What is the point of a specific benefits plan for expatriates?

Expatriates, whether students, employees, free-lance workers, retired people or globe-trotters, unlike people on temporary assignment abroad, are not eligible for healthcare and death & disability coverage provided by the French Social Security system. In certain cases, they are required to contribute to local social security basic schemes which do not reimburse healthcare expenses at the same rate, nor provide the same level of coverage on occasional trips to France.

Expatriates should be aware that healthcare costs vary greatly from one country to another, and can far exceed costs covered by French complementary insurance plans ("mutuelle"). For example, a visit to a general practitioner in the USA costs on average €90. Daily hospital fees in Switzerland can reach €2,500 as opposed to €1,000 in France.

An expatriate who enrolls in a local insurance plan runs the risk of:

  • uncovered medical expenses or limited reimbursements; and
  • no coverage for visits to France or trips to countries outside of their country of expatriation.

How do I know if the French Social Security considers me an expatriate or an employee on assignment abroad ("détaché")?

An employee who has signed an employment contract with a company whose head office is in France, and who is sent on assignment abroad, is considered by the French Social Security system as a détaché, or employee on assignment.
The length of assignment is limited to a period between six months and five years according to French Social Security agreements. Both the détaché and their employer continue to contribute to the French Social Security system to ensure that the employee receives continuous coverage against all risks. In order for the employee to receive reimbursements, an agreement must be signed between the country of assignment and France (cf. www.cleiss.fr).

Détaché status is by no means obligatory; it is for the company to choose or refuse. An employee is a détaché when their employer decides that the French Social Security legislation will continue to apply throughout the employee’s temporary professional assignment abroad.

An employee is considered an expatriate by the French Social Security under the following circumstances: they have signed a contract that falls under foreign legislation; they have been directly recruited by a foreign company or by a foreign subsidiary; their assignment exceeds five years; they obtain expat status in a country that has not signed an agreement with France; they are going abroad for personal reasons (business, vacation, study, Working Holiday Visa, etc.).

What insurance options does an expatriate living abroad have?

In order to maintain the same level of coverage provided by the French Social Security in the country of expatriation and during trips to France and abroad, expatriates have two options:

What is the best choice: CFE coverage plus complementary insurance or comprehensive coverage as of the first Euro?

Enrollment with the CFE is a personal choice and must be decided on an individual basis. CFE contribution rates are determined according to the expatriate’s particular circumstances: age, income, professional status. The biggest advantage of CFE coverage is that the individual remains linked to the French system and benefits from uninterrupted coverage upon return to France.

Comprehensive coverage as of the first Euro is a better option for you if you do not wish to maintain the link with French Social Security. In some cases, the first Euro option has proved less cumbersome, but the choice remains an individual one and it may be necessary to compare rates.

Why isn’t the insurance provided by my carte bleue enough?

The medical assistance coverage included with French credit cards is only valid for the first three months of a stay abroad. Ongoing treatment or treatment following an accident that occurs during this time are not covered beyond this initial period and may not be covered by insurance purchased after the fact.
Moreover, insurance provided by credit cards may have deductibles or consist solely of cash advances.

I want to go abroad with peace of mind. What do I need to do before I leave?

In order to leave in perfect peace of mind, we recommend you sort out several health matters first: update vaccinations, have a dental exam (very important), and if need be, get a medical check-up and ask your doctor for a medical certificate. This will enable you to practice all sorts of sports worry-free (scuba diving, for example).

We also recommend that you leave your insurance policy number and contact details of the insurance company with a family member or friend, as well as your address abroad and a number where you can be reached.


Who does ASFE work with?

We have forged partnerships with major players in insurance such as AXA and LE GAN, and work closely with assistance companies renowned for their experience and expertise such as Europ Assistance.

We are also the number-one partner for complementary coverage to the Caisse des Français de l’Etranger (CFE). All policies and reimbursement procedures are handled swiftly and efficiently from one centralized office.

What are the advantages of being with ASFE?

With over 15 years of experience in providing individual healthcare insurance for expatriates, ASFE goes to great lengths to make life easier for its members. ASFE means:

  • Four quality-certified claims departments according to ISO 9001 standard affirming a tried and tested know-how;
  • Direct payment in case of hospitalization or medical treatment exceeding €400 or $400 US, making cash advances unnecessary;
  • A centralized office for complementary coverage to the CFE: one address and one contact for your reimbursement procedures reducing claims processing turnaround time;
  • On-line services for easy administration of your contract;
  • Reimbursements in the currency of your foreign bank account;
  • Coverage includes stays in France as well as travels outside of the country of expatriation in case of emergency treatment.

What options does ASFE offer?

  • optical / dental (optional).
  • maternity (optional).
  • medical assistance / repatriation (optional benefit)
  • death & disability (optional)

Why choose legal protection insurance (automatically included, except for the Start'Expat plan)?

There might be many causes for disputes in ordinary lifehellip; The legal protection insurance provides you with the legal and financial resources you require in order to inform, assist and defend you to assert and exercise your rights. You will find more information on this type of coverage in our information guides.

Why choose third-party liability coverage?

In France, third-party liability insurance is usually included in our home insurance plan. Expatriates may not realize, however, that this insurance is not valid abroad. This can be a problem in countries where people are prone to press charges. Third-party liability insurance alone that covers the entire world is costly and prices vary widely from country to country. That is why it is automatically included in most ASFE packages. You will find more information on this type of coverage in our information guides.

Why choose emergency medical assistance and repatriation coverage (optional)?

It may sometimes be necessary to seek medical treatment in a neighboring country with medical facilities that are better equipped to administer quality care. That is why it is important to be covered by a plan that includes medical evacuation and repatriation. This type of coverage has considerable advantages not to be underestimated in certain circumstances, such as travel expenses for the expatriate to visit a hospitalized relative, or in the event of a death, or for a relative to visit the expatriate in case they are alone and hospitalized for over five days. You will find more information on this type of coverage in our information guides.

Why choose death & disability coverage (optional)?

Because we know that an accident or sickness can entail much more than just medical fees, we recommend death and disability coverage as well. This guarantees maintenance of your lifestyle in case of work disability or sick leave, and avoids financial distress for your family in case of death. This coverage is included in our comprehensive packages and available à la carte according to the level of coverage chosen.

What on-line services does ASFE offer?

You can do the following on our fully secure website:

  • Get a quote in just a few clicks, download our brochures or apply for enrollment on-line;
  • Pay your premiums on a fully secure website;
  • File claims for your healthcare expenses and check the progress of your claims on-line;
  • Print out your personal insurance ID card;
  • View your reimbursement statements via your personal pages: an e-mail alert is sent each time a new statement is available;
  • Get a detailed briefing about health in 150 countries throughout the world including required vaccinations, local diseases, information about diet and water;
  • Access a database of healthcare practitioners all over the world (contact details, spoken languages, available hospital services, etc.);
  • Submit an inquiry.

What are the coverage limits?

Coverage limits depend on the type of plan.

  • QUARTZ : €400,000 / USD500,000 per person per year
  • PEARL : €800,000 €/ USD1,000,000 per person per year
  • SAPPHIRE : €1,600,000 €/ USD2,000,000 per person per year
  • DIAMOND : €2,400,000 €/ USD3,000,000 per person per year
  • Start'Expat: €250,000

What treatment and services are not typically included in policies?

It depends on the policy, but in general the following is not covered:

  • treatment for conditions indicated on the certificate of coverage,
  • treatment received in detox, anti-aging and weight loss centers,
  • stays in rest homes, nutrition centers, convalescence homes, spas, treatment related to cosmetic surgery not resulting from an accident,
  • medical treatment for which the insured member did not request prior approval, or for which prior approval was not granted by the insurer,
  • hospital stays related to psychiatric disorders beyond the 30th consecutive day of hospitalization,
  • treatment for mental disorders (nervous or mental conditions, psychoanalysis and/or psychotherapy),
  • treatment not reimbursed by CFE or French Social Security, except otherwise specified in the chosen options,
  • treatment started before the start date of coverage or after coverage end date, or after policy termination (please note: the date of treatment that appears on CFE statements is the only date that counts).
It is in your best interest to read carefully the general terms and conditions that apply to your policy to be aware of all the treatments and services that are not covered.

What sports are excluded from coverage?

Healthcare coverage does not apply to the practice of certain extreme sports such as airborne sports, combat sport and high mountain climbing.

In our Start'Expat plan, extreme sports other than those listed above, are not excluded from coverage if they are not practiced in a Sports Association, Club or during competitions or championships.

If you practice one or more of these sports, we recommend you do so as a member of a Sports Association or Club. Licensed practice is usually covered in case of an accident.

What zone does my country of expatriation fall into?

Zone 5: USA + Zones 1, 2, 3, 4

Zone 4: Bahamas, Brazil, China, Hong Kong, Jersey, Saint Barth, Saint Martin, Singapore, Switzerland and United Kingdom + Zones 1, 2, 3

Zone 3: Australia, Austria, Canada, French Polynesia, Greece, Ireland, Israel, Italy, Japan, Monaco, New Zealand, Portugal, Qatar, Russia, Saint Pierre and Miquelon, Taiwan, Turkey, Spain, UAE and Vanuatu + Zones 1, 2

Zone 2: Angola, Argentina, Azerbaijan, Bahrain, Barbados, Belgium, Belarus, Bolivia, Bosnia-Herzegovina, Bulgaria, Chile, Colombia, Costa Rica, Croatia, Cyprus, Czech Republic, Denmark, Djibouti, Dominican Republic, Ecuador, Finland, France, Georgia, Germany, Guatemala, Hungary, Iceland, Kazakhstan, Kuwait, Latvia, Lebanon, Liechtenstein, Luxembourg, Malaysia, Mexico, Mozambique, Norway, Nigeria, Oman, Panama, Holland, Peru, Polynesia, Saint Barth, Saint Martin, Saint Pierre and Miquelon, Saudi Arabia, Slovakia, South Africa, Sweden, Thailand, Ukraine, Uruguay, Venezuela, Vietnam and Wallis and Futuna + Zone 1

Zone 1: Worldwide excluding countries from Zones 2 to 5

Certain islands and territories are not included in the list of countries for legibility reasons. Please contact us if your country of expatriation does not appear in the list.

Important: these zones do not apply to the Start'Expat plan, for which the geographic zones are divided as follows:

  • ZONE A: all countries excluding USA
  • ZONE B: all countries including USA

Does ASFE provide insurance for lost luggage?

Yes, luggage insurance is automatically included in our Start’Expat plan and is effective throughout the entire duration of the policy, and not only during the travel to/from your country of expatriation.
However, our other plans do not provide for such insurance. Therefore loss or theft of luggage is not covered.


Who can enroll in ASFE?

Any person of legal age, regardless of their professional status, who is looking for health insurance for themselves or their family while abroad.

Important: age limits to purchase insurance and length of stay are different depending on the plan.

How far in advance before I leave should I purchase coverage?

You can enroll in coverage at the earliest two months before departure for the country of expatriation, and at the latest two days before.
We recommend that you enroll as soon as possible, to ensure that coverage begins when you want it to, and that you have all the necessary documents in hand before you leave.
Please note that coverage is not retroactive, that is, with a start date that precedes the date your file was actually received.

When does coverage start?

ASFE coverage starts at the earliest the day after your enrollment request - including on-line enrollment - is received, on the condition that your medical questionnaire is approved, all original documents submitted and payment settled.
Coverage then starts immediately. However, there may be a waiting period if you were not previously covered by a similar plan (see question re: waiting periods). In any case, you are covered as of the first day after validation of your enrollment in case of hospitalization following an accident or unforeseen illness.

Is there a waiting period?

Coverage goes into effect at the earliest the day after your policy is approved and validated or at a later date (on condition that any additional information requested after review of your medical questionnaire is provided). However, a qualifying or waiting period may apply to certain treatment (according to your plan’s conditions) if you were not previously covered under a similar insurance plan. The waiting period is:

  • 3 months in respect of the following benefits: routine ‘Dental/Vision consultations and care (excluding Emergencies)’ and ‘Periodontics’,
  • 6 months in respect of the following benefits: ‘Vision’, ‘Dental (excluding dental consultations and care): Dentures, dental implants, bone grafts and dental surgery’ and ‘Equipment and medical, orthopedic and hearing Prostheses’,
  • 10 months in respect of the following benefits: ‘Maternity’ (including Pre and postnatal care),
  • 12 months in respect of the following benefits: ‘Orthodontics’, ‘Fertility treatment (including Medically assisted reproduction)’ and ‘Psychiatric treatments and care’.
Important: waiting periods do not apply to the Start’Expat plan.

What is the minimum policy period?

All policies remain in effect for a minimum of six months.

Important: the minimum policy term does not apply to Start’Expat plan which can be purchased for 1 month only.

How are premiums and reimbursements settled?

  • Premiums can be paid monthly on a quarterly, bi-annual or annual basis with no extra costs according to the chosen policy: by direct debit from a French bank account, by check in euros, by bank transfer or bank debit card (on-line on our secure website or by telephone with an administrator).
    Please note that upon enrollment, the first payment must be made by check in euros or by direct debit from a French bank account.
  • Reimbursements are issued by check or transfer in the currency and bank account of your choice, in France or abroad.
Important: for the Start’Expat plan, you are required to settle the entire premium amount in one single payment, either by check or by credit card on your Member’s Area.

How do I enroll in ASFE?

Enrollment in ASFE is easy.

By internet: at www.asfe-expat.com.
By mail: send in the following:

  1. Complete, date and sign the enrollment form and the medical questionnaire;
    • a copy of your passport or a two-sided copy of your national ID card;
    • the authorization for direct debit (French bank accounts only) completed, dated and signed, together with your bank account details slip for payment of premiums, or, if you do not opt for direct debit, a check in euros made out to ASFE in the amount corresponding to one quarter of premiums;
    • bank account details slip or IBAN (French or foreign accounts) for reimbursements from ASFE;
    • proof of previous insurance issued less than one month ago to avoid waiting periods (not required for Start’Expat plans);
    • a school/university attendance certificate for children aged 20 to 25 if you are enrolling in a First Euro plan (not required for Start’Expat plans).
  2. Place the medical questionnaire in the envelope provided marked "Attention: Consulting Physician" along with any additional information requested.
  3. Mail all documents to:
    ASFE - Service Adhésions (Enrollment)
    82, rue Villeneuve - 92587 CLICHY cedex - France.


Am I covered when on vacation in a country other than my country of expatriation?

Of course, with ASFE, you are covered:

For the new range of plans (First’Expat +/Relais’Expat +) - after September 2015

With the First’ Expat + and Relais’Expat + plans, you are covered in all the countries included in the selected coverage zone, as well as in the countries of the lower coverage zones, regardless of the type of medical services received (emergency or routine care).

For the START’EXPAT plans :
You are covered worldwide in the event of an accident or unforeseen illness.

What do I do if I have a question when I’m already abroad?

Upon enrollment, you will receive a personal insurance ID card with all the contact details of our four claims departments. You can reach us 24 hours a day, 7 days a week. Our teams speak more than 30 languages, including French, English and Spanish. You can also log in to our secure website, under "Participants' Pages", to review reimbursement procedures, fill out a claim form, view the status of a claim, or obtain hospital precertification agreement.

How can I get the names of qualified doctors, clinics and hospitals around the world?

Upon enrollment with ASFE, you will have access to the "Participants' Pages" of our secure website where you will find a database of recommended doctors and health facilities, their contact details, languages spoken and available services, country by country or by specialty. Our regional headquarters can also provide you with this information.

How can I avoid making cash advances in the case of hospitalization?

Upon enrollment, you will receive a personal insurance ID card with all the contact details of your claims department. You or hospital personnel can contact us from anywhere in the world for hospital precertification. We strongly recommend you keep this card on you at all times and present it upon arrival in a hospital.

Are my dependents entitled to the same coverage as myself?

Yes, your dependents are entitled to the same coverage as you, unless otherwise specified by our consulting physician upon enrollment.

Do I need to translate documents into French/English or convert currencies in order for my claims to be processed?

No. We can process claims in any language and deal with healthcare expenses in over 150 currencies. We use the exchange rate published by Natixis the last day of the month prior to the date healthcare was administered to calculate reimbursements.

If I enroll in a 12-month Start'Expat plan and come home after 6 months, am I entitled to a reimbursement?

No. The duration of coverage specified in each plan must be respected. If you are not sure how long you will be abroad, we recommend enrolling for one month with the option to renew for 1 or 12 months upon written request sent by e-mail to our enrollment department up to 15 days prior to policy expiry.

Important: the Start’Expat plan can be renewed twice if you are aged between 16 and 30, and only once if you are over 30.

What should I do if I move to another country of expatriation during the course of my ASFE contract?

To the extent that it is possible, you must inform ASFE of the change in country of expatriation at least one month prior to your move. Once ASFE is aware of the change, you can proceed with any changes to your coverage to better meet your needs in the new country. Any modifications will go into effect the first day of the calendar month following your request. If a rate increase applies, you must fill out a new enrollment form. Please note that the insurer has the right to refuse rate increases, accept them within certain limits, or impose additional premiums.

Important: this provision does not apply to Start'Expat plans.

What should I do if my family situation changes?

If your family situation changes (marriage, birth, divorce, death of spouse), you must notify ASFE within 30 days and provide official papers (marriage, birth, divorce or death certificate), so that these changes can be incorporated into your policy.

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