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Gracie Bialecki in France: How to sign up for health insurance

For the first year after I arrived in France, every time I went to the pharmacy or doctor, they’d ask for my carte vitale. This is the health insurance card every French person has which allows them to be reimbursed for medical expenses, and each time I politely explained I didn’t have one, the person checking me out would be shocked. To be paying out of pocket for my medical costs was unheard of, even though they were fractions of what I was used to in the U.S.

It took me longer than it could’ve to realize I also qualified for medical insurance or assurance maladie. After going through the process, the first document I received was a temporary social security number or numéro provisoire. If you’re in France on a carte de séjour visiteur, this is the only number you’ll be assigned. However, if you are here on a visa talent or visa vie privée, you’ll be eligible for a permanent social security number, as well as a carte vitale.

Who Qualifies?

Anyone living in France in a “stable and regular manner” qualifies to be covered by France’s healthcare system. This means you do not have to be born in France, married in France, or even working in France to register. However, it means you do have to have spent at least three months in the country and have a valid titre de séjour.

How do I Register?

To register you need to send copies of the following documents to the closest health insurance office. You can look up which one that is here.

Required Documents:

  • National Identity Card or passport or residence permit, as well as any documentation of your civil status.
  • Extract of birth certificate with filiation or full copy of birth certificate
  • Completed “Demande d’ouverture des droits d’assurance maladie.” (The second page of the form also lists the necessary documents to include.)

In my case, I sent copies of my passport and current titre de séjour, as well as the récépissé of my PACS — all documents which showed I was a ‘permanent’ resident in France. I also included a long form copy of my birth certificate which had an apostille and had been translated into French, as well as a letter d’hébergement saying I lived with Fred. Luckily, I was doing this process soon after being PACSed and had all these documents on hand. Proving you live in France usually all boils down to the same set.

My new card finally arriving!

Why is it Taking so Long?

The Short Answer: Assurance Maladie is a single government health agency which serves the entire country of France. Unsurprisingly, it can take them a long time to process documents, especially since you’re required to mail in your application.

The Long Answer: There are many reasons why an application can be deemed incomplete –– perhaps you sent an abbreviated version of your birth certificate, perhaps you forgot to sign a certain form, perhaps your dossier is inexplicably missing. This was the case for my first attempt, and after waiting three months and without a word from the health insurance office, I went back and discovered they had no record of my ever having filed for a numéro provisoire.

Tip: Whenever possible, try to keep track of who you’re speaking to, their name and contact info, and any trace that could be helpful in tracking down your file. In my case, I simply resubmitted everything and waited a few more months. As you can see, it’s always worth it to follow up and be on top of these processes.

Bonus Question: What’s the difference between a temporary and permanent number?

Your temporary number allows you to be reimbursed for expenses, assuming to keep the form the doctor or pharmacy fills out, as well as any prescriptions, and mail them to assurance maladie. The reimbursement is done directly to your French bank account on file, though the entire process can take up to a month.

With a permanent number, you qualify for a carte vitale which acts as a debit card and means the French government is paying the up front costs, or at least the percentage of costs covered by the health care system.  You can create an online account on Ameli (the French government’s healthcare site) which means you no longer have to mail completed forms and proof of doctor visits to be reimbursed. That said, as I’ll talk about in a future article, being reimbursed doesn’t mean that one hundred percent of the costs are covered.

If, like me, and you’ve assumed that you don’t qualify for healthcare because you’re not French, I hope this article is helpful. As you can see, the process of applying is relatively straightforward and worth it from a financial sense and for the mental relief of being “covered.”

This article originally appeared on The American in Paris blog. It’s reposted here with permission.

See more from Gracie here in Dispatches archives.

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Gracie Bialecki is a writer and literary coach based in Paris, France. Her work has appeared in various publications, including Catapult and Epiphany Magazine where she was a monthly columnist. Bialecki is co-founder of Thirst, a gallery and storytelling series; a poetry editor at Paris Lit Up; and the author of the novel Purple Gold (ANTIBOOKCLUB).

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