Moving abroad means stepping outside the safety net of the French national health system. Expat insurance fills that gap: it covers your medical bills overseas, organises your evacuation in a medical emergency and protects you against the everyday risks of life far from home. The sooner you take it out, the more peace of mind you carry with you.
What expat insurance actually covers
Medical expenses and hospital treatment abroad
Hospital care can run to tens of thousands of euros in certain countries, particularly the United States, Canada or Singapore. A solid expat insurance policy typically covers:
- routine GP visits and prescription medicines;
- hospitalisation (surgery, intensive care);
- dental and optical treatment, depending on the level of cover chosen;
- maternity and paediatric care, if you are moving with a family.
Some policies offer international direct billing, sparing you the need to pay large sums upfront and wait for reimbursement.
Medical repatriation and emergency assistance
This is the most critical benefit of any expat insurance policy. If a serious accident or illness requires treatment that local facilities cannot provide, your insurer organises and funds the appropriate medical transport: an equipped air ambulance, an adapted commercial flight or a ground ambulance. The assistance line operates around the clock, every day of the year.
Beyond transporting the patient, policies generally also cover:
- repatriation of remains in the event of death;
- the return home of companions who were travelling with you;
- the travel costs of a family member coming to your bedside if you are hospitalised far from home.
Third-party liability abroad
Depending on the plan you choose, expat insurance may include liability cover for bodily injury, property damage or financial losses caused to third parties. This is particularly valuable in countries where legal proceedings can be extremely costly.
CFE, first-euro contract or both: which structure suits you?
There is no one-size-fits-all answer. Three broad options are available, depending on your profile, destination and budget.
Joining the CFE to keep your link with the French system
The Caisse des Français de l’Étranger (CFE) is a voluntary scheme that allows you to remain affiliated with the French general health insurance system while living abroad. Membership is not compulsory, but it has one key advantage: it validates your pension quarters and makes returning to France more straightforward.
The CFE reimburses on the basis of French social security rates, which is often well below actual costs in high-expense countries. It is therefore frequently paired with a supplementary international health plan. The cost is estimated at between €57 and €228 per month, depending on your age and situation.
Opting for a first-euro contract
A first-euro contract covers all your healthcare spending without routing claims through the French social security system. One point of contact, generally faster reimbursements and cover better calibrated for countries with high medical costs. The trade-off is a higher premium, and some insurers require a medical questionnaire at the time of application. This structure is particularly well suited to expats in the United States, Canada or the Gulf states.
Combining CFE and an international health plan
For destinations with moderate medical costs (South-East Asia, Latin America, French-speaking Africa), pairing the CFE with an international complementary plan often delivers the best value for money. The top-up plan bridges the gap between CFE rates and actual expenditure, and the combined cost usually comes in lower than a standalone first-euro contract.
The average cost of an international health plan alone ranges from €80 to €200 per month for an adult, depending on destination and the level of cover selected. Combining both contracts, the total annual outlay can range from €400 to over €10,000 depending on your profile and the options you choose.
Take out my insurance onlineThe key factors when choosing your cover
Destination and local medical costs
A country such as Thailand or Mexico has healthcare costs far below those of the United States or Switzerland. Before comparing policies, research the real level of medical expenditure in your host country: this directly determines the level of annual limits you need.
Length of stay and your employment status
A standard travel insurance policy rarely covers trips beyond 90 days. For a long-term move, you need a contract specifically designed for extended stays. If you have been posted abroad by a French employer, check whether your company already provides partial cover.
For a deeper look at the steps to prepare before you leave, see our guide How to prepare for your move abroad.
Your family situation
Moving with a partner and children multiplies your needs: maternity cover, paediatrics and possibly school-related medical requirements. Some contracts offer family plans with a sliding scale for additional insured members; others charge each person pro rata according to their age.
What to watch out for before you sign
Exclusions for pre-existing conditions: most international health plans exclude pre-existing conditions or impose a waiting period. Read the small print carefully before signing.
Waiting periods: certain benefits (maternity, chronic conditions) do not activate until several months after you join. If you are leaving soon, plan ahead.
Cover during stays in France: when you visit France temporarily, does your expat policy still apply? Check the maximum number of days per year you are allowed to spend in France without losing cover.
The partner hospital network: an international network of partner clinics and hospitals means you can use direct billing without paying upfront, a real comfort in the event of emergency hospitalisation.
The assistance service: 24/7 availability, languages spoken, dedicated emergency number. This is often the decisive difference between a budget policy and a premium offering.
For a closer look at choosing the right health benefits, read our comparison guide Choosing expat health insurance and repatriation cover.
FAQ
Is expat insurance compulsory?
French law does not require it. However, some host countries ask for proof of health cover as a condition of granting a visa or residence permit. Beyond that, leaving without cover means exposing yourself to potentially ruinous medical bills, particularly in countries with no public healthcare system accessible to foreign nationals.
What is the difference between travel insurance and expat insurance?
Travel insurance covers short trips, generally up to 90 days, typically for tourism or occasional business travel. Expat insurance is designed for long-term stays: it covers routine care, chronic conditions (subject to policy terms) and includes benefits tailored to life as a settled resident abroad.
Can I take out expat insurance after I have already left?
Yes, in most cases, but waiting periods usually run from the date of application, not the date of departure. It is best to take out cover before leaving France to avoid any gap in protection and to ensure your benefits are active from the moment you arrive.
Is the CFE enough on its own?
Rarely. The CFE reimburses on the basis of French social security rates, which fall well short of actual costs in many countries. It is generally insufficient without an international top-up plan, except in destinations where healthcare costs are close to French levels.
How does medical repatriation work?
In the event of a serious medical emergency, you (or someone with you) call your insurer’s 24/7 assistance line. A medical team assesses the situation in liaison with local doctors and decides on the appropriate means of transport: ambulance, adapted commercial flight or air ambulance. The insurer handles all the logistics and costs. It is essential to keep your insurance documents accessible at all times.
Which policy features should you check first?
Three points are non-negotiable: the annual reimbursement limit for medical expenses, the medical repatriation benefit (with 24/7 assistance) and the exclusions for pre-existing conditions. Also check your cover during visits back to France and whether the policy includes an international direct-billing network.
