French health medical system

To obtain access to the French health system, residents without an "E" certificate have choice between :

      - insure a TOTAL private medical policy (called 1st Euro coverage to provide basic + additional cover)

      - paying 9% of total incomes to CPAM and getting a Carte Vitale to obtain access like "E" residents


Whereas Residents having an E121 certificate have automatic access to the basic health system (CPAM).

CPAM refunds around 70% of usual medical expenses and largely less for dental, eyes and strong  hospitalisation ...

Then, additional medical cover is advisable.

Basic complimentary medical insurance policies will only refund a part of the cost not covered by the French system.

Some French medical insurance providers like Aviva will refund almost all your medical costs at the hospital, even the most expensive operations.


Residents having an "E" certificate or those paying 9% get a Carte Vitale.

This card contains no medical information but only administrative details.
It is imperative to retain the paper "Attestation Vitale" and show it to each professional : in many situations you will not need to send the CPAM document called «Feuille de soins» because the card gives exemption in advance.
It is the third part payment " Tiers payant ".

Carte Vitale has no deadline but it must be upgraded (mise à jour) after each important change in your life : wedding, move, maternity, long-term illness ...

Advice : 

* choose a referring doctor (GP), if not CPAM will keep an excess on each refund.

* Before dealing with a specialist or surgeon, remember to ask if he plans to charge some extras over CPAM's refund.  He must tell you if he has signed the "CAS" or "OPTAM" contract which allows French top up to refund largely more than 200% ! ( "CAS " means Contrat d'Accès aux Soins ).


* Changing your Health insurer is as easy as changing your Car or House insurance : no medical questions.