.

Put the timeline together and you could be resident for six months or more before you're fully registered. That's why private cover through the early months matters, even after your visa is granted.

What PUMa costs: the CSM

PUMa isn't free for everyone. Residents with little or no earned income but significant investment or property income may pay an annual contribution called the cotisation subsidiaire maladie, or CSM. FrenchEntrée's guide to PUMa sets out the formula: 6.5% of capital income above half the annual social security ceiling (the PASS), reduced if you have some earned income.

The PASS for 2026 is €48,060, so the threshold is €24,030. As an illustration, a single person with no earned income and €50,000 of investment income would pay 6.5% of €25,970, around €1,688 a year. Someone whose capital income is below the threshold pays nothing. Holding private insurance doesn't exempt you from the CSM, as French law firm AGN Avocats points out.

Planning a budget for your new life? Our guide to the cost of living in France vs the UK compares everyday costs, and you can browse property for sale in France to see what your budget buys.

Stage 3: What the State pays and where a Mutuelle Helps

State healthcare in France is shared between the state and the patient. GOV.UK says it "is not free", and you may pay upfront before part of the cost is refunded.

A GP visit shows how it works. According to service-public.fr, a consultation with a sector 1 GP costs €30. If you've declared that doctor as your médecin traitant, your regular GP, the Assurance Maladie reimburses €19, after deducting a €2 flat contribution. Without a declared médecin traitant, the reimbursement drops to €7.

The gap is what a mutuelle is for. GOV.UK describes it as top up insurance that covers all or part of the costs the state doesn't. A mutuelle isn't a legal requirement for residents, but FrenchEntrée's guide for retirees describes one as highly recommended, because the state doesn't cover all costs.

If You're Moving to Work

If you've been hired by a French employer, GOV.UK says your employer must start your PUMa registration before your first day, and you apply for your social security number at CPAM as soon as you start. Your cover is then funded through your social security contributions. Buy private insurance to bridge the gap while your registration is processed.

Frequently Asked Questions

Do I need private health insurance to move to France?

If you're moving on a residence visa, usually yes, at least at first. A long stay visa that works as a residence permit (VLS TS) normally requires private medical insurance that meets French national requirements, and you can't join the state system, PUMa, until you've been resident for three months. UK State Pensioners may be able to use an S1 instead. Workers are registered by their employer but should still have private cover until registration is complete.

Can I use my GHIC if I live in France?

Not as your long term cover. GOV.UK explains that the GHIC and EHIC are for temporary stays and posted workers, not for living in France. FrenchEntrée reports that the French Embassy in the UK accepts a GHIC for the four to six month temporary visitor visa (VLS T), but not for the VLS TS residence route. Once you live and work in France, GOV.UK says you can't use a UK issued EHIC, though you may be eligible for a French one for travel.

How much does PUMa cost?

There's no joining fee for PUMa. Workers fund it through their social security contributions. Residents with low earned income and capital income above half the annual social security ceiling may pay the CSM, a contribution of 6.5% on income above the threshold. With the 2026 ceiling of €48,060, that threshold is €24,030. You still pay a share of each medical cost, such as the €2 flat contribution on a GP visit.

Is a mutuelle compulsory in France?

No. A mutuelle is an optional top up policy that covers the part of medical costs the state doesn't reimburse. With a standard GP visit reimbursed at €19 out of €30, the gap adds up over a year. FrenchEntrée's legal checklist for movers notes that a mutuelle covers the remaining share of standard costs and more for dental, optical and hospital care, and in most situations saves you paying upfront. Compare what each policy covers, not just the monthly premium.

Build health cover into your moving plan

Think of your health cover as a timeline. Private medical insurance or an S1 secures your visa and covers your first months. PUMa follows after three months of residence, with the carte Vitale arriving later. A mutuelle then fills the gaps for the long term. Plan each stage before you move and the cover will keep pace with the rest of your new life.

Once you know your costs, it's time to find the right home. Set up a free property alert on propertyinfrance.com or browse more than 5,000 properties for sale in France. Planning to retire? Read our guide to retiring to France from the UK.