Latest news on CPAM affiliation – French social security
The end of 2025 and the beginning of 2026 are marked by significant changes in the rules governing affiliation with the Caisse Primaire d’Assurance Maladie (CPAM). Between legislative reforms, digital modernization, and practical adjustments in the processing of files, here are the key points for users and professionals involved in international mobility.
Introduction of a Minimum Contribution for Certain Non‑European Foreign Nationals
As part of the review of the Social Security Financing Bill (PLFSS) for 2026, the National Assembly adopted in November 2025 an amendment imposing a minimum contribution on non‑European foreign nationals holding a long‑stay “visitor” visa. This contribution would determine the opening and maintenance of their rights to healthcare coverage through Universal Health Protection (PUMa).
Context
- Currently, PUMa allows any person regularly residing in France for more than three months to access basic health insurance without any specific contribution, even without professional activity, provided they can demonstrate sufficient financial resources.
- The amendment aims to correct what some members of parliament perceive as an “anomaly”: non‑European foreigners may currently obtain free health coverage after three months without contributing to the system’s financing.
- The text specifies that the amount and modalities of this contribution will be set by decree; the original text does not provide any specific figures.
Stated Objective
- Strengthen contributive fairness, particularly for individuals who are not taxable in France, such as some retirees, who are sometimes described as benefiting from advantages compared to French residents.
- The text was adopted by a majority in the National Assembly but must still be examined by the Senate before possibly coming into force.
Digital Carte Vitale: Nationwide Rollout Confirmed
A major development of autumn 2025 is the expansion of the Carte Vitale mobile app (previously mentioned in a 2023 news update) to all insured persons in France: since 18 November 2025, the mobile application is available to everyone, regardless of their insurance or health coverage scheme.
What This Means
- This digital version complements the physical card: it allows users to display their entitlements, track reimbursements, and present proof of health insurance during medical appointments or at the pharmacy using their smartphone.
- The digital shift is part of a broader strategy of modernizing the system, aiming to make access to healthcare and online services smoother.
- Activation is not mandatory, and the physical card can still be used.
Important for Foreign Users or Those with Temporary Identification Numbers (NIA)
- Some specialized information sources report that certain categories of people (e.g., those with a temporary identification number, NIA) cannot yet activate the digital Carte Vitale.
- It is therefore recommended to keep the physical Carte Vitale if it has already been issued.
Document Requirements Related to the NIA
A final but crucial point—often less publicized—relates to CPAM’s requirements concerning the documents needed to process affiliation files and issue the Temporary Identification Number (NIA).
Reminder: What Is the NIA?
- The NIA is assigned to individuals who do not yet have a permanent social security number (NIR) but who meet the conditions for affiliation, giving them the same temporary rights as a NIR.
- It is later converted into a permanent NIR once documents are verified and certified.
New Requirement for Civil Status Documents
- File processing rules now require that “civil status documents such as birth certificates submitted […] must have been issued less than one year before the NIA is created.”
- This requirement aims to improve the reliability and compliance of the documents provided, particularly for individuals born abroad, in connection with identity verification measures.
- This requirement—confirmed both by CPAM practical guides and our own experience handling affiliation files—appears to apply to all civil status documents (birth certificates, marriage certificates, etc.).
Our team dedicated to CPAM French social security affiliation remains at your disposal for any questions!
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