In a world where international mobility continues to grow, healthcare remains a key issue for French expatriates. According to the latest activity report from the Caisse des Français de l’Étranger (CFE), the French population living abroad continues to grow, and its social protection needs are evolving. Here’s a look at the major trends and solutions for better health protection abroad.
A changing expatriate profile
On January 1, 2024, almost 2.5 million French people were living abroad. While the 41-60 age group remains the most represented, young professionals and families are taking an increasing place. Increasingly, expatriates are choosing to leave to improve their quality of life. They are turning expatriation into a personal or family adventure, rather than a decision imposed by their employer.
This diversity of itineraries implies a variety of healthcare needs, whether in terms of coverage for short stays, maintaining rights in France, or protection for chronic illnesses and maternity.
Health: a heavy cost
The cost of healthcare in many countries remains a source of concern. According to the Expat Communication barometer, 28% of expatriates have no health insurance. Yet medical expenses continue to rise, particularly in North America, where cost inflation is running at up to 12% a year. The quality of care remains generally satisfactory, but expatriates often find the financial burden excessive.
With this in mind, it’s essential to plan ahead and compare the benefits available on the market.
CFE: a key player in solidarity
In 2024, CFE, the social security fund for French nationals abroad, strengthened its offer to adapt to these new needs. In addition to “French-style” coverage, with no medical selection or reimbursement ceilings, it offers packages tailored to students, families, retirees and individual entrepreneurs.
Among the new features, the IntégralExpatSanté contract launched in Brazil combines CFE coverage with supplementary health insurance, for easier access to care and simplified procedures.
CFE has also modernized its digital services for smoother, more transparent management, and set up a dedicated business unit to meet the needs of large groups and SMEs.
CFE’s limitations and alternatives
While CFE provides essential coverage, guaranteeing that you will continue to enjoy “French-style” social protection, it does not always cover all costs incurred abroad. In some countries where hospital fees are very high (such as the United States, Hong Kong or Singapore), CFE reimbursements can leave you with a substantial out-of-pocket expense. In addition, processing times can be lengthy, and certain local services (specific medicines, dental or optical care) are not always covered. For this reason, many expatriates also take out a private international health insurance policy, which complements the CFE to provide more comprehensive coverage adapted to local realities. These limitations have led CFE to forge partnerships to better support its policyholders in certain countries.
A strategic partnership with santexpat.fr
To provide better support for French nationals in the United States and the United Kingdom, CFE is working with its partner santexpat.fr, the reference for these two destinations. This partnership enables policyholders to benefit from local expertise and personalized support, to find the solution best suited to their specific needs in complex healthcare systems.
Julien, working in Singapore, says: “The healthcare system is excellent, but without supplementary cover, a simple hospital stay could have cost several tens of thousands of euros.
A look at local specificities outside the USA/UK/Brazil
In other major expatriation regions, healthcare challenges are often of an entirely different nature. In South-East Asia, the quality and accessibility of healthcare varies greatly from country to country: Singapore and Thailand offer modern but expensive medical infrastructures, while in countries such as Cambodia and Myanmar, facilities are inadequate and evacuation to a neighboring country is sometimes the only option for serious treatment. In the Middle East, expatriates in the United Arab Emirates or Qatar benefit from high-performance but very expensive healthcare systems, often conditional on compulsory private insurance. In Africa, particularly sub-Saharan Africa, access to quality care is uneven, and public hospitals are generally under-resourced. Infectious risks, poor public coverage and medical deserts in certain areas require rigorous preparation, and often insurance to cover repatriation.
Protection tips
- Don’t wait: It’s vital to take out health cover as soon as you begin your expatriation.
- Evaluate your real needs: Depending on your age, family situation and host country, your needs vary greatly.
- Prioritize continuity with France: Some offers allow you to remain affiliated to the French social security system, which can prove invaluable in the event of a return to France or for heavy care.
- Compare options: Coverage, exclusions, reimbursement terms… everything needs to be reviewed.
What are the health risks for expatriates? Expatriates are faced with often costly medical care, uneven medical infrastructures, local diseases (tropical, infectious) and psychological risks linked to isolation or stress.
What type of health insurance should you choose for abroad? The ideal solution is to combine the Caisse des Français de l’Etranger, to maintain your rights in France, with a private international health insurance policy adapted to your host country, to cover all expenses and benefit from better service.
Is CFE enough to cover you abroad? No, CFE alone doesn’t always cover 100% of costs in countries where healthcare is very expensive. A complementary international health insurance plan is often essential for optimum protection.
Health risks specific to expatriates
In addition to cost and access to healthcare, expatriates are exposed to specific health risks. Mental health is regularly cited as a major point of concern: remoteness, cultural barriers, family uprooting and professional pressure can lead to stress, isolation and burn-out, particularly for spouses or expatriates on long assignments. According to a study by Cigna (2023), 89% of expatriates surveyed said they felt stressed, and almost a third reported symptoms of anxiety or depression. On the physical front, the risk of contracting tropical diseases (dengue fever, malaria, chikungunya, typhoid fever) remains high in certain regions of Africa, Latin America and Asia. Water and food quality are also problematic in many developing countries, leading to gastro-intestinal and parasitic infections. Pre-departure medical preparation and vaccinations are essential to limit these risks.
To meet these challenges, santexpat.fr is actively involved in forging targeted partnerships with specialized players. One example is FeelBetter Company, a platform dedicated to the psychological support and well-being of expatriates, providing easy access to online consultations with French-speaking professionals, wherever you are in the world.
“When we left for Angola, we quickly realized that we needed insurance to cover repatriation: my daughter caught appendicitis, and we had to rush her to Johannesburg,” says Claire, who has been living in Africa for 3 years.
What you need to know about expatriate health in 2025
Expatriation offers tremendous opportunities, but also exposes you to health risks. Against a backdrop of rising costs and diverse situations, it is more important than ever to anticipate, inform oneself and choose the solution best suited to one’s life project.
CFE’s mission – to ensure the continuity of French social protection throughout the world – remains as relevant as ever, providing a unique safety net for French people living abroad.
Proper protection is the key to enjoying the adventure of expatriation with complete peace of mind. Don’t wait any longer to take stock with an expert and build the right solution for your situation. To find out more about health insurance abroad and receive personalized advice, contact an expert at santexpat.fr.
