France is known for having one of the best healthcare systems in the world. However, many people are surprised to learn that public healthcare in France usually does not cover the full cost of medical treatment.
Instead, the French system works in two parts. The public healthcare system reimburses part of your medical expenses, and many people take out additional insurance called a mutuelle to cover the remaining costs.
If you’re living in France or planning to move, understanding how health insurance works is important. This guide explains how the French health insurance system works, what a mutuelle is, how much it costs, and whether you need one.
How health insurance works in France
Health insurance in France works differently from many other countries. While the public healthcare system covers a large portion of medical costs, it usually does not pay for everything. Instead, patients are typically reimbursed for part of their medical expenses, and many residents choose additional insurance called a mutuelle to cover the remaining costs.
The French healthcare system is based on a shared cost model.
Most medical expenses are partly reimbursed by the public healthcare system, known as Assurance Maladie.
For example:
- A standard doctor visit costs €25
- The public system reimburses about €16.50
- The remaining €8.50 is usually paid by the patient or covered by a mutuelle
This means that even though healthcare is affordable, patients are still responsible for part of the cost.
Because of this, many residents take out complementary insurance to cover the remaining amount.
To understand this system in more detail, you can also read our guide on how the French healthcare system works.
What is a mutuelle?
A mutuelle is complementary health insurance that covers medical costs not reimbursed by the public healthcare system.
It is sometimes described as top-up health insurance.
Mutuelle policies typically cover:
- the remaining cost of doctor visits
- hospital fees
- dental treatment
- glasses and optical care
- specialist consultations
Many people in France have a mutuelle because the public healthcare system rarely covers 100% of medical costs.
Is a mutuelle mandatory in France?
A mutuelle is not always mandatory, but it depends on your situation.
Employees
Most employees in France receive company health insurance.
Employers are legally required to:
- offer a mutuelle
- pay at least 50% of the monthly cost
Employees can usually choose to include their family members as well.
Self-employed workers
Self-employed workers must choose their own mutuelle.
There are many providers offering different levels of coverage depending on your needs.
Retirees or unemployed residents
People who are retired or not working can also choose a private mutuelle to complement the public healthcare system.
What does a mutuelle cover?
Coverage depends on the specific policy, but most mutuelles reimburse the part of healthcare costs not covered by the public system.
Common areas of coverage include:
Doctor visits
The mutuelle often covers the remaining portion after public reimbursement.
Hospital stays
Hospital coverage may include:
- additional fees
- private rooms
- specialist charges
Dental care
Dental treatment is one of the areas where the public healthcare system reimburses less, so mutuelles often provide additional coverage.
Optical care
Glasses and contact lenses are also commonly included in mutuelle policies.
Specialist appointments
Some specialists charge higher consultation fees, which a mutuelle may partly reimburse.
How much does a mutuelle cost?
The cost of a mutuelle depends on several factors, including:
- your age
- the level of coverage
- whether you include family members
- dental and optical options
Typical prices are approximately:
| Profile | Monthly cost |
|---|---|
| Young adult | €20 – €40 |
| Adult | €40 – €80 |
| Family | €80 – €150 |
Higher levels of coverage usually mean higher monthly premiums.
Do you need a mutuelle in France?
Technically, you can live in France without a mutuelle.
However, many residents choose to have one because the public healthcare system rarely covers all medical costs.
Without a mutuelle you may need to pay:
- the remaining portion of doctor visits
- hospital extras
- dental treatment
- glasses or specialist care
For this reason, a large majority of residents in France choose complementary health insurance.
How to choose a mutuelle
When choosing a mutuelle, it’s important to compare several factors.
Look at:
- reimbursement levels
- dental coverage
- optical coverage
- monthly cost
- waiting periods
- exclusions
Different providers offer different levels of coverage, so comparing policies can help you find one that matches your needs and budget.
Health insurance support for low-income households
Some residents with lower income may qualify for financial support that helps reduce healthcare costs.
In certain situations, assistance may be available alongside other social benefits.
You can learn more about these types of support in our guide explaining how family benefits (CAF) work in France.
FAQ
Is healthcare free in France?
Healthcare in France is not completely free. The public healthcare system reimburses a large part of medical costs, but patients often pay a remaining portion unless they have complementary insurance.
Do foreigners need health insurance in France?
Foreign residents usually gain access to the public healthcare system once registered. However, many people also choose a mutuelle to cover the part of costs not reimbursed by the public system.
How much does health insurance cost in France?
Mutuelle insurance typically costs between €20 and €100 per month, depending on the level of coverage and the policyholder’s age.
Can you live in France without a mutuelle?
Yes, it is possible to live in France without a mutuelle. However, you will need to pay the part of medical expenses not covered by the public healthcare system.
If you are registering with the French healthcare system or a mutuelle for the first time, you may find the following guides useful: