A newcomer’s guide to French social security

Moving to France means joining one of the world’s most comprehensive welfare systems, including family benefits, retirement, unemployment, and workplace accident cover.

But this system is also unique, and involves navigating a new system with its own paperwork, policies, and requirements.

The challenge is knowing what you’re entitled to, how to register, and what costs you’ll still face.

That’s where we come in. In this guide, you’ll learn:

• What Sécurité sociale is, and how it works
• How to get a social security number and a Carte Vitale
• Why a mutuelle matters
• How CAF benefits work
• What to know about pensions, unemployment, and work accident coverage
• The most common mistakes newcomers make, and how to avoid them

By the end, you’ll know how the system works, what you should apply for, and how to keep your out-of-pocket costs under control.

Let’s get into it!

Sécurité sociale in France: the basics

France's Sécurité sociale runs on a principle of solidarity, with everyone contributing through payroll taxes and employer contributions.

Once you've registered with Social Security, you'll receive your numéro de sécurité sociale, a 15-digit number that follows you throughout your time in France.

French social security covers five distinct branches:

1. Health insurance (Assurance Maladie): doctor visits, hospital stays, medications
2. Family benefits: child allowances, childcare subsidies, housing assistance
3. Retirement (Retraite)
4. Work accidents and occupational illness (AT/MP): injuries at work or during commute
5. Unemployment (Assurance Chômage): income support between jobs

For most newcomers, health insurance and family benefits matter most in the early months.

The Carte Vitale is your physical proof of coverage.

It's a green card with a chip that you present at pharmacies, doctors' offices, and hospitals. When you use it, the reimbursement process happens automatically.

While waiting, you'll use an attestation de droits as temporary proof of coverage.

Many newcomers also take out temporary private cover to bridge the gap, which is where Feather’s expat health insurance can help.

Who can apply for Sécurité sociale?

Almost everyone in France is covered under sécurité sociale, but the details depend on your situation:

• If you work in France, your employer registers you automatically amd CPAM (the health insurance fund) manages your claims.
• If you're self-employed, you register your activity with URSSAF and obtain a SIRET number. Health coverage still runs through CPAM.
• If you're a student, you can register through etudiant-etranger.ameli.fr.
• If you live but don't work in France, you're covered under PUMa (Protection Universelle Maladie) after three consecutive months of residence.

EU, EEA, and Swiss citizens typically present ID and proof of residence. Some may use an S1 form (for pensioners or posted workers).

Non-EU citizens need a valid visa or residence permit, along with the same pathway proofs.

How reimbursements work

France’s welfare system is famously effective, but if you’re expecting “free healthcare,” you’re in for a surprise.

“The biggest misconception newcomers have is that it’s free,” says Eloi Lanthiez, Feather’s insurance expert in France. “You usually pay the doctor, then get reimbursed.”

Here’s how it works:

1. You pay a portion (known as the ticket modérateur) upfront
2. Your local CPAM reimburses part of the cost to your bank account
3. Your mutuelle covers all or some of the rest

The key concept to understand is the parcours de soins, the coordinated care pathway. You need to register a primary doctor (médecin traitant) and get referrals for specialists.

Eloi Lanthiez explains it simply: "Think of it as bill → CPAM → mutuelle. The provider bills you, CPAM pays its share, and your mutuelle covers some or all of the rest automatically."

Alternatively**, tiers payant** is a system where you don't pay upfront for the CPAM portion. It's standard at pharmacies and labs, and increasingly available at doctors' offices.

How much does healthcare cost under sécurité sociale?

French social security handles primary care at base tariffs, maternity care, and many hospital costs quite well.

Let's look at what you'll actually pay in common situations:

The 100% Santé reform also guarantees zero out-of-pocket costs for certain glasses, hearing aids, and dental work when you have a qualifying mutuelle.

If you have a chronic condition listed as an ALD (Affection de Longue Durée), related care can be covered at 100% of the base tariff.

The government recognises 30 serious conditions for full ALD coverage, including diabetes, cancer, multiple sclerosis, Parkinson's disease, and severe hypertension.

If your condition isn't on the list but requires treatment lasting more than six months, your doctor can still request ALD coverage.

What is a mutuelle, and why is it important?

A mutuelle is additional private insurance to supplement the sécurité sociale. It is incredibly popular in France, and 96% of residents have one.

Your mutuelle covers the ticket modérateur, hospital charges, and much of your dental and optical costs. They are "strictly optional but highly recommended," says Eloi Lanthiez.

When choosing a mutuelle, look out for**:**

• Dental and optical coverage levels
• Hospital daily charges (forfait journalier)
• Coverage for sector 2 surcharges
• Alternative medicine coverage
• English-language support (helpful for newcomers)
• Post-surgery assistance

Employers in France must provide a mutuelle to employees. These are generally solid for basics, though you can top up individually if you need better dental, optical, or specialist coverage.

If you're on a low income, check if you qualify for CSS (Complémentaire Santé Solidaire), which is a state-aided complementary cover that costs little or nothing.

What to do after applying for sécurité sociale

Registering a médecin traitant is the first step. This is your primary care doctor who coordinates your healthcare. Without one, your reimbursement rates drop for many consultations.

Doctolib is France's main appointment booking platform. You can filter by language, location, and availability.

Some doctors also accept direct bookings by phone.

Eloi Lanthiez's advice is to "go to Doctolib and find a doctor you're confident in, and one who speaks English if your French isn't strong yet."

If you need urgent care, you can reach out to your médecin traitant, SOS Médecins, or the maison médicale de garde (on-call clinics).

For emergencies, Call 15 (SAMU) or go to urgences (A&E)

Family support and housing assistance: the CAF

The Caisse d'Allocations Familiales (CAF) handles a surprisingly wide range of benefits, including:

• Monthly family allowances (allocations familiales)
• Early childhood benefits (PAJE)
• Housing assistance (APL, ALF, ALS)
• Working bonus for low earners (prime d'activité)
• Disability support (AAH)
• Back-to-school allowance (allocation de rentrée scolaire)

Many newcomers don't realise they're eligible for housing assistance or prime d'activité, but they can make a real difference to your monthly budget!

France offers three types of housing aid:

• APL (Aide Personnalisée au Logement) for apartments under specific agreements
• ALF (Allocation de Logement Familiale) for families not eligible for APL
• ALS (Allocation de Logement Sociale) for everyone else (students often get this)

Only one applies to your situation, and the CAF determines which. The amount depends on your rent, location, income, and household composition.

The prime d’activité is a working bonus for low-income earners. If you work and earn below certain thresholds, you may qualify for monthly payments that top up your income.

To apply for the CAF, you'll need to create an account at caf.fr and submit:

• Identity documents
• Proof of address
• Family situation documents
• Income information

For newcomers without French tax returns yet, the CAF has processes to verify income from your home country.

Processing times vary, and some benefits can be backdated. Check the specific rules for each benefit at service-public.gouv.fr.

The French pension system

France uses a pay-as-you-go pension system. Your contributions today fund current retirees, and future workers will fund yours.

You'll build pension rights through two main systems: the **basic pension (**managed by CNAV for employees), and complementary pension, a points-based system for private sector employees.

Both start accumulating from your first day of work in France.

Here’s the key information to remember

• Your contributions count immediately. Even if you only work in France for a few years, you'll have built some pension rights.
• EU regulations coordinate pension systems, so your contributions in other EU countries count toward your total.
• Minimum contribution periods: You generally need to have contributed for at least one trimester (equivalent to around 150 hours at minimum wage) to receive any French pension.
• Checking your record: You can view your pension statement (relevé de carrière) online through info-retraite.fr. This shows all your registered contributions and projected pension.
• If you leave France, your French pension rights stay with you. When you reach retirement age, you can claim your French pension from abroad with a little extra paperwork.

Unemployment benefits

France's unemployment system is managed by France Travail. The main benefit is ARE (Allocation d'aide au Retour à l'Emploi).

Your ARE amount depends on your previous salary. Expect somewhere between 57% and 75% of your reference wage, with higher percentages for lower earners.

For higher earners, benefits reduce by 30% after a certain period (currently after 6 months for those under 57).

You can also work part-time while receiving benefits. Your ARE adjusts based on your earnings, and unused benefit days get pushed back so you don't lose entitlement.

To qualify for unemployment, you need:

• At least 6 months of work in the last 24 months
• To have lost your job involuntarily (or ended a fixed-term contract)
• To be registered as a job seeker
• To be actively looking for work

Receiving unemployment benefits also comes with obligations, including regular meetings with your France Travail advisor, and participating in training if recommended.

Missing meetings or failing to meet requirements can lead to benefit suspension.

EU citizens can transfer unemployment rights under certain conditions. If you were receiving benefits in another EU country, and moved to France to look for work, you may be able to continue receiving them.

Work accidents and occupational illness

Work accident insurance (AT/MP) provides better coverage than standard health insurance when you're injured on the job.

AT/MP includes:

• Work accidents: injuries that happen while working
• Commuting accidents: injuries during your journey to or from work
• Occupational illnesses: conditions caused by your work environment

Medical care is covered at 100% (no ticket modérateur) when you're covered under AT/MP, and you receive daily allowances during recovery (typically 60% of salary for the first 28 days, then 80%).

Here’s what to do if you suffer a work-related injury or illness:

1. Inform your employer within 24 hours
2. See a doctor and get a certificat médical initial
3. Your employer must declare the accident to CPAM within 48 hours
4. You'll receive a feuille d'accident du travail that provides free care during treatment

Permanent disability leads to a pension based on the degree of impairment

Special situations

If you're starting freelance work in France, you'll register with URSSAF and pay contributions directly.

Your health coverage still runs through CPAM, however you’ll have to manage your own contributions, and rates are based on your declared income.

International students can register for the standard social security system on arrival through etudiant-etranger.ameli.fr.

Students must pay the CVEC (Contribution Vie Étudiante et de Campus) each year (currently €100) which funds student services.

PUMa (Protection Universelle Maladie) covers non-EU residents who aren't working but live legally and stably in France for at least 3 months.

To apply for PUMa, you'll need to prove lawful residence and continuous presence.

Some visa situations create coverage gaps. If you're unsure whether you're covered, expat health insurance can provide continuity while you sort out your status.

Common mistakes and tips to avoid them

Eloi Lanthiez sees the same mistakes repeatedly:

• Assuming healthcare is free at point of use: Remember, you pay first then get reimbursed later.
• Not registering a médecin traitant: This drops your reimbursement rates and makes the system less efficient for you.
• Sending partial dossiers: Missing documents slow everything down, so always double check requirements and submit complete applications.
• Not keeping receipts: You’ll need receipts for reimbursements, especially while waiting for your Carte Vitale - so keep them handy!
• Missing CAF deadlines: Not all benefits can be backdated, so it’s important to apply on time.

To avoid falling into any of these pitfalls, we recommend following these top tips:

• Register for your numéro de sécurité sociale as soon as you're eligible, either through your employer, as a student, or via PUMa.
• Get a médecin traitant early. This ensures full reimbursement rates and gives you a primary care home base.
• Consider a mutuelle seriously. The 30% gap adds up, and 96% of residents have one for good reason.
• Explore CAF benefits. Housing aid and prime d'activité are commonly missed by newcomers.
• Keep all documents. Payslips, attestations, and receipts are essential for navigating French bureaucracy.
• Use temporary cover while waiting. Expat health insurance can bridge the gap until your Carte Vitale arrives.

Useful resources

If you ever find yourself with more specific questions, or in need of additional information, you might want to check out these resources:

• ameli.fr: France’s national health insurance portal
• caf.fr: Family benefits and housing support
• service-public.fr: Official government information
• info-retraite.fr: Information surrounding pensions and retirement
• France Travail: Unemployment services (Chômage)
• Doctolib: Find and book doctors in France

In addition, your employer's HR department is often the best first point of contact for questions about your specific coverage and contributions.

Conclusion

Integrating into the French social security system involves understanding its complexities, from health insurance and family benefits to unemployment coverage.

While the system offers extensive support, newcomers often face challenges due to misconceptions about costs and processes.

Registering promptly, selecting a primary care doctor, and considering a mutuelle are essential steps to minimize out-of-pocket expenses.

By being informed and proactive, you can effectively navigate France's welfare system and maximize your benefits.