Children’s healthcare in France

As an expat moving to France with little ones, you can rest assured that the country provides free, high-quality healthcare for all. That said, you will probably still want to know the specifics and what to expect when it comes to accessing children’s healthcare in France.

Therefore, this guide is here to help you navigate the system by providing the following information:

Children’s healthcare in France

Similar to much of Europe, the overall standard of children’s health in France is generally high. Indeed, 95% of French children are in good or very good health, and only 0.6% are in bad or very bad health, which is below the EU average of 0.8%. That said, according to OECD data, despite having a low obesity rate, young people tend to smoke more and exercise less than in other OECD countries, giving them a fairly average overall health rating.

The French healthcare system is an integrated network of public and private institutions and healthcare providers. And anyone residing in France who has a French state health insurance card (Carte Vitale) can access free or highly subsidized healthcare. Notably, if you are a foreigner and have been in France for more than three months, you can also access state healthcare through the Protection Universelle Maladie (PUMA). This is a universal healthcare protection scheme that covers the costs of healthcare if you change your employment, family, or residential status. Furthermore, the Complémentaire Santé Solidarité system can help cover extra medical expenses for those on a low income.

Essentially, children up to the age of 18 are automatically covered by their parent’s health insurance. However, they can request their own insurance card or PUMA once they turn 16. You can either register your child with a family GP (médecin traitant) or a pediatrician. However, it is worth noting that minors are exempt from the co-payment and flat charges that can apply to adult healthcare.

Dedicated pediatric health centers

There are pediatric medical centers in France, such as CMI, EPSM, and CMSEA. However, these are not your first port of call, but rather where your pediatrician or GP would refer your child. There are also local centers called PMI (Protection Maternelle et Infantile) that offer additional social and healthcare support for pregnant women and children up to the age of six. While the services they offer and the medical staff on hand vary greatly from region to region, they typically include on-site pediatricians, midwives, and/or gynecologists.

How to access healthcare for your children

In 2020, France spent 12.4% of its GDP on general healthcare, which is one of the highest in Europe. All children, regardless of nationality, can access healthcare for free through their parent’s health coverage policy. State insurance covers short-term hospitalization at a rate of 80%, and any additional private health insurance (which is known as Mutuelle) covers the remainder. However, the state covers 100% of medical costs for hospital stays that are longer than one month.

There are different types of Mutuelles to choose from, and some cater to a particular segment of the population, such as teachers, doctors, or state employees. Some also provide better coverage for particular medical expenses, such as glasses or dentures.

You can compare health insurance providers and find a policy that best suits your needs on Les Furets or Devis Mutuelle. Alternatively, you can visit our expat health insurance quotes page. The state health insurance website, Ameli, also provides a section in English that includes advisory phone lines for English speakers.

Public healthcare for children in France

You can register for subsidized healthcare in France through your employer, and this also covers your family. However, if you are self-employed, you should contact the Regime Social des Indépendants (RSI). You can also contact your local CPAM (Caisse Primaire Assurance Maladie) office if you qualify under PUMA.

The French public health insurance card (Carte Vitale)

Unless you are in France illegally, or for less than three months, you will have access to free healthcare through state social security (i.e., public health insurance). This applies even if you are not working in the country. If you are a non-European resident, on the other hand, then you need to possess documents, such as a long-stay visa and residence permit, which prove that you are in the country legally. Then, you simply need to fill in a form to sign up for the sécu health insurance system.

You will need to present copies of the following documents to complete your application for the Carte Vitale:

• Your passport or valid ID
• Proof of French residence
• Proof of address such as recent a French utility bill
• Marriage or birth certificates, if you need to include family members
• Evidence of income, if relevant
• A Declaration de Médecin Traitant to register yourself with a local GP

Notably, this process is the same for expat children, as long as their parents can show that they are in France legally.

Once you have gone through this process, you will receive a Carte Vitale (French public health insurance card) that also covers your children. It will be scanned in every pharmacy, clinic, or hospital to give you access to free or reimbursed healthcare. This means that it covers almost all types of treatment, including specialists.

If the practitioner is a registered healthcare professional, they will scan your card, which then registers the consultation or purchase and communicates the information directly to your state and private insurance. It is important to note that social security may not cover some alternative therapies, such as naturopathy, sophrology, or reflexology, but your Mutuelle can at least partly cover this.

Private healthcare for children in France

Fortunately, public health insurance covers almost all healthcare costs for children in France. However, if you choose to sign up for complementary healthcare (Mutelle), it will also cover your children. Notably, while independent medical providers in France still offer their services through the public healthcare system, they often charge more. In practice, this means that the health system classifies doctors as sectors 1, 2, and 3.

Sector 1, 2, and 3 healthcare providers

Sector 1 doctors, who choose to practice under the state insurance’s financial conditions, have a fixed consultation fee. The state social security scheme reimburses 70% of this fee, and the patient’s Mutelle (private insurance) covers the remaining 30%. The state’s public health insurance only covers 100% of the costs for the most vulnerable populations.

However, Sector 2 and 3 doctors set their own fees, with Sector 3 doctors being the most expensive as they have no agreement with the state. Because of this, state security (public health insurance) reimburses very little.

Many private doctors and specialists receive funding through the state insurance scheme, which means that they will still provide their services through the public healthcare system. Likewise, those with public insurance can access most privately run hospitals. However, the costs of privately run services will be higher. So although your state health insurance will cover the same percentage of expenses, you will have to pay more for the part that isn’t covered.

Having said that, if specialists (Sector 1) are high in demand, then you may want to go private (Sector 2 or 3) or access alternative therapies that are not covered by the state. Generally, Sector 2 and 3 health providers have shorter waiting times but will charge more. Therefore, it is wise to take out complementary Mutuelle insurance to cover part of these additional costs.

Private health insurance providers

Some of the main private health insurance providers that offer supplementary coverage in France include:

• Allianz Care
• APRIL International
• Cigna Global

Taking your child to the pediatrician

While pediatricians specialize in children’s healthcare in France, there is a shortage, with only one pediatrician per 5,300 children. As a result, waiting lists for appointments can be long. Therefore, you should register your child with a local GP or pediatrician as soon as possible.

Despite this shortage, 60% of children under the age of two are registered with a pediatrician. However, 85% of medical appointments that involve children in urban areas are with a GP instead of a pediatrician. This is more the case with older children, too. Fortunately, the local PMI center can track your child’s development and conduct routine medical checkups from birth to the age of six.

Typical medical checks

Pediatricians can follow your child’s medical progress from birth into late adolescence, and there is no defined age limit. They often practice in independent clinics with a few colleagues and a medical assistant who looks after the administration.

Pediatricians also perform the following tasks:

• Regular check-ups
• Follow your child’s growth and development
• Administer vaccines and write prescriptions
• Offer advice on a wide range of matters, such as breastfeeding to sleep patterns and tantrums

It is helpful to know that even though it may be challenging to get an appointment, pediatricians keep daily spots open for urgent matters.

Finding a GP or pediatrician

It is worth asking other parents at your child’s school or nursery for GP recommendations. Notably, some GPs are child-friendly, while others cater more to adult patients. Another thing to remember is that a GP consultation has a set fee of €25, whereas consultations with specialists (including pediatricians) can cost double that upfront. However, national health insurance only reimburses a fraction of that, which means that your added private insurance should cover most of the balance.

You can use the Doctolib website to search for both GPs and specialists near you and book an appointment either online or over the phone.

Routine childhood health checkups in France

Between birth and the age of 16, every child in France has 20 routine medical exams, which the state fully covers. Some are done by the child’s GP or pediatrician, while others (such as hearing and language exams) take place at nursery and school, and are administered by local specialists who are assigned to do the rounds. In the latter case, parents can sign a consent form and obtain results in a closed envelope from the school.

In the first year of life, your baby will have set monthly appointments. And until the age of three, they will go for routine check-ups every six months or so. Beyond that, three medical exams are scheduled around four, five, and eight, as well as one in early adolescence (11 to 13) and a final one at 15 to 16.

This last exam is generally done, at least in part, without the parents being present as it covers sensitive issues including menstrual pain, acne, and depression. The doctor will also record each exam and stage of their development in a personalized booklet known as the carnet de santé.

List of routine checkups

• Growth curve
• Psychomotricity
• Emotional development
• Early detection of genetic anomalies or deficiencies
• Vaccinations
• Promoting healthy behaviors and activities
• Eyesight and hearing
• Language and learning issues

Vaccinations for children in France

Importantly, children born before 2018 must have a DPT vaccine (protection against diphtheria, whooping cough, and tetanus) to access schools in France.

For children born after 1 January 2018, a series of vaccinations are mandatory to protect them against the following 11 diseases:

• Diphtheria
• Tetanus
• Polio
• Whooping cough
• Hemophilus influenzae type B
• Hepatitis B
• Meningococcus C
• Pneumococcus
• Measles, mumps, and rubella (MMR)

Notably, additional vaccines, including hepatitis A and tuberculosis (TB), are not mandatory. However, it is recommended for children born in, traveling to, or whose parents are from countries with high TB rates. Pediatricians may also recommend vaccines for the flu or chickenpox, depending on the child’s health and immunity.

Taking your child to see a doctor or specialist

Your child’s GP or pediatrician will always be your first point of call, and these consultations are covered by state insurance. You should only head to your local hospital or call 112 in an emergency. However, if it is not an emergency, but you can’t get an appointment with your doctor, you can always take your child to the nearest SOS Médecins clinic (emergency doctors), which is open 24/7.

If you are taking your child to see a doctor for the first time, you can use the Doctolib website to find available GPs or pediatricians near you. Once you find a suitable healthcare professional, they need to sign a form called the déclaration du choix du médecin traitant to register as your child’s primary practitioner. You can then forward this completed form to the sécu (state health insurance).

France has a well-developed healthcare system, so specialist services, such as neurology, endocrinology, osteopathy, pneumology, psychotherapy, cardiology, and oncology, are available for children as well as adults. That said, specialized children’s wards may only be located in major cities and large hospital centers.

Below are examples of centers that specialize in children’s health:

• Centre Médical Infantile (CMI) – a multidisciplinary pediatric healthcare center in Romagnat
• Établissement public de santé mentale (EPSM) – a public institute for psychiatry, psychology, and mental health care for children and adolescents in Lille
• Centre Médical Spécialisé de L’Efant et de l’Adoloscent (CMSEA) – a multidiscuplinary pediatric medical center in Paris
• Centre de Pneumologie de L’enfant – a specialized pneumology (respitory) medical center for children in Paris

Children’s hospitals in France

You don’t need to go through your GP or pediatrician to access hospital care in France. However, the GP can, of course, refer your child for hospitalization if necessary. The state social security system covers most of the medical expenses of a hospital stay. However, you or your private insurance will need to cover standard rooming costs (forfait hospitalier), which are roughly €20 per day, and any additional comfort-based requests, such as a private suite or television.

Moreover, if a parent can’t work because they are caring for a hospitalized child, then the state provides a daily allowance of €50 per day for up to 310 days. This allowance is known as the allocation journalière de présence parentale (Ajpp). You can request it through your local Caisse d’Allocation Familiales (CAF), which is an allowance fund for families.

The SPARADRAP Association for sick children also provides a list of vocabulary and illustrated leaflets (in French) to help parents, children, and adolescents. It explains how the hospital system works and can reduce some anxiety about what to expect. 

While there are pediatric divisions in every major hospital in France, you may still need to search for specialized wards depending on your child’s condition. To that end, an annual list of top-rated hospitals is published each year by Le Point magazine, including listings by pathology.

In terms of pediatrics, there are 589 hospitals in France that treat children, and a top 50 list (in French) from 2019 includes the following ones:

Hospitals in Paris and central France

• Hôpital pédiatrique Clocheville: 49 Bd Béranger, 37044 Tour
• CHU d’Estaing Clermont Ferrand: 1 Rue Lucie et Raymond Aubrac, 63100 Clermont-Ferrand
• Armand Trousseau: 26 Avenue du Dr Arnold Netter, 75012 Paris 
• Necker-Enfants Malades: 149 Rue de Sèvres, 75015 Paris
• Robert-Debré: Bd Sérurier, 75019 Paris

Hospitals in western France

• CHU Hôpital Mère-Enfant: 330 Av. de Grande Bretagne, 31300 Toulouse
• Hôpital Pellegrin: Place Amélie Raba Léon, 33076 Bordeaux 
• CHU Rennes – Hôpital Sud: 16 Bd de Bulgarie, 35200 Rennes
• Femme-Enfant-Adolescent: 38 Bd Jean Monnet, 44000 Nantes

Hospitals in eastern France

• CHU Grenoble – Site nord: Boulevard de la Chantourne, 38700 La Tronche
• CHU Hôpital Nord Saint-Etienne: Avenue Albert Raimond, 42270 Saint-Priest en Jarez
• Hôpital de Hautepierre: 1 Avenue Molière, 67100 Strasbourg
• Femme-Mère-Enfant: 59 Bd Pinel, 69500 Bron

Hospitals in northern France

• Jeanne de Flandre: Av. Eugène Avinée, 59000 Lille
• Charles-Nicolle CHU Rouen: 37 boulevard Gambetta, 76000 Rouen
• CHU Amiens-Picardie: 1 rond-point du Professeur Christian Cabrol, 80054 Amiens

Hospitals in southern France

• Hôpitaux pédiatriques Nice CHU: 57 Av. de la Californie, 06200 Nice
• Hôpital Saint Joseph: 26 Bd de Louvain, 13008 Marseille
• CHU de Montpellier: 191 avenue du Doyen Gaston Giraud, 34295 Montpellier

Children’s dental care in France

Your state health insurance will cover your child’s first dental visit at age three, and then once every three years until the age of 24. You will receive a reminder (the M’T dents form) for this. Dentists will charge for any other dental appointment in between these. In essence, these regular check-ups aim to prevent later and potentially more painful treatment.

Once you receive your M’T dents form, you can take it to any local dentist for a free check-up. Just search for ‘Chirurgien-dentiste‘ on the Ameli directory, Annuaire Santé.

Unlike in many other countries, you don’t need to register with a dentist in France. However, dental surgeries are very busy, and making an appointment can be a challenge. Moreover, if you miss two appointments, the dentist may still invoice you for the consultation and likely refuse another consultation until you settle your account.

As long as you have state health insurance, most dental treatment for children will be free, with some exceptions, such as braces. The SPARADRAP Association also provides an illustrated leaflet (in French) with information for parents and children about dental care and what to expect when visiting the dentist.

Dental healthcare campaigns

Although there are often local campaigns to promote good dental hygiene to children in France, the state does not organize these at the national level (in French). Therefore, you may find that local schools, associations, administrations, or regional health insurance providers organize such initiatives or send you informational brochures. In any case, dentists in France recommend using a very small amount of fluoride toothpaste while brushing a child’s teeth twice daily.

Mental healthcare in France

In France, behavioral and psychiatric issues (in French) are the most frequent cause of long-term medical treatment in youth under 15. Following the COVID-19 health crisis, the French government also moved towards providing more funding for psychological support.

This support includes the MonParcousPsy program, which provides professional psychological support for children and adolescents aged three to 17. As of 2022, the state insurance, when accompanied by a medical reference, will also cover eight therapy sessions for patients aged three and up who are struggling with mild to moderate psychological issues.

If your child is experiencing mental health issues, your first port of call will be their GP or pediatrician. You can discuss your child’s struggle with your doctor, who will refer you to the most appropriate structures and services. Your child might then receive an appointment with a psychologist, psychiatrist, psychoanalyst, or psychotherapist. In addition, the proposed therapies can include relaxation methods, hypnotherapy, cognitive and behavioral approaches, or family therapy sessions.

Psychological support may also be available within your child’s primary school through a national network known as Réseau d’Aide aux Enfants en Difficultés (RASED). Again, the SPARADRAP Association for sick children provides an illustrated leaflet to help both parents and children broach the topic of mental health.

Preventative healthcare programs for children in France

France’s National Public Health Plan focuses on prevention and comprises an extensive list of early interventions to promote good health from childhood to old age. Specifically, the plan consists of 25 flagship measures, some of which focus on children and young people. These include:

• Preventing obesity in children through a strengthened promotion of physical activity
• Health promotion in secondary schools to tackle poor lifestyle choices including smoking, alcohol, nutrition, physical activity, and the environment
• Preventing hearing loss in young people through free check-ups for teenagers and awareness campaigns
• Piloting a condom card for young people under 25 to access sexual health services and free contraception
• Strengthening young people’s counseling services through collective and preventive outreach interventions with families
• Providing 80% of the population with First Aid training to respond to emergencies and situations of physical distress
• Providing students with First Aid training on mental health to respond to psychological distress

Schools are largely responsible for promoting healthy lifestyles and providing prevention advice. For example, they encourage and teach children as young as three or four to swim and ride bicycles. In addition, French school canteens provide a varied and balanced diet with locally-sourced ingredients, and teachers cover the topic of nutrition in class.

Beyond schools, local administrations are developing infrastructure that favors walking and bicycling, and the government is funding associations that promote physical and mental health to children and young people. Further actions include protecting children from advertisements for unhealthy food and drinks. Instead, local media channels focus on promoting healthy living initiatives.

Useful resources

• Le Cleiss – the liaison body between the French social security institutions and their foreign counterparts with information about the French healthcare system (in English)
• Info droits étrangers – provides detailed information for foreign nationals about the documents and procedures required to access health coverage in France
• L’Assurance Maladie’s AMELI – the French government’s health insurance department
• QualiScope – an online portal to help you choose a healthcare provider
• Doctolib – a website that allows you to search for local healthcare providers and book an appointment online
• Service Public – the public service website that allows you to navigate social rights and obligations in France
• Ministère des solidarités et de la santé – the Health Ministry website with more information on children’s healthcare
• Ministère de l’Education – the Education Ministry website which covers health-related topics including vaccinations, disabilities, and psychological support in schools
• OECD – provides detailed research and statistics on children’s health in France and other OECD countries