France health costs: retirees face higher bills in 2027
Retirees, the self-employed and others who finance their own complementary health insurance will be among the hardest hit by rising healthcare costs next year, as the government moves to reduce state reimbursement rates across multiple categories of care.
Four draft decrees submitted to the Assurance Maladie for consultation would lower the state's share of costs for dental care, certain medicines, medical devices and medical transport beginning January 2027. The measures come as France grapples with a healthcare deficit estimated at 16 billion euros for 2025, which could balloon to 41 billion euros by 2030 without major reforms, according to the Assurance Maladie's 2026 annual report.
Health Minister Stéphanie Rist confirmed that a fifth decree, which would have doubled the annual ceiling on franchises médicales—fixed fees deducted from patient reimbursements—has been dropped. These charges, introduced in 2008, currently stand at 1 euro per medication box, 1 euro per paramedical act, and 4 euros per medical transport, capped at 50 euros annually per person.
"People will pay more out of pocket and some may start trying to manage their health on their own rather than consult a GP. The government has chosen short-term savings over people's long-term health. It is idiotic."
— Féreuze Aziza, a health advocate for France Assos Santé
What healthcare reimbursements could change
The state's share of dental care reimbursement is expected to fall from 60% to 50%. This marks the second reduction in three years, following a drop from 70% to 60% in 2023. For medical devices such as dressings and braces, the state share would decrease from 60% to 50%, while reimbursement for medical transport would fall from 55% to 45%.
The government has pledged that the 100% Santé dental package, introduced between 2019 and 2020, will remain fully covered. This scheme provides zero out-of-pocket costs for certain dental prosthetics including specific crowns, bridges and dentures for those with complementary insurance. However, treatments outside this protected basket will become more dependent on mutuelle coverage.
The Mutualité Française estimates the changes will transfer between 1.5 and 1.7 billion euros in costs to complementary insurers. France's total health spending reached 325 billion euros in 2023, representing a 3.5% increase from 2022, with public funding accounting for 75.4% of total expenditure. The country's healthcare spending stood at 11.5% of GDP in 2023, significantly above both the high-income country average of 8.2% and the European average of 8.1%.
Impact on complementary insurance premiums
Minister Rist stated that higher mutuelle premiums are not automatic and that the government is negotiating with insurers to limit increases. However, she acknowledged she cannot impose a price freeze. A legal freeze on premiums was passed for 2026, but insurance firms challenged it as unconstitutional and almost all raised prices this year, mostly by 3-10%.
Féreuze Aziza warned that policyholders will feel the impact.
"Health top-ups will get more expensive in 2027. And the reduced reimbursement rates are just the tip of the iceberg since there are lots of hidden expenses on treatments that are not reimbursed by the state—and these are always becoming more expensive."
She cited a UFC-Que Choisir estimate of a further 4-8% increase following a 4.7% rise in 2026.
Retirees and S1 holders among those affected
The changes are particularly relevant to retirees, self-employed people and foreign residents who may pay for their own mutuelle, rather than benefiting from an employer contribution. Since 2016, French employers have been legally required to provide complementary health insurance to employees and contribute at least 50% of the premium cost—a protection unavailable to those outside the workforce.
Foreign retirees with an S1 form are also exposed. The S1 gives them access to French state healthcare under reciprocal arrangements but does not provide complementary insurance. Those who take out a mutuelle themselves can therefore face higher premiums in 2027 if more costs move to insurers, while people without one—estimated at around 4% of the eligible population—will have to meet the extra costs themselves. Approximately 95% of French residents hold complementary health insurance.
"Older people already pay more so will be more at risk of rising costs. And these figures only cover reimbursed healthcare costs—there are many other costs that are not reimbursed at all."
— Féreuze Aziza
Out-of-pocket spending currently accounts for 8.9-9.3% of total health expenditure in France, with long-term care representing the largest share at 37% of out-of-pocket costs, followed by medical goods including pharmaceuticals at 27%.
Aziza suggested the government could have looked elsewhere for savings, including cutting down on over-prescribing and unnecessary tests.
Government justification and patient advice
The government states the measures are intended to control healthcare spending and help fund hospitals, access to care and new medicines. Under the current system, France typically reimburses 60-70% of medical costs through the state for standard care, with the remaining portion covered by complementary insurance or paid out-of-pocket.
Aziza urged people to review their mutuelle cover.
"It is vital that people check they are not paying too much."
It may also be worth checking whether policies will absorb the additional costs when the 2027 changes take effect. Contracts can be cancelled penalty-free after one year.
