How are health expenses covered for foreign students in France?

Can foreign students be reimbursed for their health expenses incurred in France?

Are European students covered by French French Health Insurance?

Students who are nationals of one of the countries of the European Union (EU) or the European Economic Area (EEA) can be covered by French French Health Insurance. To do so, they simply need to request a European Health Insurance Card (EHIC) from the French Health Insurance organization in their country of origin. There is no other step to take.

If you come from the European Union or the European Economic Area, but you were not able to obtain your European Health Insurance Card, you will have to apply for membership on the etudiant-etranger.ameli.fr website, as for non-European foreign students. You will not need to send a residence permit. However, you will be asked to provide the form of entitlement issued by the French Health Insurance organization in your country of residence (form S1).

Can foreign students from outside Europe be covered by French Health Insurance?

Yes, foreign students from outside the European Union (EU) or the European Economic Area (EEA) or from Switzerland can be covered by French Health Insurance. To do so, they must apply for affiliation to the French French Health Insurance system. This application can be made on the website etudiant-etranger.ameli.fr

To apply for affiliation to the French French Health Insurance system, you will be asked to provide the following documents

• Your national identity card or passport
• Your residence permit
• A certificate of schooling for the current year
• A proof of income
• If you are a student under 16 years old: a parental authorization certificate
• An IBAN for the reimbursement of your health expenses
• A civil status document to create your French Health Insurance number. The accepted documents are :
  • A complete copy of your birth certificate
  • An extract of the birth certificate with filiation
  • A family record book
  • Or a marriage certificate

You will then receive a French Health Insurance number and a provisional attestation. As soon as you receive your provisional number, you will be covered by French Health Insurance.

Once your registration is validated, you will be able to download the definitive French Health Insurance affiliation certificate (attestation of rights). With your definitive number, you will be able to connect to your Ameli space.

In your Ameli space, you can consult the reimbursements of your health expenses and carry out the main steps towards the French Insurance Fund.

Exceptions: some foreign students do not need to apply for French Health Insurance

The case of Quebec students

Students from Quebec do not need to register with French Health Insurance because there is a reciprocal agreement between the Régie d'Assurance Maladie du Québec (RAMQ) and the Caisse Primaire d'Assurance Maladie. The student only needs to present the form SE 401-Q-102 vis or SE 401-Q-106 when he/she makes a medical expense to the French Health Insurance Fund of his/her department of residence.

The case of foreign students who receive a grant from the French government

Students who receive a government grant are automatically affiliated to the student French Health Insurance system. They do not have to do anything.

The case of students covered by their parents' French Health Insurance system

Students who are covered by the French Health Insurance system of one of their parents who is an international civil servant or member of an international organization do not need to register on the etudiant-etranger.ameli.fr website.

Do foreign students have to declare a primary care physician?

Yes, like all French, foreign students in France must declare an primary care physician if they want to benefit from good coverage by the Health Insurance..

The attending physician is the patient's referring physician: he/she is the one who will follow up on his/her health. He has the patient's medical history in mind and can refer him to a specialist if necessary.

As for all the insured persons of the health insurance, foreign students must declare an attending physician, otherwise the reimbursement of their consultation, whether it is with a general practitioner or a specialist, will be less well reimbursed.

• If you have a general practitioner or a specialist, you will be reimbursed for 70% of the basic rate
• If you do not have a regular doctor, you are not following the health care pathway. Your consultation will be reimbursed at 30% of the basic rate

Generally, referring doctors are general practitioners.

How can I find a referring doctor for my university stay in France?

A doctor is not obliged to accept to become your attending physician. In fact, finding a treating physician can be difficult: a study by UFC Que Choisir magazine showed in 2019 that nearly one out of two general practitioners refuses to act as a treating physician for new patients.

To find a GP quickly, we recommend that you approach your university health center.

If, despite your best efforts, you are unable to find an attending physician, you can contact the Health Center of your University who will help you with the process.

Once you have found a doctor who agrees to become your attending physician, you must fill out the "declaration of attending physician" form with him/her. This declaration can also be made online, during a consultation.

International students: many universities in France require international health insurance

In France, many universities require non-EU students to get, before their departure and international health insurance. The purpose of international health insurance is to cover emergency medical expenses for students during their stay in France.

This type of health insurance generally offers

• Full hospitalization coverage: the cost of the stay is reimbursed at 100% of the actual cost
• Coverage of medical, dental and optical expenses at 100% of actual costs, but with an annual ceiling of between 200€ and 2000€ depending on the type of expense
• These international health insurance plans offer extensive repatriation assistance, as well as civil liability insurance

Is it necessary to join the French Social Security System if you already have an international health insurance ?

One might think that joining the Social Security is unnecessary for those who already have international health insurance.

However, we recommend that non-European students apply for Social Security for several reasons

1. Membership in Social Security is free and foreigners who are affiliated with the French Social Security system receive a discount on the price of their international health insurance. For example, a student born in the United States in 2002 and coming to study in France for the 2022 - 2023 school year (from September 1 to June 30) will pay 490€ for health insurance if he or she is not affiliated with the French Social Security. If the student is affiliated with Social Security, the same health insurance will cost 360€, a price reduction of 130€.
2. Social security and international health insurance are complementary:
   • International health insurance reimburses hospitalization expenses very well and offers significant assistance, which allows the student to be repatriated in case of a serious event. On the other hand, there is a ceiling on reimbursements for routine medical, optical and dental expenses, and these ceilings can be reached quickly.
   • Social security reimburses medical expenses: consultations are covered at 70% of the basic rate. Another advantage: Social Security reimbursements are not capped.

How much does it cost to pay for health care in France for foreign students?

What is the coverage of health expenses by the French Health Insurance for foreign students?

Once registered with French Health Insurance, foreign students benefit from the same coverage of their health expenses as French students.

In France, the coverage of health care expenses by French Health Insurance is high: 78% of health care expenses are covered by French Health Insurance.

However, this coverage is far from uniform: some expenses such as hospital care are very well covered by French Health Insurance. On the other hand, certain equipment such as glasses or dental prostheses are not well covered by French Health Insurance. It is also important to know that French Health Insurance never reimburses medical extra fees.

How much do students have to pay for health care in France?

Here are the remaining costs for different health care expenses in France for a foreign student affiliated to the general health insurance system and consulting health care professionals who do not charge extra fees (sector 1):

These examples are valid for a patient who does not consult a doctor in the case of a Long Term Disability (ALD). The medical deductible and the fixed contribution have been integrated into the reimbursements.

We observe that the remaining out-of-pocket expenses are high in France for :

• optical expenses, because the basic Social Security rate is very low (2.84€ for a frame, for example) and has nothing to do with the rates charged by opticians
• Hospitalization expenses, which are well covered by the Social Security in proportion (80%) but as the amounts involved are significant (often several thousand euros) the remaining cost is important for the patient
• consultations in natural medicine (psychologist, osteopath, etiopath...) which are not covered by Social Security

Moreover, all these rates apply to sector 1 doctors, i.e. those who do not charge extra fees. However, in the big cities, in the south and in the east of France, there are many doctors who charge more than the standard fee.

What expenses are reimbursed by Social Security for foreign students?

Social Security reimburses a significant portion of the following health expenses:

• Consultation with a health professional: general practitioner, specialist, paramedic
• Laboratory tests and examinations
• Hospitalization expenses: room and board, medical fees
• Medication with a high or major medical service rendered

On the other hand, Social Security does not reimburse the following expenses:

• Glasses
• Dental prostheses
• Hearing aids
• Drugs with low medical value
• Vaccines

Social Security does not reimburse the following expenses:

• Medical excess fees
• Many drugs and vaccines are not covered by Social Security
• Hospital comfort expenses: private room, comfort expenses, accompaniment expenses
• The daily fee in case of hospitalization (20€ per day), the medical deductible and the fixed contribution are not covered by Social Security

How much does it cost to join the Social Security system for foreign students in France?

Affiliation to Social Security is free for all. Since September 2018, students no longer have to pay an annual Social Security fee of 217€. On the contrary to French Student, they don't have to pay for the Student Life and Campus Contribution.

Student social security no longer exists: students are now affiliated with the general social security system.

How can students reduce their out-of-pocket expenses?

To reduce their out-of-pocket expenses, students can subscribe to a private health insurance.

This health insurance will complete the reimbursements of the Social Security and will allow you to have access to the 100% health basket: glasses, dental prostheses and hearing aids proposed without any remaining expenses for the patient.

Some mutual insurance companies also reimburse consultations in natural medicine: acupuncture, chiropractor, dietician, naturopath, osteopath, psychologist.

All "responsible" health insurance companies must now cover consultations with psychologists in the MonPsy program (up to 4 consultations per year at a cost of €60 per session).

Do you want to subscribe to a private health insurance?

1. Our guide to choosing between a hospitalization contract and a responsible contract
2. Everything you need to know to save on your complementary health insurance
3. Our comparison tool to find the best contract
4. Do you have a question that has not been answered in our article? Do you need help? Book an interview with us!

Do foreign students have to subscribe to a private health insurance in France?

It is not mandatory for foreign students to subscribe to a mutual health insurance. However, we recommend that you subscribe to a complementary health insurance plan to reduce your out-of-pocket expenses, which can be very high if you consult doctors who charge extra fees or are hospitalized.

Foreign student: how to choose a health insurance plan?

You should know that a complementary health insurance contract lasts for one year. It is not possible to cancel a complementary health insurance before this period of one year. It is therefore only recommended that you subscribe to a health insurance plan if you are going to spend at least one full academic year in France.

The price of the health insurance depends on the guarantees subscribed to. The more important your mutual insurance company will reimburse, the more expensive it will be. As a general rule, the amount of reimbursements is expressed as a percentage of the basic Social Security rate and includes Social Security reimbursements.

If a physician belongs to the sector 1 it means he can't charge any extra fees. If he belongs to the sector 2, it means he can charge extra fees

If your mutual insurance company displays a 100% cover of the cost of consultations with a specialist, if you go to see a sector 1 dermatologist for regular follow-up, the consultation will cost 30€ and will be covered as follows

• the Social Security reimburses 70% of the consultation - the moderating fee (1€) is 20€.
• the mutual health insurance company will reimburse 30% of the cost of the consultation, i.e. 9€.

With this type of contract you will only have to pay the moderating fee (1€).

Most health insurance contracts reimburse extra medical fees: thus, if you subscribe to a contract that covers consultations up to 150% of the basic rate, you will not have to pay anything if you consult a sector 2 doctor who charges rates equal to 1.5 times the basic rate.

In France, the price of a health insurance also depends on

• age : the price increases with age, so young people pay less for their complementary health insurance than older people
• where you live : health insurance is cheaper in the west of France and more expensive in the south and east

How much does a health insurance plan cost for a foreign student?

Here are the prices of the health insurance companies for a student born in 2022 and living in Rouen (76). If you wish to consult the prices of complementary health insurance and subscribe online, you can access our comparator here:

Compare prices of private health insurances