Medicare and health insurance for Americans in France
Does Medicare work in France? Health cover for American retirees: Medigap abroad, private insurance, French public healthcare (PUMa) and keeping Part B.
Updated · Expat Academy · Education, not advice
Medicare is built for care in the US. In France it pays almost nothing, so every American retiree in France needs a plan for health cover, and the plan depends on whether you move or spend a season there.
What Medicare and Medigap do abroad
- Medicare Parts A and B generally don't pay for care outside the US.
- Medigap plans C, D, F, G, M and N include emergency care abroad: 80% of the cost after a $250 yearly deductible, up to $50,000 over your lifetime, and only for emergencies that begin in the first 60 days of a trip.
- Medicare Advantage plans may include worldwide emergency cover; terms vary by plan.
That's travel cover, not residence cover.
If you spend a season in France
Keep Medicare for the US and add long-stay travel medical insurance for the whole stay: emergencies, hospital and repatriation. It also meets the temporary visa's requirement of at least €30,000 of cover. In France you pay doctors and pharmacies directly, keep the receipts and claim from your insurer. As a visitor you can't join French public healthcare.
Read the definitions on pre-existing conditions; travel policies often exclude them unless they've been stable for a set period. And bring a season's supply of prescriptions with the generic names.
If you move to France
Year one: private insurance. The visitor visa requires private health insurance for your whole first year. Keep it until your French public cover is confirmed.
Then PUMa. After three months of stable and regular residence you can apply to the public system (protection universelle maladie) through your local CPAM office. Expect to provide your passport and visa or residence card, a birth certificate (apostilled and translated by a sworn translator), proof of address and of three months' residence, a French bank RIB, and proof of income. Three months is the minimum wait; processing can take weeks to months more.
How it pays. For a GP visit at the standard fee, the system pays 70% of the official tariff (less a small fixed charge). Prescriptions are reimbursed at 15% to 100% depending on the drug, and long-term conditions on the official list are covered at 100% of the tariff. Declare a GP (médecin traitant), or you're reimbursed less. The carte Vitale sends claims directly, so money reaches your account within days.
The mutuelle pays most of what's left, including the gap when doctors charge above the tariff. Compare a few; prices rise with age.
Keep Medicare Part B, or drop it?
| Keep Part B | Drop Part B |
|---|---|
| Pay the premium ($202.90 a month in 2026, more with IRMAA) | Save the premium while you're in France |
| Cover the day you're back in the US | Re-enrol only from January to March, with cover starting later |
| No penalty | A 10% higher premium for each full 12 months without it, for life |
Someone who drops Part B at 70 and comes home at 80 would pay double the standard premium for the rest of their life. Many people who expect to return in their 80s keep it as insurance. Part A costs nothing to keep if you qualify.
IRMAA still applies abroad: Medicare premiums are based on your US income from two years earlier, wherever you live.
The cost in your budget
Healthcare in France is one of the few things that usually costs less than in the US once you're in the public system, with the mutuelle as the main recurring cost. Year one, with private insurance, costs more. Add both to your plan in the free Two-Home Budget Planner.
Questions
Does Medicare cover me in France?
Generally no. Medicare Parts A and B don't pay for care outside the US except in rare cases. Medigap plans C, D, F, G, M and N pay 80% of emergency care abroad after a $250 deductible, up to $50,000 in a lifetime, for emergencies that begin in the first 60 days of a trip.
Can American retirees join the French health system?
Yes, once they're residents. After three months of stable and regular residence, retirees with no French work history can join the public system (PUMa) through the local CPAM office.
Should I keep Medicare Part B if I move to France?
It's a personal decision. Keeping it costs the standard premium ($202.90 a month in 2026, more with IRMAA) for cover you can only use in the US. Dropping it means a 10% higher premium for each full 12 months without it if you re-enrol later, for life. Many people who expect to come home keep it.
What is a mutuelle?
A French top-up health policy that pays the share the public system doesn't, plus extras such as dental and glasses. Prices rise with age.
Go deeper
- C6 Social Security and Medicare abroad: Social Security follows you to France; Medicare mostly doesn't. Decide about Part B before you go, because dropping it can cost you later.
- F9 Healthcare in France: Private cover for the visa year, then PUMa after three months, a carte Vitale, a declared GP and a mutuelle. How reimbursement works and what it costs.
- A8 Healthcare for months abroad: Medicare doesn't pay in Europe, Medigap's travel benefit stops after the first 60 days of a trip, and a visa needs its own cover. How to put together insurance for a season.
Sources
- Does Medicare cover me outside the US?, AARP
- Medigap Plan G benefits, Priority Health
- Taxe PUMa 2026, Keobiz
- France long-stay visitor visa (VLS-TS), Migaku
Education, not advice. This guide explains general rules as of the date above. Rules change every year; confirm your own situation with a qualified adviser in the US and in France.