Healthcare — Sécurité sociale and the mutuelle Supplement

France's public health coverage is run through the health branch of Sécurité sociale (Assurance maladie). Since the 2016 introduction of PUMa (Protection universelle maladie), anyone with stable, regular residence in France (résidence stable et régulière) and lawful status can access health coverage regardless of occupation or income. Two things stand out compared with Korea's National Health Insurance. First, patients usually pay first and are reimbursed afterwards (when tiers payant applies the deduction is immediate). Second, public reimbursement is typically around 70%, which is why taking out a mutuelle (supplementary health insurance) is effectively standard.

Core mechanics:

• CPAM registration and NIR issuance — once your residence is recognised as stable (typically by showing 3+ months of regular residence), you register with CPAM (Caisse primaire d'assurance maladie). The social security number (NIR) issued to you links not only health but also family allowances, pensions, and every other branch.
• Carte Vitale — the green chip card that connects your treatment record and reimbursement information so pharmacies and clinics can settle on the spot.
• Designating a médecin traitant — registering a primary-care doctor (médecin traitant) is required for normal reimbursement rates. Going straight to a specialist without a referral cuts your reimbursement under the parcours de soins coordonnés rules.
• Typical reimbursement structure — for GP visits, treatments, and medication, after public reimbursement a patient share (ticket modérateur) remains, which the mutuelle covers. Hospitalisation, severe conditions, and chronic diseases recognised as ALD (affection de longue durée) often attract higher rates or 100% coverage.
• CSS (Complémentaire santé solidaire) — a scheme that lets low-income people receive supplementary coverage with no or very low contributions, assessed against income and household composition.
• EHIC (European Health Insurance Card) — useful for short visits from EU/EEA/Switzerland for emergency or necessary care. After settling in France, switch from EHIC to PUMa rather than relying on the card for ongoing treatment.
• EU social-security totalisation — under Regulation 883/2004, contribution periods in EU/EEA/Switzerland are automatically counted toward French eligibility.

Common pitfalls for newcomers:

• PUMa eligibility and a mutuelle are separate. Public coverage alone leaves a meaningful out-of-pocket share, so sort out either an employer group mutuelle (which is effectively mandatory once you start a job) or an individual mutuelle early.
• Reimbursement rates on prescription drugs depend on the SMR classification. Drugs are reimbursed at 100%, 65%, 30%, or 15%, and what your mutuelle tops up varies by policy.
• Dental, vision, and hearing aids historically came with high out-of-pocket costs, but the "100% santé" reform now offers no-out-of-pocket options for some products. Check the policy details.
• Travel insurance brought from Korea is for short stays only. Once you settle in, the standard route is to switch to PUMa plus a mutuelle.
• ALD (long-term illness) registration is requested through your doctor; once recognised, reimbursement rates for treatment of that condition rise substantially.

Official guidance: ameli.fr, service-public.fr — santé