Published November 10, 2025
A single line in a new French law changes everything: France has ended free access to its public healthcare system for non-working foreign residents. Passed by 176 votes to 79, the reform now imposes a mandatory minimum contribution on retired foreigners, particularly from the U.S., U.K., and other G20 nations. Behind the vote lies both political intent—and deep concern among thousands of long-settled expatriates.
Until now, foreigners who had lived in France for over three months could access public healthcare through PUMA (Protection Universelle Maladie). Once registered with CPAM, they received care at French public rates — often without contributions if not working.
The 2025 reform changes this: any foreign retiree without employment will have to pay a minimum annual contribution, with the exact amount set by decree in spring 2026. As MP François Gernigon (Horizons) put it:
"National solidarity cannot be one-way."
Around 60,000 foreign retirees could be affected (approx. 35% Americans, 25% British).
Main drivers:
France is moving toward universal contribution: every stable resident participates, even symbolically.
| Profile | Previous regime | New regime | |
| --- | --- | --- | |
| EU retirees with S1 | Covered via home country | Little or no immediate change | |
| Non‑EU retirees (US, Canada, etc.) | PUMA access after 3 months | Mandatory contribution from 2026 | |
| Returning French nationals (not working) | Rights by nationality | No change | |
| Students & workers | Covered via contributions | No change |
Most affected: Americans, post‑Brexit British, and some Swiss not on LAMal FR.
Examples:
"We thought France welcomed foreign retirees," says Mike (71), resident since 2012. "We bought a home, pay local taxes—and now we're told we cost too much."
EU citizens are partly protected via S1, which transfers healthcare rights while coverage remains with the home country.
Note: S1 generally applies to those receiving a state pension. Private/occupational retirees may need to contribute locally.
Possibilities under discussion:
Data‑sharing between tax and CPAM is planned to reduce abuse; a one‑stop foreign resident desk opens in 2026.
Expat forums (SurviveFrance, ExpatExchange) show mixed reactions:
"I'd rather pay €500 than lose coverage." — Sarah, British retiree in Carcassonne
"It's the end of the French dream." — US retiree in Dordogne
Real‑estate agents fear a slowdown in some second‑home markets.
| Country | Minimum health contribution for foreign retirees | Notes | |
| ------ | -------------------------------------------- | ---------- | |
| France | From 2026: PUMA contribution required | Amount by decree | |
| Spain | €60–€150/month for non‑residents | Convenio especial | |
| Portugal | 5% of declared income, min ~€400/year | SNS + private top‑up | |
| Italy | Regional charge (≈ €500–€2,000/year) | Access to SSN | |
| Germany | Mandatory public/private insurance | Higher but standardised rates |
The trend: no more total free access for non‑contributors.
Government aims: fairness and sustainability. In return, expect faster PUMA processing and improved international reimbursements. A multilingual information campaign is planned for spring 2026.
Key question: does this shift make France less welcoming to foreign retirees—or simply clearer about shared responsibility?
Non‑EU foreign retirees living in France without employment will pay from 2026, unless covered by an S1 or a bilateral agreement.
Not if they hold a valid S1. Otherwise, contributions will be required via CPAM registration.
Expected range €500–€2,000 per year depending on declared income. Final amount to be confirmed by decree in 2026.
For more practical insights on this topic, explore our related articles:
Conclusion: The end of free access to French healthcare marks a new social contract: solidarity now comes with contribution. For EU residents, the S1 remains a safeguard; for others, private insurance becomes essential. France remains generous—but the era of cost‑free care for foreign retirees is closing.
1 tip per week, no spam.
Jules Guerini is a European expat guide sharing practical, tested advice for navigating life abroad. Contact: info@expatadminhub.com
Across Europe, expats report rising health costs, longer waits and more complex paperwork. In 2025, the continent quietly widens the gap between nationals and newcomers. The good news: this gap is largely administrative and strategic, not medical, and you can close much of it with the right choices.
Read the article
Healthcare abroad isn’t luck—it’s a process. With the right documents and two habits (detailed invoice + digital folder), you get appointments and refunds without stress. This 2025 pillar compares FR/DE/ES/CH, explains when to use EHIC/GHIC, how to register as a resident, what S1/S2 cover, and how to act in emergencies.
Read the article
The fever isn't the scariest part—it's how to quickly find someone trustworthy inside a healthcare system you don't know yet. The good news: there's a simple method, copy-paste scripts, clear checklists, and shortcuts to skip long waits. This 2025 guide takes you from "no idea where to start" to "appointment booked, reimbursement guaranteed."
Read the article