In France health insurance is compulsory to all students.

The public health insurance service is called "securité sociale" - The National Health Security Service. It's official administrator is the CPAM (Caisse Primaire d'Assurance Maladie).

The student's health insurance scheme is a particular chapter of the Health Insurance Service in France. This scheme is opened to foreign students under certain conditions. If you can not benefit from it, then you can apply for a Universal Medical Cover "Couverture Maladie Universelle" (basical CMU) depending on the  location of your place of residence , and in case your demand is refused you can subscribe a private health insurance.

Whatever the case, the students' health insurance scheme is compulsory up to the age of 28 years maximum.

Exception may be granted to students preparing their Phd, under certain conditions.

Caution :If your stay in France begins with the university academic year, the students' health insurance scheme is applicable from 1st of October of the university year (and is valid till the 30th of September of the following year). But if you arrive mid-year (and after the 31st of December) your health insurance will only be effective from the 1st day of the month following your subscription (in most cases, when you enrol at the university) this means you might be without medical cover for a few days or weeks. (If any difficulty arises contact Accueil Info Etudiants/Guichet Unique)

Caution: "Sécurité Sociale" Health Security Service and private insurance are only the basic health cover, as you get refunded for only a part of your medical expenditures (70% maximum repayment). It is therefore advisable to subscribe to a supplementary health insurance to get a better repayment rate. A consultation fee is between € 21 and € 26 for a general practitioner and between € 25 and € 45 for a specialist.

If you are: Member of the European Economic Area Agreement

Your scheme:
- Your should have the European Health Insurance Card which replace the form E 128 (ex. E 111)  you should ask for it at the the health insurance institution of your  country (to be asked for before your departure), you are exempted from subscribing to the French student health insurance scheme.
Your medical treatments will be taken up by the CPAM.

- If you have a private health insurance which does not deliver either the form E128 nor the European Health Insurance Card you should provide an attestation from the insurance firm to the university administration at the time of your enrolment (except students from Switzerland and Monaco). In which case, you are exempted from paying for the students' health insurance cover. And your medical expenditures will be taken over by your insurance firm.

You are: From other country than the European Economic Area Agreement

Your scheme:
- If you are less than 28 years old, you must subscribe to the student's health insurance scheme
- If you are more than 28, you can no longer benefit from the student's health insurance scheme, but will then have to ask for the CMU (basical CMU) or get a private health insurance cover in France, if you are refused the CMU.

- If you take up a private health insurance your medical expenditures will be taken up by the insurance firm you will not need to pass through the CPAM for validition. You can also choose to subscribe for a private health insurance in France to give you the minimum medical cover, if the CPAM advices you

You are: French Government Grant-holder

Your scheme:
You automatically benefit from the student's health insurance cover without any cost, if you are less than 28.

Your medical expenditures will then be taken up by the SEM in Paris which will organise your health insurance cover for the CNOUS or Egide through a specialised protection system.

- If you are more than 28, you can no longer benefit from this scheme and can must subscribe to a private health insurance.

You are: A student from Quebec

Your scheme:
- You are exempted from the French health insurance cover , if you are in possession of the form SE401Q106 bis.
- If you are not a student under an inter-university exchange system, you are exempted from subscribing to the French health insurance cover scheme if you possess the form SE401Q102BIS

-If you do not possess any of these documents you should follow the general procedure, (see nationals from other countries than the European Economic Area Agreement)

If you can not benefit from the basic health insurance cover, (student's health insurance scheme or the CMU), you should get a private health insurance cover. But beware, subscription fees are rather high, it is advisable to compare the different gaurantees proposed.

Subscribing to the Student's Health Insurance Scheme
This is done at the same time as your enrolment in your institution of study (university, "grande écoles", etc...) either by paying the subscription at a student's rate together with your enrolment fee, or by showing your health insurance attestation (European Health Insurance Card, private health insurance, etc.).

In order to get your medical expenses refunded you must follow a special procedure which varies depending on the scheme you have taken up (see points on " How to get your medical expenses refunded").

The fee for the student's health insurance scheme is 189 € for 2006/2007 academic year (except for grant holders).

Subscription to the Universal Medical Cover (CMU)

The basical CMU is free if your annual income par household does not extend the official limit of 7083 € on 01/10/2006. (income tax index: 2005). For those whose income is superior to this amount they are entitled to a participation. This insurance will than be for a year from the 1st of October of the current year to the 30th of September the following year.

The Complementary CMU:

It also gives a complementary medical cover to people with low income. It is obtained on condition of  income: inferior to 562 € per month ( for 1 person), but may require contribution.

Where to address to, how to proceed ?

- you should get a form at the CPAM, fill it in and return it to the CPAM with the documents requested.

- documents to provide:

1 -  your national identity card or passport (and a family record book or an administrative record of family details if your family is with you in France),

2 - if you are in charge of any person: your family record book or marriage certificate or a 'PACS' registration

3 - if you are a foreigner, your stay permit (carte de séjour) in order (knowing that there is a long waiting period before you obtain your stay permit the CPAM accepts your appointment sheet given to you by either the prefecture).

4 -  a proof of a stable address (rent receipt, gaz or electricity bill...)

5 - a proof of school or university attendance and eventually your university registration card,

6 - If you were already suscribed to the CPAM, then you will have to provide your social security carte 'carte vitale' and the attestation of its validity.

7 - a proof of your income (even those earn abroad) for the civil year preceeding the demand.

You will be affiliated to the CMU at the time of your request and you will benefit from the general health security service scheme (granting of medical, pharmaceutical, and hospital expenses...)

Subscribing with a private Mutual or an Insurance Company "Mutuelle"
You may subscribe a private health insurance with different firms :

The mutual insurance companies for students (LMDE, MGEL, …) offer contracts which rates vary from € 120 to about € 650 depending on the guarantees proposed. Information and prices are available at Accueil Infos Etudiants / Guichet Unique .

The Private Insurance Companies offer a variety of guarantees and at different rates. Be very careful when you subscribe.

EGIDE offers students and trainees whom it is in charge of a guarantee of social risks scheme. Information and rates are available at the regional office of EGIDE. Tel + 33 (0)3 54 50 54 32
Complementary insurance covers

These complementary insurances allow for a better rate of reimbursement of your medical expenses, but they are not compulsory.

The health insurance service fixes approved medical fees on which it refunds treatments. Overcharge of fees are not refundable. The percentage of repayment is calculated on the basis of an approved rate (between 35 % and 80 %), with an average of 70 %. A complementary health insurance cover may allow the reimbursement of "ticket modérateur" (see glossary).

The health insurance service repayment rate is a maximum of 70 %. In order to benefit from a 100 % repayment rate, you will have to subscribe to a student's "mutuelles" or another mutual insurance company.

1. The companies in charge of students' mutuels and students' health insurance scheme also offer complementary insurances. They propose a variety of interesting subscription rates (from € 80 to € 350€ per year) depending on the repayment rates offer. If you decide to take up one of the student's mutual you may do so at the same time as your enrolment  and the health insurance in your institution of studies.

A list of names and rates of these mutuals are given at the time of your enrolment (MGEL, LMDE, …) or can be obtained at Accueil Infos Etudiants / Guichet Unique.

Note: It is common that companies that offer complementary health insurances also offer other insurance services: house insurance, car insurance, civil liability insurance ..., which often make the search for insurance transactions easier, when you have chosen an insurance company.

Addresses of student's "mutuelles" in Nancy :
- MGEL, 44 cours Léopold, 54 000 Nancy, Tel: +33 (0)3 83300 300
- LMDE, 13, rue de la Ravinelle?  54 000 Nancy, Tel : +33 (0) 810 600 601

Addresses of student's "mutuelles" in Metz:
- MGEL, (Ile du Saulcy) 11 boulevard Sérot 57000 Metz, Tel : 03 87 30 34 14
- LMDE, 8 boulevard Sérot 57000 METZ, Tel: 03 87 32 43 06

Other usefull addresses :
- EGIDE regional office: c/o Nancy-Université, 34 cours Léopold 54052 NANCY CEDEX tel: 03 54 50 54 32
- SEM PB. 519 - Paris D'Enfert Rochereau - 75666 Paris cedex 14. Tél +33 (0) 1 44 41 74 48.

2. If you benefit from the CMU scheme, you may also benefit from the complementary CMU cover it may be free under certain conditions.

Required conditions :you must reside in France on regular basis for more than 3 months and have a monthly income of less than 598.23€ per person, (for other rates: contact  Accueil Info Etudiants /Guichet Unique or the CPAM).

Where to address to, how to proceed ?

- you may take out a form from the CPAM or at Accueil Info Etudiants / Guichet Unique of Nancy, fill it in and indicate which organisation you have chosen to handle your complementary CMU (MGEL and LMDE can also handle it), then return the form to the CPAM, with the required documents. It is advisable to make an appointment before hand.

- documents to provide are: the same as those required for the CMU, but concerning your income you have to provide documents for the 12 months before your demand.

- The CPAM will inform you by letter of its decision and will also inform the company handling your health insurance cover. You then have to update your insurance card and you will then receive an attestation which you will need to present at the chemist when and if it is needed, without advance fees. 

You must choose an attending/usual physician.

- At the doctor's, you will pay for your consultation fee and then present you health insurance card, (see glossary 'carte vitale').  The information on it will be transmitted electronically to the health insurance company and you will be refunded rapidly.  But if the doctor provides you with a treatment sheet then you have to send your treatment sheet (unless you had used your "Carte Vitale", see glossary). to your health insurance service or health insurance firm, depending on your case, you will either go there in person to get refunded.

- At the hospital, you normally do not pay anything , unless you do not have a complementary mutual and unless there is a bill overcharge (overcharge rates are not refunded), or if it is a private clinic.

- At the chemist, you will only pay the part that is not refunded by the health insurance service and your complementary mutual, if you have one. This is called the “ tiers payant” (see glossary).

Reminder: if you benefit from the complementary CMU, then you do not advance the fees at the chemist.

- How to get refunded:

If you benefit from the student's health insurance scheme: you should before hand choose a payment centre amongst the student's mutuals, that are recognized to handle student's health scheme (MGEL, LMDE). The mutual that you have chosen will be registered on your student card. You should then present this card as soon as possible to the mutual concerned (MGEL ou LMDE) in order to get you health insurance card and registration number.

For this registration a birth certificate, or an administrative family record (an individual record book), or a certified photocopy of your passport, with your parents names mentionned on it will be required. Get it ready before coming to France.

If you benefit from the minimum CMU, the centre of your residential area will be the one handling you health insurance cover (list of the different centres in Nancy are available at Accueil Infos Etudiants / Guichet Unique ). The name of the centre will also be indicated on your student card.

If you are using the the European Health insurance card, form E128, SE401Q... or if you have subscribed a private health insurance with an insurance company and you are from a country of the European Economic Area Agreement - the EEAA (except Monaco): you will have to go to the International Relations Service of the CPAM for your first repayment by showing your treatment sheet + your E128 form ..., your private health insurance attestation + your student card + a proof of bank account details "relevé d'identité bancaire -RIB". The CPAM then records your file and proceeds to refund you straight away (no repayment is done by cash). For any other repayments all you have to do is send your treatment sheets to this same centre, (if you have a complementary insurance, you should send the CPAM worked out sheet to the insurance company) - but sometimes the CPAM also send this sheet directly to your complementary insurance company. If you have a private health insurance: you depend on a private centre and it is to that centre that you will have to send you treatment sheet. It will refund you according to its terms and delays.

Your contact:

International Relations Service of the CPAM
9 boulevard Joffre
54047 Nancy CEDEX
Tel: + 33(0)3 820 904 184

10, rue Bon Pasteur
57070 Metz
Tel: +33 (0)3 820 904 205

The University Health Service Centre or (SANTE U) deals with all that concerns students' health (receiving and advicing students).

It organises and carries out students' medical tests at their first enrolment in a higher education institution.

Social workers are on duty on the campus to inform and help you on certain family, personnal, financial, and administrative problems. List and information concerning their duty hours are available at Accueil Infos Etudiant / Guichet Unique and at the CROUS.

In Nancy :
SIUMPPS (close to the Faculty of Sciences)
6 rue Jacques Callot
Rond Point du Vélodrome
54500 VANDOEUVRE-LES-NANCY
Tél.: + 33 (0)3 83 53 34 75

In Metz :
SUMPPS (on the University campus)
Ile du Saulcy
BP 80794
57012 METZ Cedex 1
Tel: +33 (0)3 87 31 50 35

In France, you can either choose to have a private or public medical service

- Public medical service is offered by public hospitals and it is accessible to those who benefit from the compulsory minimun medical cover (student's health insurance scheme, the CMU, etc.) on presentation of your medical insurance card. You can also consult a specialist on appointment (be careful, in general there is a long waiting list).

- The same case is applicable for General Practitioners who give treatments in hospitals, with two possible options: without an appointment, and consulting in a "public sector" (in this case you present your medical insurance and mutual cards and you do not pay anything); or with and appointment in the "private sector": in this case you may have to pay for over charged fee.

Other than in hospitals, there are also public dispensaries, but most General practitioners work in town (privately). You are free to choose your doctor, who normally has specific consultation days and times, so take an appointment first.

Beware of the fees: for limited rates, you are advised to take a doctor who does not practise overchaged rates (this information must be pinned up in the surgery). A list of the different doctors proposing these fees can be consulted at the CPAM's reception hall in Nancy, can be obtained by phoning  0 820 904 184.

- Specialists can also be consulted at their private surgery in town on the  recommendation of attending/usual physician. Most specialists can be consulted at the hospital. 

- Home visit by a doctor (only General Practitioners), chemist expenses, especially at night, on Sundays and Public holidays, are at supplementary rates (they are refunded by the Health Insurance service under certain conditions and by your mutual depending on your health insurance cover).

- In case of emergency (at night, on Sundays, etc.) there are always doctors and chemists on duty. You can obtain their names and addresses from the central police station or by dialing one of the emergency numbers.

A list of the different hospitals, public dispensaries, doctors, etc. are available at Accueil Info Etudiants / Guichet Unique.

in Nancy guichet-etudiants@nancy-universite.fr - Tel: + 33 (0)3 54 50 54 00

in Metz acc-metz@nancy-universite.fr - Tel: + 33 (0)3 87 65 81 40

Medical system in France:

General information about the French medical insurance service

Glossary :

- An approved doctor without fees overcharge 'secteur 1': a doctor approved by the CPAM and who is applying the minimum fee imposed (Generalist Practitioners: € 20 specialist: €23). The repayment rate of the CPAM is based on these rates. A list of consulting doctors is available at the reception of the CPAM.

- An approved doctor with free rates 'secteur 2': a doctor approved by the CPAM but who practices free rates. Your complementary insurance can refund this overcharge, depending on the type of medical insurance cover you have subscribed to.

- An approved doctor with overcharge rates 'secteur 3: a doctor approved by the CPAM but who practices free rates, (yet less expensive than a doctor with free rates). Your complementary insurance can refund this overcharge, depending on the medical cover you have subscribed to.

- Treatment Sheet: if you do not have the health insurance card, then the doctor will give you a treatment sheet after consultation, (a standardized type - brown and white in colour) which you should send to the company handling your health insurance to get refunded. 

- Third party payer "Tiers payant": is a simplified paying system, especially at the chemist. On presenting your health insurance card and eventually your complementary insurance card, you only pay for what is not refunded by the CPAM which is called moderator ticket - "ticket modérateur".

- 'Ticket Moderateur': is the difference between what the National Health Insurance services refunds for medical expenses, medicine or hospitalisation . It is a minimum participation of the person insured to his/her health expenses. It can however, be refunded by your mutual (depending on the health cover you have subscribed to). Chemists normally ask for a supplementary none refundable fee for small packaged products "petit appareillage" (e.g : bandages, surgical collar, etc).

Warning: unbranded medicines should be preferred, and they can only be refunded if they have been prescribed by a doctor (medical prescription). If you buy it on your own you have to pay for it and it will not be refunded. Certain medicines can be obtained only on presciption (these normally have a red line on the packet). There are also medicines which are not refundable.

- "Mutuelle" = Mutual Insurance Company: is the common name given to complementary insurances, which normally functions this way: your subscription money, is used for reimbursements.

- Vitale Card: Is delivered by the CPAM or by the different students mutuals (LMDE, MGEL). It allows for a simplified and rapid electronic managment of medical expenses repayment (there is no longer a treatment sheet to be sent). Caution: "Vitale" card is not a payment card !

latest update october 2007