France's healthcare system is heavily subsidized, but unlocking that system requires the Carte Vitale (the green state health insurance card). If you are an EU citizen moving to France, you do not get this card automatically when you cross the border. Navigating the bureaucratic gap between arriving and getting your card is a rite of passage.

🇪🇺 The EHIC Bridge (For EU Citizens)

If you are an EU citizen, your home country's European Health Insurance Card (EHIC / Carte Européenne d'Assurance Maladie) covers you for medically necessary care while you are a temporary resident or tourist.

  • Emergencies: If you need emergency PEP (TPE) at a hospital, show your EHIC. The hospital will treat it as state coverage.
  • The Pharmacy Problem: While you can use your EHIC to see a general practitioner (you will pay upfront and apply to your home country for reimbursement), French pharmacies cannot easily process an EHIC for free PrEP. If you try to pick up PrEP with a foreign EHIC, the pharmacy will almost certainly charge you full price out of pocket.

⏳ The Application Reality (CPAM)

If you are moving to France to work or study, you must apply to CPAM (Caisse Primaire d'Assurance Maladie) for a French Social Security Number (Numéro de Sécurité Sociale).

The Wait: The French administration is notoriously slow. Processing your CPAM application and issuing a permanent social security number and physical Carte Vitale can take anywhere from 3 to 6 months.

During this waiting period, you will eventually be issued a "temporary" social security number. With a temporary number, you still have to pay upfront at the doctor and pharmacy, but you are given a brown paper receipt called a feuille de soins. You mail this paper to CPAM to eventually get your money back.

🌉 The Gap Strategy

How do you get free PrEP and STI tests during the 6 months you are waiting for your physical Carte Vitale?

You use the CeGIDD.

Because CeGIDD clinics are 100% free and do not require a social security number, ID, or insurance card, they are the ultimate safety net for expats and immigrants. Use the CeGIDD for your quarterly testing and PrEP prescriptions until your Carte Vitale arrives in the mail. Once you have the card, you can transition to a private GP and a neighborhood pharmacy.

🛡️ La Mutuelle (Top-Up Insurance)

The French state (Sécurité Sociale) does not cover 100% of all medical costs. It typically covers 70% of a doctor's visit and a percentage of lab tests.

To cover the remaining 30%, residents use a Mutuelle (private top-up insurance).

  • If you are employed in France, your employer is legally required to provide and heavily subsidize a Mutuelle for you.
  • If you are a student or freelancer, you can buy one privately for around €30–€50 a month.

Is PrEP 100% covered? Yes. The state recently classified PrEP as 100% covered by Sécurité Sociale. However, the routine blood tests and swabs required to maintain your PrEP prescription are usually only 60-70% covered by the state. You need your Mutuelle to cover the rest of the lab bill, or you will have to pay a few euros out of pocket at the lab each quarter.

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