Your complete guide to the French healthcare system as an American. This section explains how France's two-tier public and complementary insurance system works, who qualifies for PUMa and when, how to register with your local CPAM office, what documents the process requires including the sworn French translation of your birth certificate, realistic timelines for rights confirmation and Carte Vitale delivery, and how to stay covered during the transition period before your CPAM registration is complete. We also cover finding English-speaking doctors and specialists, how the medecin traitant system works, understanding your reimbursement rates, choosing a mutuelle, and what to do if you need urgent or specialist care before your Carte Vitale arrives.
If you read one guide on this topic, make it How to Set Up Healthcare in France as an American: CPAM, PUMa & the Carte Vitale (2026).
Americans not employed in France wait three months of continuous residence before joining French healthcare. The Carte Vitale often takes months more.
Aurelio Maurici20 min read
Most American CPAM files are incomplete on first submission. CPAM does not tell you. From arrival to a provisional social security number: 6 to 9 months.
Aurelio Maurici26 min read
A French social security number starting with 7 or 8 is provisional. You are reimbursed as normal, but the Carte Vitale waits for the permanent number.
Aurelio Maurici17 min read
The CSM exempts anyone drawing US Social Security or a pension. You owe it only on capital income above €24,030, plus the 2026 visitor-visa contribution.
Aurelio Maurici18 min read
No. With CPAM, a €30 doctor visit leaves you €11, a hospital day costs €23, and two flat fees run up to €70 a year each. The real bill for Americans.
Aurelio Maurici26 min read
What the French ALD status is, which illnesses qualify, how the protocole de soins opens 100% coverage, and which costs stay with you, per Assurance Maladie.
Aurelio Maurici9 min read
How a French nursing home (EHPAD) bills its residents, which aid pays part of it (APA, ASH, housing allowance, tax reduction), and why Medicare pays nothing.
Aurelio Maurici11 min read
What TRICARE For Life and the VA Foreign Medical Program pay when a veteran or military retiree lives in France, why Part B must be kept, and how to file claims.
Aurelio Maurici9 min read
No. Medicare does not pay for care in France. Part A stays free, Part B costs $202.90 a month in 2026, and dropping it adds 10% per full year without it.
Aurelio Maurici17 min read
Why English-speaking residents in France use an insurance broker, what a courtier actually does, and how to choose a good one with confidence.
Aurelio Maurici15 min read
International plans average 3,500 to 3,600 euros a year, and US coverage is the big price lever. What qualifies for your visa and how to pay less.
Aurelio Maurici17 min read
CPAM covers roughly 70% of most healthcare costs. Here's what a mutuelle covers, what it costs in 2026, and whether Americans in France actually need one.
Aurelio Maurici18 min read
How to find a médecin traitant in France: Doctolib, shortage workarounds, CPTS referral, ameli.fr declaration, and English-speaking doctor options.
Aurelio Maurici20 min read
The French tools for the day you cannot decide for yourself: the mandat de protection future, advance directives and the trusted person, and what they do not settle for Americans.
Aurelio Maurici9 min read
No. The Assurance Maladie repays 60% of set fees: a 23 euro dental check-up leaves 9.20 euros. With a mutuelle, 100% Santé crowns and glasses cost nothing.
Aurelio Maurici17 min read
Moving to France on HRT? Why your US prescription cannot be filled, who can restart testosterone, and how ALD 31 covers transition care at 100 percent.
Maxime Roseau11 min read
French pharmacists advise clinically and handle minor problems without an appointment. How the ordonnance works, Carte Vitale reimbursement, and generics.
Aurelio Maurici16 min read
Controlled medications travel on you, with the original prescription. The letter to bring, the Adderall problem, and a checklist to keep your treatment going.
Aurelio Maurici19 min read
Mental health support in France is reimbursed once you are with CPAM. Up to 12 psychologist sessions a year cost 50 euros each, 60 percent covered.
Aurelio Maurici17 min read
Maternity care in France is covered at 100% from the sixth month, and you have five days to declare the birth. A baby of two Americans is not born French.
Aurelio Maurici17 min read
