Sécurité sociale and PUMa
Anyone who works in France, or lives in France in a stable and regular way, is covered for health costs under the Protection universelle maladie (PUMa). If you do not work in France, rights generally open after three months of residence. Nationals of countries outside the European Economic Area and Switzerland also need a valid residence permit. Once registered with Assurance Maladie, you receive a social security number and, in time, a carte Vitale.
The public system reimburses only part of the cost of care. The rest, together with any extra fees charged by some doctors (dépassements d'honoraires), is yours to pay unless you have additional cover.
Complémentaire santé (top-up health insurance)
A complémentaire santé, often called a mutuelle, pays some or all of what Assurance Maladie does not. Many private-sector employees join their employer's group plan. If you are self-employed, retired or between jobs, you choose one yourself. The useful comparison is not the monthly premium alone but the cover for hospital stays, dental care, glasses and lenses, and specialist fees.
The CFE, if you keep French cover while abroad
If you leave France, the Caisse des Français de l'étranger (CFE) is a voluntary scheme that provides cover modelled on the French Sécurité sociale while you live abroad. It can be used alone or combined with a private policy that pays on top of it. Joining before you leave, or within three months of settling abroad, avoids a waiting period.
International health insurance
Private international health policies cover care from the first euro, worldwide or in the zones you select, and usually include medical repatriation. They suit people who move between countries or whose home-country cover stops when they leave. Before signing, compare the geographical zone, the annual ceilings, the waiting periods and the exclusions, especially for pre-existing conditions.