What Is the Healthcare File for Asylum Seekers in France?

Legally, all asylum seekers in France are entitled to health coverage, even if they are subject to "accelerated" or "Dublin" procedures. However, during the first three months of residence in France, adult asylum seekers (aged 18 or older) cannot benefit from standard health coverage; they can only receive free hospital treatments through the "urgent care" system.

Asylum seekers who can prove their residence in France for more than three months are entitled to health coverage. Minor asylum seekers (under 18 years of age) and children accompanying an asylum seeker are also entitled to this coverage without any waiting period.

Over time, the asylum seeker will also be entitled to complementary health coverage free of charge—Universal Health Protection (PUMA), previously known as Universal Health Coverage (CMU)—which is accessible to anyone whose resources are around €750 per month.

- Universal Health Protection (PUMA) allows you to receive healthcare free of charge and covers all medical expenses at the hospital, during doctor visits, or for medication, whether for yourself, your spouse, or your children.

- How to obtain Universal Health Protection (PUMA):

- To access these rights, you must visit the Primary Health Insurance Fund (CPAM) at your place of residence on the date specified in the invitation issued to you by the reception center/association or the French Office for Immigration and Integration (OFII).

If the reception facility has not scheduled an appointment for you with the Primary Health Insurance Fund, you should inquire about the matter.

- In some cases, you may not need to book an appointment with the Health Insurance Fund directly; instead, the reception organization/association will complete the health coverage application form and attach the following documents:

- The asylum application certificate issued to you by the prefecture upon registration of your claim.

- The administrative proof of address certificate issued by the shelter or reception center.

- Any document proving your residence in France for more than 3 months, if you are 18 years of age or older.

*- Notice: In certain cases, you may be asked to declare your financial resources over the past 12 months, including earnings in your country of origin. Be mindful of the currency conversion into Euros; this requirement is enforced in only some regions.

Once the file is completed, it is placed in a postal envelope, and you will be asked personally to drop it into the Health Insurance mailbox, usually located directly outside the CPAM headquarters in your area of residence. (A photograph of the deposit is recommended).

*- Notice: It is essential to attend this appointment and submit the file as quickly as possible. Failure to do so will make securing another appointment difficult and create major obstacles to receiving free healthcare and health insurance in the future.

- Treatment procedures and choosing your attending physician:
When you receive the Universal Health Protection (PUMA) certificate—which is typically valid for one full renewable year—you can visit the doctor, hospital, and pharmacy free of charge simply by presenting your health insurance certificate or complementary solidarity health coverage certificate.

- You can also choose an attending physician near your residence who will register you in their patient registry. During each medical visit or consultation, the fees will be settled through complementary health coverage. For this purpose, the doctor will ask you to sign a care sheet (feuille de soins) at each visit until a health insurance card ("CARTE VITALE") is issued, keeping in mind that this card has no longer been issued to asylum seekers since July 2017.

Temporary alternative for asylum seekers: During the waiting period or prior to obtaining the physical card, the applicant receives a paper document called (Attestation de droits) to prove their right to free medical care; see the illustrative image.

- Urgent and vital care:

While waiting to obtain the Universal Health Protection (PUMA) certificate—formerly CMU—asylum seekers can benefit from urgent care, which covers the following areas:

- Care whose absence could endanger the person's life or lead to a serious and lasting deterioration in the individual's health status or the health of an unborn child.

- Care aimed at preventing the spread of disease to those around them or to the community (such as COVID-19 and infectious diseases).

- Care for pregnant women and newborns: specifically preventive examinations carried out during pregnancy, delivery, and post-partum.

- Termination of pregnancy (voluntary or for medical reasons).

To access this care, asylum seekers can visit the Health Care Access Units ("PASS") permanently established in hospitals. There, you will be attended to by doctors and provided with medication free of charge. Waiting times may extend for several hours, but this is routine and justified given the high volume of cases in emergency wards.

In addition to the above, if you require treatment for an emergency or a chronic illness during the waiting period for health insurance approval, or if you are under the "accelerated" or "Dublin" procedure and are unable or unwilling to visit the hospital PASS units, you can contact certain non-governmental organizations that provide permanent access to general medical, dental, ophthalmological, or psychological care without requiring insurance. The most prominent of these organizations is "Médecins du Monde"; therefore, it is advisable to contact the organization's local branch in your area of residence to receive assistance and treatment.