The Caisse des Français de l’Étranger(CFE) was created for French expatriates. Its purpose is to offer French nationals living abroad the right to benefit from the same social protection as in France. To date, it covers over 200,000 French nationals worldwide. Despite this, the CFE remains independent of the French social security system, with its own guarantees and contributions.
Who is CFE for?
The Caisse des Français à l’Étranger is open to French nationals, but also to citizens of the European Union (EU), the European Economic Area (EEA) and Switzerland, under certain conditions of prior residence in France. You can benefit from it whether you are an expatriate employee, a self-employed person, a person not in gainful employment, a pensioner or a student. It also covers beneficiaries, i.e. the insured’s dependents, such as children under 20 or spouses.
All expatriates and nationals of the EU, EEA and Switzerland are therefore eligible to join CFE, whatever their nationality:
- their family and professional situation
- country of expatriation
- age
- their state of health
When joining CFE, future expatriates are not required to complete a medical questionnaire, so you can join even if you are chronically ill. This means there are no exclusions from coverage of health expenses. So you can join CFE even if you are chronically ill or require long-term treatment.
Subscription by the employer
Your employer may decide to subscribe to CFE for you and your family. This can have a number of advantages for your company. There will be no contributions to family allowances, although these may be paid if the family remains in France. Sickness, maternity and disability contributions are lower than for the general scheme. The rate can be adjusted according to the number of members attached to the contract. What’s more, the expatriate’s social protection is lower than that of the secondment to the French social security system. This can be a real advantage when an opportunity arises to work abroad.
CFE and chronic illness
People living with chronic illnesses need to pay particular attention to their health cover when expatriating. CFE reimburses part of the cost of care related to these conditions, but often not enough to cover the full cost, which can be very high in some countries. For example, regular or specialized treatments may not be fully reimbursed, and the cost of medicines may exceed the amounts provided by the CFE. It is therefore advisable to take out supplementary health insurance to guarantee adequate coverage and avoid unforeseen costs.
When should I join CFE?
CFE membership is voluntary and not compulsory. You can apply at any time, before or during your expatriation.
Nevertheless, we recommend that you apply as soon as possible. Your membership will not start until the 1st day of the month following your application. If you apply more than 3 months after your departure, you will be subject to a waiting period. This waiting period will be 3 months for those under 45 and 6 months for those over 45.
It’s important to note that CFE membership does not exempt you from paying compulsory health insurance contributions in your host country, if one exists (as is the case in Canada, for example).
What does CFE cover?
CFE offers its members a range of services tailored to different profiles:
- A health insurance package that guarantees coverage of healthcare costs worldwide (MondExpat santé, JeunExpat santé, RetraitExpat santé) or in France only (FrancExpat santé). A maternity option is also available.
- Old-age insurance, enabling employees to continue contributing to their pension while working abroad.
- Professional risk insurance, to cover employees against unforeseen events in the course of their professional activity, such as an accident in the workplace. It also covers occupational illnesses contracted in the course of employment. It reimburses medical expenses incurred as a result of illness, and provides daily benefits in the event of sick leave or disability. There’s also an option to cover you when you’re traveling on business.
To find out more about these offers, see our article “What you need to know about CFE“.
Contributions and reimbursements
The Caisse des Français à l’étranger was reformed in 2019. Since this reform, contributions to the Caisse des Français de l’étranger have been calculated on the basis of the insured’s age and family composition (single or family). It no longer takes into account the expatriate’s activity and income.
By subscribing to Caisse des Français de l’Étranger, you benefit from partial reimbursements of your medical expenses. Reimbursements are expressed as a percentage of actual healthcare costs, or as a lump sum. For example, for a consultation with a general practitioner or specialist, whatever your country of residence, you will be reimbursed at 70%, with a maximum reimbursement limit of 17.50 euros. For dental treatment, depending on your country of residence, you will be reimbursed between 10% and 30%. For hospitalization, you’ll be reimbursed between 19% and 67%. Without complementary insurance, you’ll have to pay the difference.
Do I need to take out private insurance in addition to CFE?
Subscribing to CFE insurance allows you to maintain your French Social Security rights during your expatriation, notably by ensuring reinstatement without a waiting period when you return to France, and by preserving your pension quarters. This can be particularly advantageous for frequent expatriates, such as executives or entrepreneurs looking for international flexibility.
However, it’s important to note that CFE reimburses only a portion of healthcare costs, based on the rates charged in France, which are often lower than those in other countries. For example, for a medical consultation costing 150 euros in a country like the United States, the CFE will only reimburse 17.50 euros, leaving a large part of the costs to you. What’s more, CFE does not include coverage for medical repatriation or civil liability, which are often necessary in an emergency.
In certain countries where healthcare is particularly expensive (USA, Hong Kong, Japan, etc.), it is strongly recommended that you take out additional insurance. This can cover remaining expenses and include additional benefits, such as repatriation and treatment in private hospitals without advance payment. Several international insurers offer specific contracts that complement the CFE, with optimized management of reimbursements.
