The CPAM and the number you wait months for: start the clock on day one

In Spain and Portugal the pitfall is a registration obligation nobody knows about. In France it's exactly the reverse: nothing is required — and so nothing starts by itself either. Healthcare only learns that you exist on the day you report to the CPAM, the health insurance fund of your place of residence. And from that moment a waiting period begins that counts in months. This is the longest clock of the whole French process; everything in this article serves one purpose: getting it started as early as possible.

Who is entitled straight away, and who waits three months

The French residence-based system (PUMa) covers everyone who works in France or lives there stably. If you work — employed or self-employed — you're entitled from the start of your work and can apply straight away. If you don't work, a waiting period applies: you first have to live stably in France for three months, and your means must be at least at the level of the French social minimum. Retired with a Dutch pension? Then you take a different route: the S1 form from the CAK, which you register with the CPAM — the waiting period doesn't apply to you.

If you leave before your AOW age (the Dutch state pension age), watch the date. The CAK route is expected to be open from 1 November 2026 only to new registrants with a statutory benefit — AOW, Anw, WAO, WIA or Wajong. Whoever brings only an early-retirement pension, an RVU payment or an early-drawn occupational pension then falls outside it and until AOW age takes the non-workers' route above: three months' waiting period, the means requirement, and a policy of your own for the gap. Whoever is already a CAK client keeps their rights. What exactly changes, and what you can do now.

For non-workers this means something important for phase 2 of your process: your Dutch cover stops on emigration, and the French cover only begins after months. The insurance that bridges that gap you arrange before departure — not as a side issue, but as the core of your healthcare preparation.

The application: one form, at the fund of your place of residence

The application is form S1106 ("demande d'ouverture des droits à l'assurance maladie"), to be submitted to the CPAM of your place of residence — online for EU citizens without work, or by post. What goes with it: a copy of your identity document, your IBAN, proof of three months' residence if you don't work (rental contract, rent receipts, energy bills), proof of your work if you do work, and a birth certificate.

Two stories go round about that certificate, and only one is right. Officially it has to be "certified" — a legible stamp — and the fund itself tells you whether a translation is needed; it isn't mandatory by default. That it also has to be recent appears nowhere in the official documents — at most it's something a local fund asks for. So bring your international (multilingual) extract from the Netherlands, and don't let yourself be talked into a fresh certificate plus sworn translation in advance.

The provisional number, and the deadlines nobody mentions

After your application you receive by letter a NIA — a provisional number with which you're already identified and can get healthcare costs reimbursed. But note what you can't do with it: no carte Vitale, no ameli account. So you claim on paper for months.

How long that takes is exactly the point where you'll come across wrong stories — so here's what it really says. Ameli names nine months twice, and both times it's about the definitive number: the provisional NIA is usable for nine months, and the processing time for the definitive number is at most nine months. That's a legal maximum for that one procedure, not a waiting period in which you're uninsured — with your NIA healthcare costs are already reimbursed.

What to make of it practically: the clock only starts once you start it (and for non-workers only after those three months of residence), then follows a processing that runs weeks to months, and only at the end does the carte Vitale land on the doormat. So count on a run-up of several months before everything runs smoothly, not on nine months without healthcare and not on "probably a few weeks" either.

The lesson is the same as with every long clock: it only counts from the moment you start it. Home sorted, address provable? Then the S1106 is your very next piece of post — before the boxes are unpacked.