Moving abroad is an exciting adventure, but it’s important to be well prepared, especially when it comes to your health. Medical coverage varies considerably from country to country. Unlike France, where social security covers a large proportion of medical expenses, many countries offer minimal or no coverage at all. To protect yourself against the sometimes exorbitant cost of healthcare abroad, it’s essential to take out expatriate health insurance.
Please note: This article focuses specifically onhealth insurance abroad. For information on home or car insurance, please consult other resources.
Expatriate insurance: compulsory or optional?
Before you leave to live abroad, you’re probably wondering whether it’s compulsory to take out health insurance. From the French point of view, the answer is no. However, once you’ve settled in your new country of residence or employment, you’ll generally have to join the local social security scheme, as will your family if they come with you. This means you lose your French social security rights, unless you join the Caisse des Français de l’Étranger (CFE).
In some countries, such as China, membership of the local health insurance system may be compulsory, but this varies according to status (student, employee, pensioner). Be sure to check the legal requirements of your host country before you leave. In other countries, an international health insurance certificate may be required on arrival. Good preparation will help you avoid administrative complications.
Option 1: Local health insurance
As soon as you start working abroad, you are subject to the host country’s social security system. However, local healthcare systems do not always guarantee satisfactory coverage. In France, we benefit from a system where social security, supplemented by a mutuelle, ensures access to quality care at lower cost. Abroad, the situation can be very different, and medical costs can soar.
For example, in the United States, where there is no universal public social security, a simple consultation cost an average of $120 in 2024, and an appendectomy can exceed $40,000. In other countries, although public systems are in place, they may offer limited benefits, accompanied by long waiting times or restricted access to quality care.
Before you leave, it’s essential to check the health care system in your host country, as well as the costs of care and insurance available locally. You should also check with your employer to find out whether he or she will cover all or part of your health insurance for you and your family. Careful preparation will enable you to anticipate and minimize the often unforeseen costs of healthcare abroad.
Option 2: Insure with a French company
If taking out insurance in your host country is not an option for you, there are other solutions.
EHIC (for EU member states)
The European Health Insurance Card(EHIC) is only valid for temporary stays in the European Union, Iceland, Norway, Switzerland or Liechtenstein. It entitles you to the same treatment in these countries as local residents. However, it does not cover repatriation for medical reasons, nor does it cover excess medical expenses incurred locally. For long-term expatriation or expatriation outside the EU, the EHIC is not suitable. French expatriates should turn to international health insurance solutions for comprehensive coverage.
Please note: the EHIC is only valid for temporary stays, does not cover repatriation and reimburses only up to the level of the French scheme. As a result, you’ll have to pay out-of-pocket for any additional expenses.
Before you leave, remember to ask your Caisse for form E104, also known as the “attestation concernant la totalisation des périodes d’assurance, d’emploi ou de résidence”. This certificate entitles you to benefits (in the host country) in the event of illness, maternity or death.
CFE (Caisse des Français à l’étranger)
The Caisse des Français à l’étranger (CFE) is not a public body, but a private institution under the supervision of the French government, entrusted with a public mission. Like the EHIC, the CFE offers reimbursements similar to those of Social Security, based on costs observed in France, to French nationals living abroad. The CFE does not cover repatriation, but it does ensure your coverage even outside your host country, and maintains your rights. You can find out how to register on the CFE website,“CFE mon compte“.
Please note: in addition to CFE, you can take out supplementary expatriate insurance to cover the remainder of your healthcare costs (for a monthly or annual premium).
3. Private health insurance for expatriates
Whether you’re looking to supplement your CFE (Caisse des Français de l’étranger) entitlements, or to benefit from additional coverage, you can take out private international health insurance. The principle is similar to that in France: you pay an annual premium and have access to quality care without having to pay out of pocket (no extra charges, co-payments, etc.). So you don’t have to worry about your health expenses in the event of illness or accident.
The advantage lies in the variety of formulas and cover available. It is therefore advisable to find out about the cover offered (particularly in the event of illness), the terms and conditions of compensation and the reimbursement ceilings. You can carry out an expatriate insurance comparison on our website Santexpat.fr to discover the offers best suited to your situation and the country where you are preparing to live abroad.
How do I insure myself before going abroad?
Before you leave, you can compare expatriate insurance offers and contact the most reputable companies on the market, such as April Internationale, Malakoff Humanis and others. Santexpat.fr carries out an objective comparison of all the players on the market, so that we can offer you the best deal for your needs, at no extra cost. You can also discuss this issue with your employer; it’s something you can negotiate, for example, when you sign your contract.
On the French side, don’t forget to send the“Déclaration de transfert de résidence hors de France” form to your health insurance fund, declare your departure and hand over your carte vitale. Once you’ve joined the foreign health insurance scheme, you’ll be able to submit all your claims to them.
