Health insurance when moving to France: the checkpoints

France has statutory health insurance (Assurance Maladie) with local funds (Caisse primaire d’assurance maladie, CPAM); the Protection universelle maladie (PUMa, universal health coverage) covers every person who works in France or lives there on a stable and lawful basis.

The fund does not reimburse everything: a share (ticket modérateur, co-payment), flat-rate contributions per doctor contact and annual deductibles (franchises) remain with the insured person.

From age 16 you register a GP (médecin traitant) with your fund, with the GP’s consent; without registration or outside the coordinated care pathway, the co-payment can be higher, with exceptions such as emergencies.

In principle, the state where you work is responsible for health insurance, otherwise your state of residence.

Anyone who works in France is covered there from the first hour of work, with no waiting period; you arrange the affiliation with the CPAM yourself, despite the employer’s notification.

Anyone who does not work in France can receive the PUMa on the basis of a stable and lawful residence; newcomers must prove that they have lived in France continuously for more than three months.

According to CLEISS, economically inactive Union citizens who are not covered by the statutory system of their country of origin do not automatically receive the PUMa: access exists with a right of permanent residence, before that the fund examines the individual case. How the fund handles this in your case, you clarify before the move directly with the CPAM of your future place of residence.

Since the end of 2025, the law provides for a contribution from some economically inactive people resident in France (Art. L160-1-1); whether it applies to you, you clarify with the CPAM before the move.

For stays of more than three months, the law requires sufficient funds and health insurance from economically inactive people, enrolment, health insurance and funds from students, and the activity from people in work; for up to three months, what applies to entry is sufficient.

Union citizens do not need a residence permit in France; a residence card can be applied for voluntarily.

The health insurance required for the right of residence must cover the benefits under Articles L160-8, L160-9 and L321-1 of the Code de la sécurité sociale; according to a ministry circular of 2011, private cover from France or abroad is also sufficient if the benefit package is comparable.

Whether a private policy replaces the affiliation with the statutory fund, you clarify with the CPAM; the sources we read say nothing on this. More on the policy under international health insurance.

Before you deregister (Abmeldung) in Germany, you clarify in writing what happens to your current insurance. The questions below apply to any destination country. They are questions, not legal advice: the answers are in your contract documents or come from the body you ask.

Three France topics you clarify in advance with your Krankenkasse (German health insurance fund): the EHIC, a possible S1 (form for the entitlement in the new country of residence) and what applies after your Abmeldung (deregistration) in Germany.

If you have statutory insurance: questions for your Krankenkasse

• What happens to my membership when I deregister in Germany, and on what date does it end?
• Can I suspend the membership or take it up again later, and under what conditions?
• What confirmation of my previous insurance periods do I receive, and how quickly?
• What applies to co-insured family members: who stays insured and who does not?
• Is an S1 an option for me, and who issues it?
• Until when is my EHIC valid, and does it cover my planned stay?

If you have private insurance: questions for your insurer

• Does my contract end with the move, is it suspended or does it continue?
• Is there an Anwartschaft (a German option to keep certain rights in private insurance while abroad), and what is preserved under it? Ask about the difference between the small and the large Anwartschaft, and whether a new health assessment would be needed on a return.
• Does my contract apply in the destination country, and for how long at a stretch?
• Which documents do I receive in writing before I cancel?
• Does the policy apply in France for the whole length of stay?
• Does the insurer confirm scope of cover, area and term in writing?

Do not cancel any contract before it is clarified in writing what applies afterwards. We explain the connections on the pages Health insurance when emigrating and PKV and Anwartschaft. For families, there is more at Health insurance for the family abroad.

1. The EHIC as a permanent solution

   The EHIC applies only to a temporary stay. Ask your health insurer (Krankenkasse) about the route for a change of residence.

2. Expecting everything after three months

   According to CLEISS, economically inactive Union citizens who are not covered by the statutory system of their country of origin do not automatically receive the PUMa: access exists with a right of permanent residence, before that the fund examines the individual case. Clarify your cover before the move.

3. Retiring without an S1

   Pensioners from an EU state who live in France apply for the S1 document with the pension institution and use it to register with the CPAM of their place of residence; France bears the benefits in kind on behalf of the pension state. Ask your fund about the document beforehand.

4. Not covering the study period

   Students from the EU are treated in France as temporary residents and remain in the system of their country of origin; with the EHIC, which must be valid until the end of the academic year, necessary benefits are reimbursed as for French-insured people.

5. Cancelling the policy before clarification

   Do not cancel an existing contract before it is clarified in writing what applies afterwards and what the French authorities recognise.