Expat Insurance in France 🇫🇷

PUMA (Protection Universelle Maladie) is France's universal health insurance system that entitles all legal residents to access state healthcare coverage. You qualify if you have been legally resident in France for more than 3 consecutive months, regardless of employment status. Coverage is based on residency, not employment. PUMA reimburses 70–80% of most medical costs, but it does not cover dental, optical, or the remaining co-payment — which is where a mutuelle comes in.

Yes, for most expats a mutuelle is essential. PUMA leaves a co-payment gap on nearly every medical expense — typically 30% of GP visits, 20–35% of specialist consultations, and major gaps on dental and optical. A mutuelle (also called complémentaire santé) covers all or most of this remaining gap. Since 2016, employers must provide a mutuelle for salaried employees. Self-employed and freelance workers must arrange their own.

For most residency permit applications in France, you must show proof of health insurance coverage. If you are not yet covered by PUMA (e.g., in your first 3 months), an international health plan from an approved provider is accepted. Some permit types — such as the talent passport or digital nomad visa — may have specific requirements. Valenvia can help you identify the right plan for your visa situation.

Mutuelle costs vary depending on age, the level of coverage, and whether it includes dental and optical. A basic complementary health plan for an individual under 40 typically costs €30–€70/month. A comprehensive mutuelle with strong dental and optical coverage costs €80–€150/month. International IPMI plans (which may include the mutuelle function) from Cigna, AXA or Allianz start from around €150–€350/month and are popular among expats who travel internationally.

Yes. Auto-entrepreneurs (micro-entrepreneurs) in France are affiliated with the Sécurité Sociale des Indépendants (SSI), which provides a basic level of sick pay after a waiting period. However, SSI benefits are often low and subject to conditions. A private prévoyance (income protection) policy can replace a defined percentage of your income from day one of incapacity, and is available through major French and international insurers. Premiums typically start from €40–€90/month for €1,500–€2,000/month benefit.