SETTLI

How to Register for French Health Insurance (2026) — Carte Vitale, CPAM, ameli

· 10 min read · by Settli

After your visa and bank account, one of the essential steps on arrival is registering for health insurance (Assurance Maladie). Once registered, you are reimbursed about 70% of your medical costs, and the Carte Vitale then handles your care automatically.

This guide walks foreigners and students through the whole process — when to register, which documents, the ameli account, timelines, and how to get care before your card arrives.

⚠ Disclaimer

This article is for general information and has no legal value. Always verify on ameli.fr or with your CPAM. Current as of June 2026; rules change.

📖 What is PUMa?

PUMa (Protection Universelle Maladie) provides basic health coverage to anyone who lives or works in France on a stable and legal basis. Once registered, you are reimbursed about 70% of your medical costs for a GP visit (the rate varies by type of care); the rest is covered by an optional complementary insurance (mutuelle). Students, employees and families — almost all legal residents are eligible.

Why register quickly?

If your registration takes time to process, you have to pay your medical costs upfront yourself, and the reimbursement procedure can be slower and more complex. That said, once your rights are opened, care received during processing can be reimbursed retroactively (be sure to keep your feuilles de soins and receipts). So it's best to register as soon as possible after arriving.

Students are advised to register as soon as possible after arrival (ameli's official guidance — no statutory deadline is specified).

✅ Care before registration: even before you are registered, you can see a GP, a specialist or go to hospital — the difference is not access to care but reimbursement. You pay upfront, then once your rights are open you submit the care form (feuille de soins) and receipts to be reimbursed. Keep your care forms.

Documents usually required

It varies by scheme and status, but these are commonly requested:

💡 RIB first: to receive reimbursements you need a French bank account. If you don't have one yet, see Opening a bank account in France.

Students — etudiant-etranger.ameli.fr

There is a dedicated portal for international students:

  1. Go to etudiant-etranger.ameli.fr → create an account
  2. Enter your details + upload documents (passport, visa, translated birth certificate, certificate of enrolment, RIB, proof of address)
  3. After review, you receive a social security number
  4. Create your ameli account on ameli.fr → manage proofs and reimbursements

✅ Don't lose time: in practice, many students start their application once they have their certificate of enrolment, without waiting for the VLS-TS validation — a provisional social security number can be assigned in the meantime. However, a VLS-TS validated on ANEF is still required for the definitive opening of rights and the final number.

⚠️ Mind the "student insurance" myth

Since the 2018 reform, students are covered by the régime général and basic cover is free. The former "student social security" providers (LMDE, SMEREP) are no longer needed for basic affiliation: they only sell an optional complementary insurance (mutuelle).

Employees & others — régime général

If you are not a student, the affiliation path differs:

The exact documents depend on your situation — check the list on ameli.fr.

📋 The admin checklist for your case

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Carte Vitale + getting care before it arrives

For foreigners, it's the social security number → opening of rights that takes the longest: the whole process can take from a few weeks to several months. The Carte Vitale is then issued, usually faster once rights are open. In the meantime, get care as below.

Getting care before the card arrives

✅ Declare a médecin traitant: declaring a primary doctor (médecin traitant) on ameli preserves your reimbursement rate. Without one, reimbursement is reduced (parcours de soins coordonnés).

Complementary insurance (mutuelle) — the 30%

PUMa's reimbursement rate varies by type of care — about 70% for a GP visit, more for hospitalisation, 15–100% for medicines, 100% for long-term conditions (ALD). For routine care, the remaining ~30% (the ticket modérateur, etc.) is covered by a complementary health insurance (mutuelle), which is optional.

Whether you need a mutuelle, and which one, depends on your situation. Always compare cover and price before subscribing.

FAQ

Q1. Can I register as soon as I arrive?

In practice, many students start their application once they have their certificate of enrolment, without waiting for the VLS-TS validation. However, validation on ANEF is required for the definitive opening of rights. Before registration you can still see a doctor (paying upfront); keep receipts and care forms for reimbursement once rights are opened.

Q2. Where do I get documents translated?

The birth certificate in particular usually needs a sworn translator (traducteur assermenté) (lists are held by the courts of appeal). For a foreign document, also prepare an apostille.

Q3. My Carte Vitale isn't arriving. What now?

If your rights are open, use the attestation de droits on ameli.fr in the meantime. If the card really takes long (beyond four months), contact your CPAM via the ameli messaging. A missing photo or RIB is often the cause of the delay.

Q4. Do I need both PUMa and a mutuelle?

PUMa (basic) covers almost all legal residents; the mutuelle is optional. But if the 30% co-payment is a burden, a complementary insurance becomes useful in practice. On low income, look at C2S (public) first.

Q5. My school tells me to "register with social security".

That means affiliation to the régime général (etudiant-etranger.ameli.fr). It's not paying a student insurer like before — registration is free.

Summary

The steps to register for French health insurance:

  1. Valid permit/visa (VLS-TS validated on ANEF)
  2. Prepare documents — passport, visa, translated birth certificate, proof of address, RIB, (student) certificate of enrolment
  3. Register — students: etudiant-etranger.ameli.fr ; employees: employer's DPAE + your request to CPAM (S1106)
  4. Social security number → ameli account → request the Carte Vitale
  5. Before the card: attestation de droits + feuille de soins
  6. If needed, a complementary insurance (mutuelle / C2S)

For the exact documents for your visa and situation, create your checklist in 60 seconds on Settli.

This article is for general information. For your specific situation, verify on ameli.fr or with your CPAM.
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