End of 'Free Social Security' for Foreigners in France: A Turning Point in 2025

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:

1. Rising PUMA costs (c. €800M in 2024).
2. Fairness between contributing workers and non-working retirees.
3. Political pressure around so-called social tourism.
4. European context: Spain, Portugal and Italy already require contributions.

France is moving toward universal contribution: every stable resident participates, even symbolically.

Most affected: Americans, post‑Brexit British, and some Swiss not on LAMal FR.

Examples:

• US retiree in Nice: likely €500–€2,000 per year, depending on declared income.
• British couple in Dordogne: CPAM may request income evidence and minimum participation.

"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:

• Flat €500/year minimum (Portugal-style).
• Progressive scale based on worldwide income declared in France.
• Exemptions for low income or bilateral agreements (US, CA, CH).

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.

The trend: no more total free access for non‑contributors.

1. Check S1 eligibility (EU/EEA/CH public pension).
2. Private or international health insurance (April, Allianz Care, Cigna, Henner).
3. Regularise tax status in France; contribution will likely use your tax reference income.
4. Consider FR/CH cross‑border setups (LAMal + French care).
5. For stays under 6 months, use EHIC/GHIC for necessary care only.

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?

• End of free PUMA for non‑EU retirees from 2026.
• Minimum contribution required; scale to be confirmed.
• EU S1 holders protected; others contribute locally.
• Options: S1, private insurance, LAMal, French tax residency.

• Service‑public.fr – PUMA
• CLEISS – S1 and coordination
• Ameli.fr – Health insurance for foreign residents
• April International Health Insurance