An Introduction to the Healthcare System in France
Originally posted on & updated on 7th April, 2025
The healthcare system in France is recognised as one of the best in the world and although not complicated for French people, it can be a bit confusing at first for expats who are living in France. In this article, our aim is to give an overview of the system so you know roughly what to expect.
That said, it is important to give a ‘health warning’ that each CPAM (Caisse Primaire d’Assurance Maladie) office has a certain amount of autonomy to apply their own rules. As a result, it’s important to establish what your rights may be in the area you’ve chosen to live, before deciding to make the move, especially if you have ongoing health issues.
How the Healthcare System works in France
In most instances the French social security system doesn’t pay for the full amount of medical treatment. There are however some exceptions to this, for example when there is a long-term, serious illness, but it’s safest to assume that you will not receive a full refund. What normally happens is that the social security system refunds a fixed percentage of a cost that they have determined for the treatment you have received. See below, ‘Where it gets a bit complicated’ for more detail.
When you visit a GP in France, you’ll be asked to pay a bill of 30 €uros (€35 euros for children under the age of 6, €39 euros for toddlers under 2), of which 70%, less a processing fee of 1€ will be reimbursed by the state. The same rough percentages are true for most hospital treatments. You can easily organise and follow all your costs and supporting documents with Ameli, the online platform for the Assurance Maladie/CPAM.
Key Healthcare Metrics and Trends
The healthcare landscape in France is characterised by both strengths and challenges. With substantial public health spending and a strong workforce, France remains committed to ensuring access to quality care.
However, rising wait times in emergency rooms signal areas needing improvement. This overview examines key statistics and trends that shape the current state of health care in France, highlighting its progress and ongoing challenges.
Health Insurance Market Size
In 2022, France’s health insurance market was valued at approximately EUR 180 billion, with a projected compound annual growth rate (CAGR) of 4.91% from 2023 to 2030.
Public Health Spending
In 2022, publicly funded health spending in France was approximately EUR 5,172 per capita, 26% higher than the UK’s approximately EUR 4,121, adjusted for purchasing power parity.
Hospital and Cliniques in France
In 2021, France had 2,987 hospitals, including public and private institutions (cliniques). The number of private, profit-oriented hospitals and clinics declined from 1,076 in 2011 to 1,012 in 2018, reducing 64 establishments over eight years.
General Practitioners and Nurses
As of January 1, 2023, 82,858 general practitioners (médecins généralistes) were actively practising in France, compared to 38,680 in the NHS in England as of January 2025. In 2020, France had 1,134 practising nurses per 100,000 inhabitants, surpassing the EU average of 837 per 100,000.
Waiting times in A&E/ER
The average time spent in the emergency room has increased by 45 minutes in ten years. In 2023, half of the patients spent more than 3 hours there.
Most French People Have a Mutuelle
Recent data indicates that around 95% of the French population has complementary health insurance, including “mutuelles”.
Private Medical Insurance
In order to cover the remaining 30% of your costs, in France, most people take out what’s called a mutuelle/complémentaire santé. A mutuelle/complémentaire santé is an insurance policy which will pay the part of your healthcare expenditure that isn’t covered by the state. This type of medical insurance cover shouldn’t be confused with private health care insurance in the UK. It is completely different and isn’t underwritten on your state of health for acceptance.
Read our article to learn about how mutuelles/complémentaires santé in France work, and note that it’s important to shop around because prices vary enormously. What’s more there are various ‘bells and whistles’ that can be added to policies if you need them, but be careful not to be misled into paying for them if you don’t need them. For people on low income there is the possibility to join the CMUC (Couverture Maladie Universelle Compleméntaire), which is the equivalent of a mutuelle/complémentaire santé, but it’s provided free of charge by the state in France.
Where French Healthcare Gets Complicated
Real Prices
Many medical treatments in France are provided by professionals who have the right to set their own prices, however, when it comes down to how much you get paid back by the state, there are fixed rates. The social security system sets a pricing standard and whether or not your chosen doctor or specialist adheres to these prices is up to them. In many cases, you’ll find that the prices charged are exactly as fixed by the social security, but if you’re in any doubt, it is well worth checking. Highly specialised treatments are often charged at a premium and you can find yourself unexpectedly out of pocket if you don’t do your homework.
As you’ll discover in our article about mutuelle/complémentaire santé policies, there are ways of covering costs that are over the pre-determined social security limits, but always check your own situation.
Long-Term Illnesses
Long-term illnesses or Affections de Longue Durée (ALD) in France are commonly reimbursed in full, but not always. Again, this is a complex area and while some of your associated treatment might be fully refunded, there may be others that aren’t. Needless to say, again, this is something you should seek advice on so you know what to expect.
Where to Go if You Need Assistance
If you are already registered and you have a carte vitale, register with the Ameli online system, if not the CPAM (Caisse Primaire d’Assurance Maladie) office is the place to go to get help and to find out your rights. Like anything in a foreign language, it can be complicated at first to understand, but you should persevere and at the start, take someone with you who speaks good French if you need to.
The capital city of each department has a large CPAM office and is the place that deals with the processing and decision-making surrounding the healthcare system in France at a local level. Some smaller towns will also have a permanent CPAM office, but very small towns and villages will normally have some sort of CPAM presence from time to time. The best place to find out when a CPAM representative is due to come to your town or village is to ask at your Mairie. For emergencies, here’s a list of useful numbers, we hope you won’t need.
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