Best International Health Insurance for Americans Moving to France: GeoBlue, Cigna, IMG, and Now Health Compared (2026)

Americans moving to France need private health insurance for two reasons that are easy to confuse. The French consulate wants a certificate before it issues a long-stay visa. Then, once you live in France, that same cover is what pays your medical bills until the Assurance Maladie opens your rights, which for most people without a French job comes after more than three months of residence. This guide covers both: what the certificate has to say, how long the bridge lasts for you, your spouse and your children, what US coverage does not do, and how four international plans and two other kinds of cover compare on their own terms. This article is for informational purposes only and does not constitute medical, insurance or administrative advice: check the current requirements with your consulate, your CPAM or a qualified professional.

Once you are in the French system, it pays part of each bill and leaves the rest with you: what healthcare in France really costs an American shows where those gaps are, and the mutuelle guide covers the top-up that fills them.

Source: each insurer’s own page, read on 7 November 2026: BCBS Global Solutions, Cigna Global, France, IMG Global Medical, Now Health.

Prices are not in the table because these insurers price by quote, on your age, your deductible and whether you include the US. The list keeps to insurers with established sites; it is not the whole market. Some links in this article are partner links that may earn EasyFranceNow a commission at no extra cost to you; they do not change what the insurers’ pages say, which is what this comparison reports.

Why International Health Insurance Is Not Optional

Two rules make private cover compulsory for most Americans who move to France.

The first is the visa. For an American applying from the US for a long-stay visitor visa, the France-Visas assistant lists a “travel health insurance certificate issued by the insurance company”, covering medical repatriation and emergency and/or hospital treatment for a minimum amount of €30,000, valid in France for the whole stay, and it adds that a copy of your American health insurance card is not acceptable proof of adequate coverage (France-Visas, visa assistant, Visitor (adult), read on 7 November 2026). The rule does not stop at the border: the visitor residence permit itself is issued only to a foreigner who shows health insurance covering the length of the stay (CESEDA, article L426-20), so the question comes back at each renewal for as long as you are not in the French system.

The second is the wait. A person who does not work in France joins French public cover, the protection universelle maladie (PUMa), on the ground of residence, and has to show more than three months of uninterrupted residence in France before applying (Code de la sécurité sociale, article D160-2). Until the Assurance Maladie has opened your rights, every bill in France is paid by you or by your insurer.

Registering with the CPAM covers the application itself, and the long-stay visa guide covers the rest of the visa file.

Before Your Visa Appointment: What Your Policy Must Show

Read the certificate against the France-Visas wording before you book the appointment. It should be:

• issued by the insurance company: a certificate, not a quote, a policy summary or a card

• in your name, spelled as in your passport

• explicit about emergency and hospital treatment in France

• explicit about medical repatriation

• for an amount of at least €30,000

• valid in France for the whole stay, from your arrival date at the latest

Two clauses decide whether that certificate is still worth anything after you land. The territory clause has to cover France as the country you live in, not only as a destination you visit, and nothing in the policy should end the cover once you take up residence. Ask the insurer to confirm both in writing before you pay.

The certificate is one document in a file the consulate reads as a whole. A visa dossier check reads it alongside the rest of your file before the appointment.

How Long You Need Private Cover Before CPAM

How long the bridge lasts depends on how you will join the French system. The Assurance Maladie sets out the routes on its PUMa page:

• You work for a French employer. An employee has no minimum amount of work to prove: the job itself opens the rights.

• You are self-employed in France (artisan, shopkeeper, profession libérale, micro-entrepreneur). Your healthcare costs are covered from the start of your professional activity.

• You have no professional activity (retirees, people living on their own income). You are covered on the ground of stable and regular residence in France, and you can apply after more than three months of uninterrupted residence (article D160-2).

• You are a student in higher education. You register on the Assurance Maladie’s site for foreign students, etudiant-etranger.ameli.fr, with proof of enrollment and your residence permit (ameli.fr); the student visa guide covers the steps.

• You join a spouse or partner already insured in France. There is no three-month wait: see the next section.

If you work remotely for a US company, the route depends on how that work is declared in France: confirm it with your CPAM before you count on a date.

On the residence route, the application is the S1106 form, sent with its supporting documents to the Assurance Maladie fund of your place of residence (ameli.fr, PUMa page). The three months are when you may apply, not when you are covered. You are covered once the attestation de droits says so; you download it from your ameli account, under Documents, or from the Compte ameli app (ameli.fr). Keep the private policy until that document is in your hands. The French social security number guide explains what the provisional number does in between.

Couples and Families

Each person in the family needs cover on paper, even when one contract pays for everyone.

On the visa side, each person files their own application (the France-Visas assistant has a separate entry for a minor visitor), so each file needs a certificate that names that person. A certificate that names only the main applicant shows nothing for a spouse or a child. Some insurers issue one policy per person anyway: Feather’s expat plan page says each family member needs their own policy, set up after the first sign-up (Feather).

On the French side, the rules are kinder than many couples expect:

• No three-month wait for a family member who joins an insured person. Article D160-2 (II, 3°) treats the residence condition as met at once for members of the family who join or accompany an insured person to settle in France. Those members are the spouse, the concubin (cohabiting partner) or the PACS partner, and the minor children in the insured person’s care (Code de la sécurité sociale, article L161-1). The newcomer still applies, and is covered from the date on their own attestation de droits. If one of you is already insured in France, the other’s bridge can be short; if you arrive together on visitor visas, you both wait.

• Adults are insured in their own name. Under the PUMa, an adult with no professional activity is covered personally and is no longer attached to a partner’s account: only minors keep the status of ayant droit, and a young person can be insured individually from 16 at their own request (ameli.fr, PUMa).

• Children are attached to a parent, ideally both. The Assurance Maladie advises putting a child on both parents’ Carte Vitale, from the ameli account of the parent who already has the child, or by post with the request form and a copy of the birth certificate or livret de famille. The child sits on one parent’s mutuelle; when the other parent pays a bill, that parent sends the Assurance Maladie statement to the mutuelle that covers the child (ameli.fr).

If someone in the family has an S1. The S1 is a European form: it lets an insured person and the members of their family who live in another member state register with the health insurance of their place of residence. It is issued by the competent institution or by the fund that pays the pension, and the family members it covers are determined by the law of the country of residence (CLEISS). It concerns Americans who also draw a pension from an EU country or from the UK; check with your consulate whether it replaces the certificate in your own visa file before you rely on it.

What Your US Coverage Does Not Do

• Medicare. Medicare usually does not cover health care while you are outside the US: in most cases you pay all of the costs, the exceptions are rare and tied to being in or near the US, and Medicare drug plans do not cover prescription drugs you buy outside the US (Medicare.gov). Medigap policies may cover emergency care when you travel outside the US, which is not cover for the place where you live. Medicare in France explains what to keep and what to drop.

• Your US health insurance card. France-Visas states that a copy of it is not acceptable proof of adequate coverage.

• An employer plan or COBRA. Read what the plan says about care abroad and about living abroad. Whatever it covers, the consulate wants a certificate that meets the list above.

What to Look for in an Expat Health Insurance Plan for France

Only the certificate is what the consulate checks. The rest of the policy decides what you actually have in month four, still waiting for your attestation de droits.

Territory and residence: France has to be covered as your country of residence. If you will see doctors in the US, the plan has to say so: several insurers sell the same plan with or without the US.

Hospital and outpatient care: the visa asks for emergency and hospital treatment, but daily life means GP and specialist visits. Some plans sell outpatient care as an option.

Direct billing: some insurers pay hospitals in their network directly, others reimburse you afterwards. A hospital admission is when it matters.

Pre-existing conditions: each insurer has its own rule, from a waiting period to a cap or an exclusion; the plans below show the range. Disclose your history honestly.

Maternity and mental health: often capped or kept for a higher package. Check the figures if either applies to you, and if therapy is part of your routine, finding an English-speaking therapist in France explains what the public system reimburses once you join it.

Cancellation and renewal: you will want to leave once the French system covers you. A monthly contract makes that easy; a twelve-month commitment does not.

Which of these bind you depends on your visa, your health and your plans for the US. Talk it through with our team.

Four International Plans Americans Shortlist

International plans follow you wherever you live, usually with a choice of including the US or not. What follows is what each insurer’s own page says, read on 7 November 2026; the price comes only from a quote for your age, your deductible and your area of cover.

BCBS Global Solutions Worldwide Premier (Formerly GeoBlue)

GeoBlue now trades as Blue Cross Blue Shield Global Solutions. Its long-term plan for people living abroad is Worldwide Premier, with an Outside the U.S. version for those who will not seek care in the US (BCBS Global Solutions). Its page lists an unlimited annual and lifetime maximum, a network of doctors and hospitals in more than 190 countries, many of whom bill the insurer directly, and eligibility for US citizens and permanent residents living abroad who are 74 or younger when they apply. Current health conditions are covered from the start if you send a letter showing at least six months of previous health insurance; without one, after a waiting period of up to six months.

Best fit: Americans who expect to use US care as well as French care and want one plan for both. You can compare the GeoBlue plan and get a GeoBlue quote through International Citizens Insurance.

Cigna Global

Cigna’s France page describes its Global Health Options plans as worldwide cover, including or excluding the USA, for inpatient and day-patient treatment, in three packages: Silver, Gold, which adds maternity cover and dental treatment, and Platinum, with an overall annual benefit of $1,000,000, $2,000,000 or unlimited (Cigna Global). Its Close Care plan covers only the country you live in and your home country, which for an American means France and the US, up to $500,000 a year, with modules that add dental and wider outpatient care. You choose your deductibles and cost shares, direct billing is available with providers in its network, and you can pay monthly, quarterly or yearly.

Best fit: retirees and families who want a large insurer and are ready to choose modules with care, since each one adds to the price. See the Cigna Global medical plan or get a Cigna Global quote.

IMG Global Medical

IMG describes Global Medical as a long-term, annually renewable worldwide medical insurance program for individuals and families. The page of its Silver plan lists a lifetime maximum of $5,000,000 per person, deductibles from $250 to $10,000, treatment inside the US through a PPO network, medical evacuation up to $50,000 per person and dental as an optional add-on. Pre-existing conditions are limited to $50,000 for life ($5,000 per period of coverage for conditions you did not know about) and are available after 24 months of continuous coverage, unless IMG accepts your previous comprehensive health insurance, with no break longer than 63 days, as creditable coverage and waives the limit, subject to its underwriters (IMG).

Best fit: healthy Americans on a budget who are comfortable with a higher deductible and want a plan they can renew. See the IMG Global Medical plan or get an IMG quote.

Now Health International

Now Health sells two international plans: WorldCare, with a maximum annual plan limit of $3 million to $4.5 million and optional USA cover, and SimpleCare, with a limit of $1 million to $1.5 million; both list inpatient and outpatient care, cancer care and evacuation and repatriation. The policy is managed online: a digital membership card, treatment pre-approvals and claims you follow in the member portal (Now Health).

Best fit: Americans who will mostly stay in Europe and want to manage their policy from their phone; the USA cover is an option you buy only if you need it. See the Now Health plan or get a Now Health quote.

Two Other Shapes of Cover

A plan built for France. Some insurers sell cover for the first years in France rather than a worldwide plan. Feather’s page presents its expat health insurance for France as meeting the Schengen, VLS-TS, VLS-T and VLS requirements and those of a residence permit renewal, with a certificate as soon as you sign up, a stamped and signed confirmation that the cover meets the visa requirements, no medical checks, an unlimited policy limit per year, a €25 co-payment per event, travel cover across the EU and the Schengen area, repatriation, and monthly payment that you can cancel at any time; the page shows a monthly contribution of €72. Cancelling month by month suits a bridge that ends on the day your attestation de droits arrives.

Subscription cover for a life in several countries. SafetyWing sells two plans. Nomad Insurance Essential is travel medical insurance: up to 364 days at a time, an overall limit of $250,000, up to 30 days of medical cover in your home country, US cover at extra cost, and no cover for pre-existing conditions, maternity care or cancer treatment; its page shows $62.72 per four weeks for ages 10 to 39. Nomad Insurance Complete is sold as full health insurance that works in your home country: a $1,500,000 annual limit, routine check-ups, emergency dental up to $1,000, cover in 175 countries, ages up to 64 and a twelve-month commitment, with no cover for pre-existing conditions; its page shows $177.50 a month for ages 18 to 39. Essential suits a scouting trip and the weeks before you take up residence. Whichever you consider for the visa file, hold its certificate against the France-Visas list above.

How to Choose Based on Your Situation

• You are retiring. Age limits matter (BCBS Global Solutions takes applications up to 74, SafetyWing Complete up to 64), and so does the rule on pre-existing conditions. Retiring in France as an American sets out the whole healthcare timeline.

• You will spend real time in the US. A plan that includes the US (Worldwide Premier, IMG Global Medical, Cigna or Now Health with the US option, or Cigna Close Care) spares you a second policy.

• You will stay in Europe and want the bridge to end cleanly. A France-scoped monthly plan, or an international plan without the US.

• You move as a couple or a family. Count one certificate per person, and check whether one of you will be insured in France before the other arrives (article D160-2).

• You have a health history. Compare the rules on pre-existing conditions before the price.

• You want someone to read the clauses with you. That is the work of an English-speaking insurance broker in France.

Still unsure which plan satisfies your consulate and your budget? Match your situation to a visa-compliant plan with the Health Insurance Checker.

When to Cancel and What Comes After

Cancel when you hold your attestation de droits, not when the calendar says three months have passed. Then check how your own contract ends. A French complementary health contract can be cancelled at any time after one year, without fees, and the cancellation takes effect one month after the insurer receives it (Sécurité sociale); an international plan is often a foreign contract with its own terms, and a twelve-month commitment runs its course. Ask before you buy, not when you want to leave.

Once the Assurance Maladie covers you, it pays part of each bill, and the rest is what a mutuelle is for. If you travel to the US, keep separate cover for those trips: French public cover is built around care in France, and a mutuelle covers little or nothing abroad. Setting up CPAM and the Carte Vitale walks through the first steps once your rights are open.

The Healthcare Contribution Once You Are in PUMa

Joining the French system through residence is not always free. URSSAF collects the cotisation subsidiaire maladie (CSM) from a PUMa beneficiary who meets three conditions: covered through work or stable residence in France, income from work in France below 20% of the annual social security ceiling, and capital income between 50% of that ceiling and eight times it. A married or PACS couple owes nothing if either partner’s work income is above that threshold, and a person who received a retirement pension during the year is not liable (URSSAF). The PUMa contribution guide works through the rate and what changed in 2026 for visitor-visa holders, and the healthcare contribution checker also has a page of its own.

If you are a UK citizen

A UK GHIC is for temporary stays, not for living in France: the NHS says that if you are going to these countries on a temporary basis, usually up to 90 days, you can use your GHIC for medically necessary state healthcare, and that you are eligible for an S1 only if you are lawfully present as a resident (NHS). Whether you need private cover in the first months depends on your route: see our guide to the S1, Puma and the GHIC.

FAQ

Does my US health insurance cover me in France?

Not for the visa: France-Visas says a copy of your American health insurance card is not acceptable proof of adequate coverage. For care, read what your plan says about living abroad, not only about travel. Either way, the visa file needs a certificate from an insurer that meets the France-Visas list: repatriation, emergency and hospital treatment, at least €30,000, valid in France for the whole stay.

Is a travel insurance policy enough for the visa?

The France-Visas assistant itself asks for a “travel health insurance certificate”. What decides is what the certificate states: issued by the insurer, emergency and hospital treatment and medical repatriation covered, at least €30,000, valid in France for the whole stay. A policy that ends after a set number of days, or once you take up residence, does not carry you through the year.

How long do I need private cover before CPAM takes over?

Until your attestation de droits from the Assurance Maladie. Without a professional activity in France, you can apply only after more than three months of uninterrupted residence, and the cover starts when the fund has opened your rights. A job with a French employer, or self-employment in France, opens rights from the start of the activity.

Does my spouse have to wait three months too?

Not if you are already insured in France when they arrive. A spouse, concubin or PACS partner who joins or accompanies an insured person to settle in France meets the residence condition at once (article D160-2 of the Code de la sécurité sociale). They still apply, and their own attestation de droits gives their start date.

Can one family policy cover all of us for the visa?

Only if the certificate names each person it covers, since each person files their own visa application. Some insurers issue one policy per person in any case.

What if I have a pre-existing condition?

Compare the rule before the price. BCBS Global Solutions covers current conditions after a waiting period of up to six months unless you show six months of earlier insurance, IMG limits them to $50,000 for life after 24 months of cover unless it accepts your earlier insurance as creditable coverage, and both SafetyWing plans exclude them. Disclose your history honestly: a claim refused later costs more than a higher premium.

Get Your Coverage in Place Before You Leave

The weeks before the move are the worst time to choose insurance under pressure. Give yourself two or three weeks before the visa appointment to get quotes and read certificates. To get international insurance quotes from several insurers at once, use the global quote tool. Before you buy, tick what the policy includes in the Health Insurance Checker: it tells you whether the certificate will clear the consulate’s list, and when your visa hands you over to the French system.