Living Abroad

Healthcare in France for UK Nationals: PUMa, Carte Vitale, Mutuelle and the S1

3 min read

In this guide
  1. Quick answer
  2. How does the registration sequence work?
  3. What does a mutuelle do?
  4. How does the S1 work in France?
  5. Common mistakes
  6. FAQ
    1. Who do I contact with eligibility questions?
    2. Is state healthcare free?
    3. Does this guide cover other countries?
  7. Key takeaways
  8. Related guides
  9. Sources

How does healthcare work in France for UK nationals? GOV.UK says you must have health insurance cover to live in France. State healthcare is not free and you may pay part of the cost through co-payments. You can apply for PUMa (Protection Universelle Maladie) after at least 3 months’ residence, which gives you state healthcare on the same basis as a French citizen.

Quick answer

  • Insurance cover is required to live in France.
  • PUMa is available after at least 3 months’ residence.
  • Employees and self-employed people pay for PUMa through social security contributions.
  • Buy private health insurance while your registration is pending.
  • A mutuelle is optional top-up insurance.

How does the registration sequence work?

  1. If you are employed, your employer must start your PUMa registration through the employers’ online portal before you start work. Apply for your social security number at your local CPAM office as soon as you start work.
  2. After registering, you get a temporary social security number within 1 to 3 months.
  3. Next you receive an attestation de droits.
  4. You can then apply for the carte vitale, which can take 6 months or longer.
  5. Until you have it, use your social security number and a feuille de soins to claim refunds from CPAM.

What does a mutuelle do?

It is optional top-up insurance covering all or part of the costs the state does not.

Cover Role
PUMa State healthcare on the same basis as a French citizen, with co-payments
Mutuelle Optional top-up for costs the state does not cover
Private insurance Buy it while your registration is pending
S1 UK-funded cover, registered with CPAM. You still pay part of your costs

How does the S1 work in France?

You may qualify if you live in France and receive a UK State Pension or an exportable benefit. Request the form by phone from NHS Overseas Healthcare Services, then register it with your local CPAM office. This covers you and your dependants on the same basis as French citizens. Posted workers can use a GHIC, EHIC or S1, and students should apply for a Student GHIC.

Common mistakes

  • Arriving without health insurance. It is required.
  • Expecting the carte vitale quickly. It can take 6 months or longer.
  • Skipping the feuille de soins while waiting for the card.
  • Forgetting the mutuelle if you want top-up cover.

FAQ

Who do I contact with eligibility questions?

HMRC National Insurance enquiries, NHS Overseas Healthcare Services or your local CPAM office, according to GOV.UK.

Is state healthcare free?

No. You may pay part of the cost through co-payments.

Does this guide cover other countries?

See also Spain, Portugal and Italy.

Key takeaways

  • Health insurance is required; PUMa starts after 3 months.
  • Bridge the gap with private insurance.
  • The carte vitale can take 6 months or more.

Last updated: October 2026. This guide is general information, not medical or legal advice. Rules change, so check GOV.UK and CPAM.

Sources

  • GOV.UK: Healthcare for UK nationals living in France

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