FLETCHER ARMSTRONG UPDATE

^{Recent changes to health care costs for French-visa holders}

15 January 2026, Paris.

Under the current system, long-stay visitor visa holders who never worked in France may access the country's public healthcare services without charge. The French parliament recently took steps to close this loophole. Fortunately, American retirees are still eligible to receive a carte vitale, the French health card, but in the future, they may be asked to pay a “minimal contribution”, which is yet to be defined.

Under France’s universal coverage (PUMA, la protection universelle maladie), since 2016, those who reside in France for over three months are entitled to sign up for French health care and obtain a carte vitale. In theory, visitors would pay a contribution, (CSM, la cotisation subsidiaire maladie) based on their French tax declaration. However, under a French-American treaty, American retirees do not pay French taxes on their US retirement income, creating a loophole under which many long-stay visitor visa holders benefit from the French health care system without ever having made contributions to it. The situation was brought to the attention of French legislators in part due to CNN reports and relocation agency advertisements enticing American retirees to move to France in order to benefit from France’s excellent and low-cost public health system.

On 8 November 2025 the Assemblée Nationale added a provision to budgetary legislation that will require non-EU retirees who obtain a carte vitale to contribute a “participation minimale.” The amount of the contribution will be determined in a future decree.