France has long attracted U.S. nationals looking for a slower pace of life, world-class cuisine, and one of the best healthcare systems in the world. Its public system, rooted in the principle of universal access, allows residents to access doctors, hospitals, and medical reimbursements through Protection Universelle Maladie (PUMA). Under the current framework, non-EU nationals who live in France for at least three months can apply to join the public healthcare system — a major benefit for long-term visitors and retirees.

That may soon change. In late 2025, French lawmakers approved an amendment introducing a new “minimum healthcare contribution” for non-EU nationals — including Americans — before they can access public healthcare coverage. The measure still requires Senate approval and final publication in the Journal Officiel, but it represents a major shift for expats living in France on long-stay visitor visas.

Learn more about relocating to France.

Why the Change Is Happening

Supporters of the new policy say it’s about fairness. French MP François Gernigon, who introduced the measure, noted that many retirees on “visitor” visas benefit from the French healthcare system after three months of residence without contributing to it financially. Since they often pay little or no French income tax or social security contributions, lawmakers argue the balance should be restored.

The proposed fee would ensure that all long-term foreign residents who access public healthcare help sustain it. In the context of France’s 2026 social security financing bill, the measure gained strong backing, passing the lower house with 176 votes in favor and 79 against. While U.S. nationals were singled out in the debate, the new rule applies to all non-EU or non-EEA citizens living in France under a long-stay visitor visa.

What the New Rule Means for U.S. Nationals

Currently, non-EU residents living in France on a “visiteur” visa — typically retirees or those not engaged in professional activity — can apply for public healthcare coverage after three months. Once affiliated with PUMA, they enjoy access to the same benefits as French residents.

Under the new proposal, that access will depend on paying an annual healthcare contribution first. The fee amount has not yet been determined; it will be set by a forthcoming decree. What is clear is that joining the public system will no longer be automatic after three months of residence — and the payment will become a prerequisite for affiliation.

For U.S. nationals, this means planning for an additional annual cost before being able to access France’s public healthcare system. Americans moving to France for retirement or extended stays should expect to pay this contribution before receiving reimbursements for medical care.

What to Expect in Practice

While implementation details are pending, here’s how the new system is expected to work:

U.S. nationals on visitor visas will still be able to apply for healthcare coverage after living in France for three months, but affiliation will only take effect after payment of the contribution. Those who do not pay will need to maintain private health insurance to cover medical expenses.

The reform will not change the quality or scope of public healthcare itself — only how eligibility is granted. Once affiliated, Americans will continue to enjoy the same access to doctors, hospitals, and prescription reimbursements as other residents.

This policy shift underscores France’s broader goal of ensuring that foreigners who live in the country long-term contribute proportionally to public systems, even if they are not working or paying into French social security.

Preparing for the Change

Although the measure is not yet in force, now is the time to prepare. Americans already living in France may be required to pay the contribution at renewal of their residence permits or when updating their healthcare affiliation. Those planning a move in 2026 or later should include this new cost in their relocation budgets.

Until the law is finalized, newcomers are advised to maintain comprehensive private health insurance to ensure continuous coverage. It’s also recommended to consult with a professional who specializes in French immigration and relocation services to understand how this change may affect your visa and residency status.

For those considering the move, Relocate.world provides direct access to verified immigration advisors in France who can assist with long-stay visa applications, healthcare registration, and local administrative requirements.

Key Takeaways

• The new healthcare contribution will apply to non-EU nationals, including U.S. citizens, on long-stay visitor visas.
• Access to the public healthcare system will require payment of an annual contribution before affiliation.
• The contribution amount will be determined by decree following Senate approval of the amendment.
• U.S. nationals should maintain private health insurance until officially affiliated.
• The change reflects France’s broader effort to balance access and fairness in its healthcare system.

FAQs

Who is affected by the new rule? Non-EU/EEA nationals living in France under a long-stay “visitor” visa who wish to join the public healthcare system. U.S. nationals, particularly retirees, are explicitly referenced.

Does this apply to Americans working in France? No. The amendment targets non-working “visitor” visa holders. Americans employed in France already contribute through social charges and remain unaffected.

How much will the contribution be? The amount has not yet been announced and will be determined by a forthcoming government decree.

When will the rule take effect? After Senate approval and publication in the Journal Officiel, expected sometime in 2026.

Will I still have access to public healthcare after paying? Yes. Once the contribution is paid and administrative requirements are met, Americans will have full access to the public healthcare system.

What if I don’t pay the fee? Without payment, affiliation will not be granted, and private health insurance will remain mandatory.

Does this mean I’ll owe French income tax? No, this is a healthcare contribution, not income tax. However, it signals France’s effort to ensure fair participation in social systems.

What should Americans planning to move to France do? Stay informed about legislative updates, plan for the contribution in your budget, maintain private insurance coverage, and consult with an advisor to ensure compliance with all French administrative requirements.