The CFE: the miracle solution for Europeans?

Whether you are already living abroad or preparing your first expatriation. One of the most important points is to find health insurance that can optimally cover you and your family. Many solutions exist: local or international, with different features such as prices or levels of coverage. But there is a particular and sometimes disputed formula, which could be the best value for money, especially in countries where the cost of medicine is very high. We are talking here about the CFE. Which can be the ideal partner for your expatriation when it’s combined with the right complementary. Initially designed for French expatriates, The CFE is now open to all expatriates, from the European Union, the European Economic Area and Switzerland.

How does it work? Let’s see together why the CFE can be the right solution.

What is the CFE?

The CFE, or Caisse des Français de l’Etranger, is a French organization under private law, which takes over the operation of French social security, but for expatriates.

It consists of 3 parts:

  • Health insurance for illness – maternity – invalidity, guaranteeing coverage of health costs anywhere in the world
  • Accident at work and occupational disease insurance
  • An old-age insurance, equivalent to the French pension system

Here we are talking about health and maternity insurance. The CFE has created 3 different plans depending on the age of the insured, for better support over the years.

  • JeunExpat for people under 30
  • MondExpat for employees over 30
  • RetraitExpat for retirees

Who can join the CFE?

Originally designed for French expatriates and their families (multinational or not). It was recently also been open to all expatriates, from the European Union, the European Economic Area and Switzerland.

From 18 years old (alone) and without age limit.

How does the CFE work?

Reimbursements are based on French social security. However, geographical sharing smoothing of reimbursements across the world. So the percentage of refund will be lower in a country where the cost of medicine is high, to have the same level of coverage everywhere in the world.

Here are the different zones and the reimbursement percentage:

World’s map

List of countries

Reimbursement by area

How much does the CFE cost?

CFE price is calculated by using two very simple criteria, if you are alone or with familly, and with your age and the one of your family.

Here is the fee schedule:

Premium scale 2022

Little tip, if there are two of you and you and/or your spouse are under 30. It is better to make 2 different registrations.

Why choose the CFE?

The CFE has many positive points which greatly differentiate it from traditional insurance, and which make it an interesting player in the insurance market:

  • Stable low prices, the CFE is not subject to the annual inflation of traditional insurance, which makes it a long-term solution.
  • Options that may be interesting, such as the “disability-death” for exemple.
  • Worldwide coverage
  • Fixed family price, which does not increase despite the number of children
  • Accepts the pre-existing conditions (the complementary can refuse them)

For the French people:

  • Total continuity of the SECU, in the event of a definitive return to France
  • The possibility of receiving a vital card for your care in France

Be careful, however, CFE also has some negative points here:

  • Does not allow direct billing for outpatient consultations, so the amount will have to be paid before being reimbursed within 10 to 30 days. Direct billing possible for hospitalizations thanks to the complementary that will be associated.
  • Waiting periods for peoples over 30 years of 3 months. For maternity in all cases the waiting period will be 10 months.

Why opt for a complementary?

As indicated by the reimbursement scale per zone above, the reimbursement is not 100% of the costs, you will  have a part to pay. In case of hospitalization, in best case scenario, the reimbursement is of 67% in zone 1 countries, such as Cambodia or Togo and in the worst case, only 19% in zone 5 countries, such as the USA or Hong Kong for example.

This is too low to be an optimal insurance, which can cover you in any eventuality. For exemple, a hospitalization in Hong Kong. One of the best equipped countries in the world but also one of the most expensive. In Hong Kong the average cost is €12,000 and the CFE will only reimburse you 19% of this cost, meaning 2280€.

Therefore, the main role of a complementary CFE is to cover the difference between the amount of the invoice and the CFE reimbursement. This allows you to have a complete insurance to cover your health costs.

How much does the complementary cost?

The complementary price is indexed on the same criteria as other insurances. However, the price remains most of the time, more interesting than a classic insurance, between 20 and 30% cheaper, because:

  • Part of the coverage being reimbursed by the CFE, it is a significant part that complementary insurer doesn’t have to repay.
  • Made for Europeans, complementary organizations think, often rightly, that in the event of serious illness, care will be provided in the country of origin, which greatly reducing inflation on this type of plan.
  • Direct billing on outpatient visits is not available on this type of plan. This avoids medical overconsumption and therefore lowers the amount of the premium.

A complementary insurance therefore offers you all the advantages of classic insurance, but at a more attractive price thanks to the CFE and often better reimbursements.

How to choose your complementary?

There are different criterias to consider during your search. They are mostly similar to the criteria for normal insurance. Here they are:

  • The coverage area: Even if the CFE has worldwide coverage, it’s not necessarily the same for the complementary. So be careful to be covered in your country of expatriation but also your native country. Be careful to not have too extensive coverage to reduce the price of your complementary.


  • Reimbursement levels: Most complementary have indeed reimbursement limits (annual limit or per act). Like conventional insurance, you can pay attention to its limits and the prices charged in your country of residence, low limits will in fact reduce the price and it is not necessary to be too well covered.


  • The service: One of the most important things to look at when you want to be insured is the service offered. Many insurers offer very attractive plans in terms of coverage but have poor service that does not allow you to take full advantage of your insurance. So, pay attention to the platforms offered by the insurer (website? Application?), the languages that can be used by customer service and the speed of reimbursement, for that do not hesitate to look at the comments on the internet.

Just for the complementary

  • Links with the CFE: Finally, the most important thing for a complementary is the link that the organization maintains with the CFE. Indeed, some insurers offering complementary can support the communication between you and the CFE. It is known that the Caisse des Français de l’Etranger French does not have a good service reputation. In this sense that it is imperative to choose the right complementary. For this, 3 criterias are important:
    • A single membership: This is not the most important criteria, but it is always easier not to make only one application form than 2 different.
    • A single refund: Some organizations offer you a single refund, which is more pleasant than 2 different refunds.
    • The speed of reimbursement: the reimbursement times for the CFE are long and some organizations offer a single reimbursement, advancing the CFE. The delay are  shortened to 1 week (only for outpatient visits, there is indeed direct billing for hospitalization)

How to find a suitable complementary 

For these you have two solutions. Compare yourself, by asking quotes from several organizations. It is time-consuming and it’s a difficult work, not everyone is an insurance professional, and the terms are sometimes complicated to understand.

Or, you can ask a professional, such as an international insurance broker. He will be able to provide you good advices and direct you to the right complementary. They know the coverage and services of each company perfectly.

At Expatmedicare, we have been working with CFE complementary for more than 10 years and we know perfectly this solution. Thanks to our constant search of the best products, we selected the best complementary that can follow you throughout your expatriation, protecting you and your family.

To contact us it happens here.


There are hundreds of ways to properly cover health costs abroad and it is very important to compare them to be sure of being optimally insured. The CFE combined with a good supplement is one of them and allows you an often-unbeatable value for money. Whether you are French or European national or even Swiss, alone or with your family, this still little-known solution will in most cases prove to be the ideal and long-term solution to follow you in your expatriation.

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