The French health care system

Average Social Security refund: 70% - Average top-up health insurance refund:30%

How the French healthcare system works and registration


In France, an average of 70% of health care is covered by Social Security.

It is compulsory and free for students to register with Social Security, including foreign students.
There are certain particular cases, especially for students from the EU or the EEA who can show a European Health Insurance Card to be exempt from registration.


REGISTRATION to the Social Security (2018-2019)

  • CASE 1. New foreign students:

     If you're coming to France for the first time and you're starting a course in September 2018, from the 1st of September you must register on the website:
You must register after you have paid the "Vie étudiante" subscription to the Crous (regional student support offices) and after you have enrolled in the higher education establishment.

Step 1 . Pay the "Vie étudiante" subscription to the CROUSStep 2 . Enrol in the higher education establishment Step 3 . Register with Social Security for free at


  • CASE 2. Foreign students continuing their studies:

     If you already registered with Social Security in 2017-2018 with a student insurance company or a CPAM and you are extending your studies in 2018-2019, there is nothing else you need to do.
Your Social Security cover will be extended automatically and free of charge wherever you are studying.
You just have to update your Vitale card at a Vittavi branch or with a health care professional at the beginning of the academic year.



Carte Vitale AttestationThe Vitale card


Once you've registered with Social Security, you'll receive a form which you must send back to receive your Vitale card. The Vitale card makes the process simpler for you. Show it to any health care professional for faster refunds.
While you're waiting to receive it, use the paper certificate which can be downloaded at if you already registered with Vittavi last year).



How to get a refund?


The health care professional may let you benefit from the third-party payer system: you are exempt from paying upfront for your treatment. He or she is then directly reimbursed by Social Security.
If you do have to pay upfront for your treatment, there are two options:

  • You use the Vitale card and you will be automatically refunded with no need for you to do anything further.
  • Feuille de soinsYou don't use the Vitale card. The health care professional will give you a treatment certificate which you must send to your Social Security centre in order to get a refund.



The GP


You can choose your GP in France. However, you must declare your GP to your Social Security centre in order to be fully refunded by Social Security.
You must also consult him or her before seeing a specialist. This is called the coordinated health care process.



Example of refund (in Metropolitan France)

Example of Social Security refund for GP consultation
GP consultation: €25 (statutory rate) €25
Basis of the mandatory health insurance refund (BR) €25
Social Security payment : 70% €17,50
70% of €25 = €17.50 (or €7.50 if GP not declared)

Remainder to be paid - Sums not refunded by Social Security.

€25 - €17.50 = €7.50
This remainder may be refunded by top-up health care insurance.

Please note: the insured must still pay a €1 flat-rate contribution to the Social Security part (GP declared or undeclared).


Taking out top-up health insurance is therefore optional but strongly recommended in the French health care system. It lowers the amount owed after Social Security refunds which can be high depending on the type of treatment.
Check out our top-up health insurance offers >



Useful contacts

Crous :

Vittavi :


Useful words  

translated in french

  • Coordinated health care process: Parcours de soins coordonnés
  • GP: Médecin généraliste, appelé médecin traitant lorsqu'il est déclaré
  • Insurance: Assurance
  • MS, mandatory scheme: RO, Régime obligatoire
  • Social Security: Sécurité sociale
  • Top-up health insurance: Complémentaire santé
  • TV, therapeutic value: SMR, Service médical rendu
  • Vital card: Carte Vitale