Everything You Need to Know About “Sécurité Sociale,” the French Health Insurance System

It won’t be long before you start hearing the French complain about bureaucracy. Soon enough, you might add your voice too—not only because you’re trying to adapt to the culture but because many employees, employers and landlords may not be familiar with your Working Holiday Visa holder status in France.

It’s okay, we’re here to help! You’ll see, everything gets easier when you understand how things work and what you’re eligible for.

Let’s start with the French health insurance system, the “sécurité sociale,” aka “la sécu.”

How do social insurance numbers work in France?

In France, the social security number (“numéro de sécurité sociale” or simply “numéro de sécu”) is used by the Caisse Primaire d’Assurance Maladie (CPAM) to grant beneficiaries access to healthcare. It’s also used by a number of public services, such as the caisse d’allocations familiales (CAF), France Travail and more.

This number is made up of 13 digits and a 2-digit control key. Each digit has a specific meaning:

1st digit

Gender:

• 1: Male
• 2: Female

Next 2 digits: Year of birth

Next 2 digits: Month of birth

Next 5 digits

Place of birth:

• 2 INSEE digits for department of origin
• 3 INSEE digits for the commune of origin

Last 3 digits: Serial number to avoid any mix-up between people born at the same place in the same period

The department digits are always “99” for people born aboard, and the INSEE communal code becomes the INSEE code for the country of birth (401 for Canada, for example).

Am I covered by the French healthcare system as a WHV holder?

Short answer, no. Working Holiday permit holders are not eligible for the “sécu” healthcare coverage and benefits. People with one of the so-called “statut irrégulier” (e.g. Working Holiday permit holders, and yes, the name sounds awful) can’t even get a temporary number. You will be denied if you apply to your local CPAM.

We’ve heard that a few travellers have managed to get a “numéro de sécu” but this is only because the local bureaucracy apparently wasn’t used to dealing with foreigners… this is by no means a right or the norm.

As a worker in France, a certain amount will be deducted from your gross salary as a contribution toward the “sécu” even if you’re not eligible for coverage. This is normal and legal.

Note that Working Holiday permit holders aren’t eligible for other services either, including family benefits through the CAF or unemployment benefits through France Travail.

What should I do if my employer asks for my “numéro de sécu”?

You can remind your employer that it’s perfectly legal to hire a worker who doesn’t have a social insurance number as long as they have a valid work visa. Your Working Holiday permit is proof that you can work legally in France. Your employment contract doesn’t have to specify a “numéro de sécu.” All you need is a home address on your pay slips.

You must provide your employer with:

• A copy of your Working Holiday permit
• A piece of ID (your passport)
• A “RIB” for “relevé d’identité bancaire”, which is a bank document with all the information required for direct deposit
• A home address.

What’s a “numéro technique temporaire” (“NTT”)?

As part of the pre-employment declaration (“déclaration préalable à l’embauche” or “DPAE”), your employer can create a temporary technical number (NTT) valid for a maximum of 3 months. This number will be as follows: gender (1 for a man, 2 for a woman), the company’s SIREN number, and the employee’s ID number.

Applying for a social security number for administrative purposes only is not your responsibility. It’s up to your employer to request an NTT from the URSSAF. You can find out more about creating an NTT here (in French).

If your employer doesn’t want to go through the process, apply for a “numéro de sécu” at the CPAM. You will get a refusal letter (since you’re not eligible as a Working Holiday permit holder) and that’s all your employer will need—French logic… As a last resort, you can always ask your embassy for help if you need to prove you have the right to work in France.

What if I need to see a doctor in France?

You don’t need a social security number to see a doctor in France. Clinics and pharmacies will ask for your “carte vitale” (French health card) by default but it’s only needed when you have coverage.

No healthcare professional will refuse to see you because you don’t have a “carte vitale.”

Simply pay and ask for the invoice, as you will need it to submit a claim to your private travel health insurance.

Information specific to Canadians

Canadians are eligible to extend their stay in France for an additional 12 months. In the second year, technically, you are longer a WHV holder, but rather on an autorisation provisoire de séjour (APS). That is why it becomes possible to obtain a social security number for yourself.

Make an appointment with your local CPAM office (dial 3646 or walk in to request an appointment). On the day of your appointment, you need to bring:

• The application form (“demande d’ouverture des droits à l’assurance maladie”)
• Your passport
• A copy of your Working Holiday permit
• A copy of your birth certificate;
• Proof of long-term residence in France (e.g. employment contract or pay slip) and a RIB from your bank
• Proof of residence in France (rent receipts dated less than 3 months or lease)

It takes about two months to get a numéro de sécurité. In the meantime, a provisional number (starting with 7 for a man and 8 for a woman) should be assigned to you and it offers coverage. However, you will not yet be able to create an AMELI account or apply for the “carte vitale.”