French Carte Vitale Guide for Expat Executives (2026)

Social security contributions start with the first French payslip, but the health insurance file does not open by itself: the assignee has to apply.

This French carte Vitale guide explains how an incoming executive and their family register with the French health insurance system, which documents cause most delays, and how the public scheme and the company plan fit together. It is written for HR teams, RMCs and the assignees themselves.

How Health Cover Works in France

France's health insurance system is called PUMa (protection universelle maladie). There are two routes in:

• Work. A person employed in France is covered from the start of their activity, with no waiting period.
• Residence. A person who does not work in France generally needs to show more than three months of stable, legal residence.

The carte Vitale is the green health card that makes reimbursements automatic. It comes at the end of the process, once the person has a permanent social security number.

Executives seconded from abroad

An executive who stays on their home country's social security during a secondment follows a different route. Within the EU, the relevant certificate is registered with the local office; outside the EU, it depends on the social security agreement between the two countries, and private international cover is often used. Check the position with the employer before arrival.

Step 1: Apply to the CPAM With Form S1106

The application goes to the CPAM (caisse primaire d'assurance maladie) of the department where the assignee lives, using form S1106 (demande d'ouverture des droits à l'assurance maladie), available on ameli.fr.

Typical documents:

• Form S1106, completed and signed
• Passport and visa or residence permit (with the visa validation)
• Full birth certificate showing both parents' names, with a translation when the CPAM requires one
• Employment contract (and first payslip if available)
• Proof of address in France
• French bank details (RIB) in the applicant's name

Step 2: Add the Family

• Spouse or partner: an adult files their own application, with the relevant family documents.
• Children under 18: they are attached to one or both parents with form S3705.

Step 3: Number, Ameli Account, Carte Vitale

The CPAM usually issues a provisional number first, then the permanent social security number once identity has been verified. With the permanent number, the assignee can open an online account on ameli.fr, download a certificate of rights and order the carte Vitale.

Stage

Using the System Before the Card Arrives

The assignee does not need to wait for the carte Vitale to see a doctor. Until it arrives, they pay the practitioner, keep the paper treatment form or receipt, and send it to the CPAM once their number is issued. Pharmacies work the same way. Many doctors can be booked online, and the company health plan can often reimburse its share directly once the assignee is registered with it.

The Two Layers of Reimbursement

• Public health insurance. It reimburses part of an official tariff. For a standard GP visit with a declared primary doctor, it pays 70% of the €30 tariff, minus a €2 flat contribution kept by the system.
• Company health plan (mutuelle). Private employers must offer a complementary plan and pay at least half of it. It covers the rest of the official tariff and, depending on the contract, fees above it, dental and optical care.

Declare a primary doctor (médecin traitant) as soon as possible: without one, consultations are reimbursed at a much lower rate.

Common Reasons a File Is Delayed

An incomplete birth certificate. A short extract without parents' names is often not enough. Ask for a full copy.

A missing translation. Documents in some languages are accepted as they are; others need a translation by a sworn translator. Check with the CPAM before sending.

The wrong office. The application goes to the CPAM of the department where the assignee lives, not where the employer is based.

No French bank details. The RIB is needed for reimbursements. Open the bank account first.

Changing address mid-process. Moving from temporary to permanent housing during the application can send letters to the wrong place. Update the address as soon as it changes.

What Employers Can Do

• Provide the employment contract and an employer certificate quickly.
• Enrol the assignee and family in the company health plan from the first day, so private cover applies while the public file is processed.
• Brief the assignee on keeping receipts and paper treatment forms.
• Track the file monthly until the carte Vitale arrives.

Accompanying Family Members

A non-working partner who arrives with an employee can usually be covered through the family situation of the insured person, but the documents differ from those of the employee. Children are attached to a parent. Prepare marriage and birth certificates for every family member before departure, with translations where needed.

How Le Mendèlle Helps

Le Mendèlle's Admin team prepares and tracks health cover registration for assignees and their families, alongside housing, through a single point of contact. See how it fits into the first 30 days in France and why the bank account comes first in our guide to opening a bank account in France. Immigration context: our 2026 France Talent Permit guide.

FAQ

Sources: Ameli – Form S1106 · Service-Public.fr