Health insurance in France as an international student: what you actually need to do

Since 2019, French health insurance is automatic for most students. But there are steps you still need to take — and gaps you may need to fill.

The good news: France's healthcare system is among the world's best

France's health system consistently ranks first or second globally. As a student registered in France, you have access to it. The coverage is real: doctors, specialists, hospital stays, prescriptions, and emergency care are all reimbursed by the state — typically at 70% of the regulated fee for a doctor's visit, higher for hospital care.

The question is not *whether* you can access the system, but *how to register correctly* and *what gaps in coverage you might want to fill*.

How it works since 2019: automatic CPAM registration

Before September 2019, students in France had a separate student health insurance scheme (*Sécurité Sociale Étudiante*) run by mutual organisations (LMDE, SMENO, etc.). This system was abolished.

Today, students are integrated into the general social security system, managed by CPAM (*Caisse Primaire d'Assurance Maladie*). Registration with CPAM is:

• Free of cost for students under 28
• Automatic — you don't pay premiums
• Linked to your social security number (numéro de sécurité sociale, or NIR)

However, "automatic" does not mean you do nothing. You need to trigger the registration by submitting documents, and the timeline in France can be slow.

What to do when you arrive

Step 1: Register with CPAM

If you are under 28 and enrolled at a French higher education institution, go to ameli.fr and create your account. You'll need to submit:

• Your passport or ID
• Your student enrolment certificate (*certificat de scolarité*)
• Your visa or residence permit
• A completed registration form (available on ameli.fr)

If you have previously worked in France or already have a French social security number, the process is quicker. If this is your first time in France, it may take 4–12 weeks for your NIR to be assigned and your Carte Vitale (the green insurance card) to be issued.

Step 2: Get a temporary certificate

While waiting for your Carte Vitale, CPAM can issue a temporary attestation. Carry this with you to medical appointments.

Step 3: Choose a médecin traitant

To receive the maximum reimbursement (70% of fees), you should declare a primary care doctor (*médecin traitant*). This is done through your Carte Vitale or ameli.fr. Visits outside this pathway are reimbursed at a lower rate.

What CPAM covers and what it doesn't

CPAM reimburses 70% of the regulated fee for a general practitioner visit. In France in 2025, a standard consultation with a non-specialist costs €25–26.50 (the tarif conventionné). CPAM reimburses €16.50–18.55; you pay the remaining €6–8 directly.

For specialist visits, the reimbursement rate varies. For hospitalisation, CPAM covers a large portion but not everything.

The gap — the percentage not covered by CPAM — is the main reason most students, like most French residents, also have a mutuelle (complementary health insurance).

Mutuelle: do you need it?

A mutuelle tops up the 30% not covered by CPAM. For a healthy student in their 20s with no chronic conditions, the out-of-pocket costs without a mutuelle are manageable (a GP visit costs you around €7). For dental care, optical care (glasses/contacts), and any specialist or hospital visits, the gap can become significant.

Your university may offer a group mutuelle contract at a reduced rate — check with your student services office. Companies like LMDE (now part of Harmonie Mutuelle), HEYME, and April offer student-specific policies for approximately €10–30/month.

EU students who already have European Health Insurance Card (EHIC) coverage may have adequate protection for the first year without purchasing an additional mutuelle — verify this with your home country's insurer.

Non-EU students: private insurance for the visa

When applying for your French student visa, you'll need to show proof of health insurance coverage for the visa application. Your CPAM registration is not yet in place at this point (you haven't arrived yet), so you'll typically provide a private insurance policy valid from your departure date.

Policies from Ornikar, ACS, or your university's partner insurer are commonly used. Once you've registered with CPAM and have your Carte Vitale, this private policy can lapse — you're covered by CPAM going forward.

Emergency situations

France has a national emergency number: 15 for medical emergencies (*SAMU*), 18 for fire, 17 for police. The unified European emergency number 112 also works.

Hospital emergency departments (*urgences*) are open 24/7. Treatment will not be withheld for lack of a Carte Vitale — you can settle payment arrangements after the fact if needed.

The French healthcare system rewards patience (doctors' appointments can have waiting times of several weeks for specialists) and punishes emergencies that could have been treated earlier. Registering with a médecin traitant early is the practical advice here — having a doctor who knows you makes accessing the system dramatically easier.

For city-specific cost breakdowns — including how much to budget for healthcare alongside rent and transport — see our city guides or run the numbers in our budget planner.