Your First Steps with CPAM: France’s Health Insurance System Made Easy
Introduction
It was the end of my very first day at the formation civique, the civic training class every newcomer to France attends as part of the integration process. I remember walking out of the room with a head full of new information, a tote bag full of brochures, and a to-do list forming in my mind.
One thing the instructor said stuck with me more than anything else:
“If you do just one thing this week, apply for your health insurance with Ameli.”
So that same evening, I sat at my desk, opened my laptop, and typed “CPAM France how to apply” into the search bar.
That moment marked the start of my journey into the French healthcare system — a system that, while new and a little intimidating, is surprisingly supportive once you know where to start.
What is CPAM in France?
CPAM stands for "Caisse Primaire d’Assurance Maladie", which translates to Primary Health Insurance Fund. It’s a key part of the French social security system, specifically responsible for managing public health insurance for residents. If you live in France (whether as a citizen, long-term resident, or even as a foreigner under certain conditions), you’ll likely interact with CPAM at some point.
What Does CPAM Do?
CPAM handles things like:
- Registering you for health insurance (l’Assurance Maladie)
- Reimbursing medical expenses (e.g., doctor visits, prescriptions, hospital stays)
- Managing the Carte Vitale, your green health insurance card
- Supporting access to additional help like CMU-C or AME (for low-income or undocumented individuals)
- Handling sick leave compensation, maternity/paternity leave pay, and other health-related financial support
How to Register with CPAM
If you're living in France and want to access public healthcare, you'll need to register with CPAM. The process typically includes:
1. Filling out a form (usually the “Demande d'ouverture des droits à l'assurance maladie”)
Download a form | ameli.fr | Assured
2. Providing documents such as:
Proof of residence (e.g., utility bill)- Passport or ID
- Birth certificate (translated if needed)
- Proof of legal stay (visa, residence permit)
- Proof of employment or proof of staying in France for more than 3 months (for non-workers)
Carte Vitale: Your Health Insurance Card
Once registered, you’ll receive your Carte Vitale, which you present when visiting doctors or pharmacies. It allows for automatic reimbursement of medical costs, often directly between the healthcare provider and CPAM, so you don’t need to pay everything upfront.
Getting Help from CPAM
You can contact CPAM for support via:
- In person at a CPAM office (you may need an appointment)
- By phone at 36 46 (from within France)
- Online via Ameli.fr, the official Assurance Maladie website
Tips for Expats or Newcomers
- It can take a few weeks to a few months to get fully registered and receive your Carte Vitale, so keep receipts and “feuilles de soins” to claim reimbursements manually if needed.
- If you don't speak French, try bringing someone who can help translate or ask for assistance at your local CPAM office, many are used to helping internationals.
- After you’re registered, you might consider getting a mutuelle (top-up insurance) to cover the rest of the medical costs that CPAM doesn’t reimburse (CPAM covers about 70% on average).
