Medicine and health in France

The process of making an appointment with a doctor in France is quite simple, but it has its own peculiarities. The main difference is that reimbursement of expenses depends on whether you follow the official “treatment route.” For Ukrainians, this means that it is important to know how to make an appointment and where to find a doctor.

If you use the public system (PUMA)

Appointments under public insurance are made according to clear rules:

• First, you need to choose a family doctor (médecin traitant). They will become your main treatment coordinator.
  
• ❗️ Without a referral from your family doctor, your insurance reimbursement will be lower. Exceptions are dentists, gynecologists, ophthalmologists, and psychiatrists.

You can make an appointment:

• in person at the clinic's reception desk;
  
• by phone (you often need to speak French);
  
• through the clinics' online portals;
• through Doctolib — the largest online appointment platform in France;
• through annuairesante.ameli.fr — the official directory of doctors who work at public rates.

⏳ Waiting time: in public clinics, appointments can take from a few days to several weeks, depending on the specialty and region.

📎 Tip: when choosing a doctor, pay attention to whether they are conventionné secteur 1 (working at rates that are covered by Sécurité Sociale).

If you are using private healthcare

In private clinics, the process is much simpler and faster:

• No referral is required — you can make an appointment with any specialist immediately.
• Appointments are usually available within 1–3 days, sometimes even on the day of your request.
  
• Appointments can be made online (via Doctolib or the clinic's website), by phone, or via a mobile app.

🔗 Popular services for finding doctors:

• Doctolib — a universal service with reviews and search by specialty;
• annuairesante.ameli.fr — to check if a doctor works at state rates.

Insurance and appointments with private doctors

Most private clinics accept patients with international insurance policies. Without insurance, you pay the full cost of the appointment, which can range from €25-30 in the public sector to €60-100 in the private sector.

➡️ Take out medical insurance that is valid in France and covers consultations with therapists, pediatricians, specialists, as well as tests and diagnostics. This is especially important in the first months of your stay, while you are not yet connected to the PUMA system.

Important to know

• In public institutions, priority is given to patients with urgent conditions (urgence) and referrals marked “urgences cito.”
  
• Ukrainians with temporary protection status can choose their family doctor free of charge and enjoy all the benefits of PUMA and CSS.
• For your first visit, it is advisable to have your passport, APS/residence permit, and Carte Vitale (if you have already received it).

The French insurance system is designed to ensure that everyone has access to basic medical coverage. It includes the state-run PUMA program, supplementary mutuelle policies, and private insurance, which is particularly important for foreigners in the first few months after their arrival.

State insurance (PUMA)

Basic coverage is provided by Protection Universelle Maladie (PUMA). You can obtain it after three months of legal residence or immediately after receiving temporary protection status or official employment.

PUMA covers:

• about 70% of the cost of consultations with general practitioners and specialists;
  
• 60% to 80% of the cost of most medications;
  
• up to 80% of hospitalization costs;
• 100% of the cost of treatment for serious chronic illnesses (Affections de Longue Durée).

To sign up, you need to submit an application to your local CPAM insurance office, attaching your passport, residence permit or APS, and proof of address. Once approved, you will receive a Carte Vitale, a plastic card confirming your rights.

Supplementary insurance (mutuelle, CSS)

The public system does not cover all expenses, so most French citizens and residents take out a private policy — mutuelle. It covers:

• the remaining amount for consultations;
  
• dental and optical expenses;
• the difference in cost when visiting doctors with higher rates (secteur 2).

For people with low incomes, there is a special preferential program — CSS (Complémentaire santé solidaire), which can be free or with a small monthly contribution.

Insurance for tourists and newcomers

For short trips (up to 90 days), the French consulate requires a policy with coverage of at least €30,000, including treatment, hospitalization, and repatriation. The same applies to students and employees: in the first months before connecting to PUMA, they must have a private policy.

Take out a policy before you travel, and it will take effect as soon as you arrive in France. It will cover the cost of consultations, tests, and treatment.

If you have temporary protection status

Ukrainians who have been granted temporary protection in France are entitled to PUMA state insurance and additional CSS (Complémentaire santé solidaire) coverage. This means that basic services are provided free of charge or with a minimal co-payment.

What is covered:

• consultations with a family doctor and specialists (with a referral);
• hospitalization in public clinics;
  
• most prescribed medications;
  
• laboratory tests and diagnostics.

In the case of serious chronic diseases (ALD), treatment is fully reimbursed.

If you are in France on a visa or working/studying

Ukrainians with student or work visas are eligible to join the PUMA system after 3 months of legal residence. Until then, all expenses are covered by private insurance, which is required to obtain a visa.

After registering with PUMA, the following are available free of charge or with partial compensation:

• consultations with a general practitioner;
• referrals to specialists;
  
• emergency care;
  
• examinations and tests.

What is not covered

Even for Ukrainians with state insurance, there are services that will have to be paid for additionally:

• part of the cost of dentistry and prosthetics;
  
• glasses, contact lenses, some medical devices;
• medicines that are not included in the reimbursement list.

That is why French citizens and foreigners almost always take out an additional mutuelle policy.

What documents are required

To confirm your right to free or discounted services, you will usually be asked to provide:

• Carte Vitale or a temporary number from CPAM. If you have not yet had time to apply for a Carte Vitale, it is sufficient to present your APS and proof of registration with the CPAM;
  
• identity document (passport or ID card);
  
• temporary protection status document (APS) or residence permit.

In France, pharmacies (pharmacies) are the first point of access to medicines and advice on their use. They are easily recognizable by the green cross on the facade and operate according to clear rules that Ukrainians should be aware of.

Where to find pharmacies

In cities, pharmacies are located almost everywhere, and in villages, they are located in the center of the community.

• The most well-known chains are: Pharmacie Lafayette, Pharmacie Giphar, Pharmacie Aprium.
• You can find the nearest pharmacy using Google Maps.
• To find night pharmacies (pharmacies on duty after 8 p.m.), there is a service called pharmacie-de-garde.org.

What medicines are sold without a prescription

• antipyretics and painkillers (paracetamol, ibuprofen);
• cough and cold remedies;
• antacids and basic medications for stomach disorders.

Everything else, especially antibiotics, is only available with a prescription. Pharmacists strictly enforce this rule.

How to get a prescription

In France, most strong medicines, antibiotics, and specialized drugs are only available with a prescription. This means that you must see a doctor.

A prescription can be issued by your family doctor (médecin traitant) or a specialist to whom you have been referred. If you do not yet have a designated doctor, you can still consult any general practitioner (médecin généraliste), but your insurance coverage may be lower.

For patients with chronic conditions (such as diabetes, asthma, or hypertension), the doctor may write a prescription for several months at a time. With such a prescription, you are entitled to receive medication regularly at the pharmacy without repeat visits until the prescription expires.

Electronic prescriptions (ordonnance électronique)

France is actively transitioning to a digital system. Often, the doctor creates a prescription in electronic form, and then you only need to present your Carte Vitale at the pharmacy.

The pharmacist immediately sees the prescription in the Ameli system and dispenses the medication. The patient receives a paper copy for convenience only.

Some pharmacies offer online ordering of medications with home delivery. There are also remote consultation services (for example, through Doctolib), where a doctor can prescribe a medication and issue an electronic prescription.

What you need to have with you

Passport or ID, Carte Vitale (if you already have one), as well as a document confirming your status (APS or residence permit). For first visits, sometimes only a passport and private insurance are sufficient.

📎 Tip: Bring a list of your medications with the active ingredient in English or Latin to your first doctor's appointment. This will greatly simplify obtaining a prescription and selecting analogues.

Are Ukrainian equivalents available?

The names of drugs do not always match. In this case, you should ask the pharmacy to select an equivalent based on the active ingredient (substance active). This will help avoid confusion if you are used to specific Ukrainian brands.

If you regularly take certain medications in Ukraine, it is worth bringing a certificate or statement from your doctor with a translation of the active ingredient. A French doctor can prescribe an equivalent based on this. It is important to remember that even if you have a package of medication from Ukraine, a pharmacist in France is not allowed to dispense an equivalent without a prescription from a local doctor.

Does insurance cover the cost of medication?

Yes, in France, insurance covers part of the cost of medication, but the level of compensation depends on the category of the medication and the availability of additional insurance (mutuelle).

How it works

• PUMA (state insurance):
• most basic medicines are reimbursed at a rate of 15% to 65% of the cost;
• vitally important drugs (e.g., for the treatment of diabetes, cancer, cardiovascular diseases) are covered up to 100%;
• cosmetics or drugs without proven effectiveness are not reimbursed.
• Mutuelle (supplementary insurance):
• covers the remaining amount not reimbursed by PUMA;
• in expensive cases (dentistry, optics, specific drugs), it is mutuelle that allows you to avoid large additional payments.

Example

If a drug costs €20, the state may reimburse €13, and the patient pays the remaining €7. If you have mutuelle, this difference is usually covered by additional insurance, and you do not pay anything extra.

📎 Important: reimbursement only applies to medications prescribed by a doctor and included in the official reimbursement list (liste des médicaments remboursables).

In France, emergency medical services (SAMU) and urgent medical services operate around the clock and are required to provide assistance to anyone, regardless of citizenship or insurance status. However, there are some nuances regarding payment and paperwork that Ukrainians should be aware of.

How to call an ambulance

• The main number is 15 (SAMU).
• The single European number is 112 (calls are accepted in foreign languages, including English).
  
• For the fire department, which also responds to medical calls, the number is 18.

The operator will immediately clarify the address and symptoms and send an ambulance team or advise you to go to the urgences (hospital emergency room).

Do they provide services without insurance?

Yes, emergency care is provided to everyone. But:

• if you already have a Carte Vitale or insurance, the bill will be automatically sent to the system;
  
• if not, the bill will be sent to the patient and can be reimbursed after registering for PUMA or submitting a private insurance policy.

When is assistance free

• For Ukrainians with temporary protection, all emergencies are covered by state and supplementary insurance.
  
• For chronic diseases with ALD status (e.g., diabetes, cancer), emergency care and hospitalization are fully reimbursed.
• For tourists with an international policy, the insurance company reimburses expenses according to the terms and conditions.

Hospitalization: how it works and how much it costs

In case of a serious condition, the patient is taken to the hospital to the urgences department.

• State insurance usually covers 80% of the cost of hospitalization, with the rest paid by the patient or mutuelle.
• If you have a private policy (e.g., purchased before your trip), it may cover the entire bill.
• The cost of hospitalization without insurance can be hundreds of euros per day, depending on the hospital and type of treatment.

What documents to have with you

To avoid problems and lengthy formalities, it is advisable to always have the following with you:

• passport or ID;
  
• Carte Vitale (if you have already received it);
• APS or residence permit (for Ukrainians with temporary protection);
  
• private insurance policy (for tourists or newcomers).

📎 Tip: even if you don't have a Carte Vitale, be sure to keep all medical documents and bills. They can be submitted to the CPAM for reimbursement after applying for PUMA.

🚨 If you are denied assistance or receive an unreasonable bill

Sometimes, hospitals or insurance companies try to charge for free services or refuse to provide emergency care. In such cases, you can contact Visit Ukraine lawyers — we will advise you on how to defend your rights and appeal against unlawful claims.

Preparing for a trip to France involves not only tickets and suitcases, but also documents, attachments, and basic knowledge of the healthcare system. This will help you avoid unexpected expenses and save time if you need medical assistance.

What documents to prepare

• Passport (biometric or with a visa).
• Medical insurance — mandatory for tourists, students, and employees during the first few months.
• Temporary Protection Status (APS) document — if you are planning a long-term stay.
• Carte Vitale — for those who are already connected to the PUMA system.
• Medical records or a list of medications with the active ingredient — will help the doctor find an equivalent in France.

Which mobile apps to download

• Doctolib — for online doctor appointments.
• Ameli — app for the state insurance system.
• Google Maps / G7 Taxi — for quickly finding the nearest pharmacy or hospital.
• SOS Médecins — service for calling a doctor on call to your home.

Useful links and services

• ameli.fr — information about state insurance.
• service-public.fr — official rules and documents.
• annuairesante.ameli.fr — search for doctors and clinics.
• doctolib.fr — online appointment service.

Emergency service phone numbers

• 15 — ambulance (SAMU).
• 17 — police.
• 18 — fire department (also responds to medical calls).
• 112 — single European emergency number (available in many languages).