Hello
We may be coming to live in France this year. We assume we will have to have private health insurance at first , but what is the next stage in the process of moving into the French Health system?
Thanks for your help,
You should talk to @fabien for your options… he’s the SF expert on insurances.
I’ve tagged him so he will probably respond to this topic.
There are a number of similar topics on SF you might like to research using the spyglass icon on the topic bar.
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Will you be retired or in employment? It makes a difference 
I am retired but my wife might be looking for some work.
Angela is correct, depending on your situation in makes a difference. The first step is usually to secure a visa but it also depends on whatever (or not) you already have some accommodation in France. To get a long term visa you’ll need private health insurance but I would advise you only seek a policy with insurers that are used to be dealing with “visa compatible” insurance policies as many claim they are compatible but then you’re alone facing the agent at the TLS center and sometimes figure out the hard way that they were mostly happy to take your money from you. A good online aggregator would be Fab French Insurance, the calculator is available here => Medical insurance calculator - Fab French Insurance.
Once your visa is approved and after 3 months of being in France you’ll be able to start 2 applications => 1/ Residency (carte de séjour) and 2/ French social security (CPAM). Most manage to secure both within the 1st year so before the visa expiration and then you’re basically French 
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Thanks Fabien -that sounds hopeful.
We are planning to buy a house in France so will want ,eventually, to be ‘properly’ resident.
Ray
The wrinkle to what Fabien has said is that if you are UK retired, with a UK State pension (not public sector or private) and are planning not to work, then you are eligible to apply for an s1 from the DWP. This is a form that states that the UK will remain responsible for paying for your health care to the level of a normal French national. For most visas the UK visa centres will now accept an S1 in place of private health insurance.
Oh, and even better if you are eligible then your wife can request to piggy back on this as a dependent.
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I completely agree with what @JaneJones has said there. If you are in receipt of a standard UK Old Age Pensions then the insurance situation becomes much easier. It’s what I did when I moved across and then later my partner piggy-backed onto my S1 because he is younger.
However, if your wife is planning on working you must get the appropriate visa or she will not be permitted to do so…
As usual, everyone is helpful with specific advice -thank you all.
It helps to know the landscape before venturing onto a long walk…
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When you get your S1 make a copy of it, because you will have to surrender the original when you apply for your all important Carte Vitale. The process may seem daunting, but it’s usually quite straight forward and your wife will be able to benefit from your S1 status. This makes such a difference.
The usual advice is that in between arriving in France as an immigrant and obtaining your resident’s Carte Vitale, one can use the NHS European Health Card, rather than international medical insurance, but I’d recommend you check that out, as it may not be the case in all circumstances.
Nevertheless, despite the above hassle, you’ll probably live longer over here but more importantly enjoy an extended and superior quality of life!
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Thanks very much for your optimistic attitude - I am sure we will enjoy life to the full!
Pre-Brexit Mark. All changed now.
For some visas one can use the GHIC, (EHIC only for pre-Brexit people) but many require full private health insurance. And those eligible for S1’s can now get them before they arrive to use for the visa application.
Of course, it must have been a wave of nostalgia for the good old days…
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Yup, but not always acceptable for visa applications. New article coming soon on this vey subject. Watch this space !
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Qualified this in post 12 above…
Just to say that even with an S1 and a GHIC you will need a) to be covered while you wait (and make sure you take copies of everything you send to CPAM along with the original S1 - they lost my birthday certificate although it likely crumpled in their hands as I’m old) and b) that when you get into the system you will still need top-up insurance as only 70% is covered.
Yes,a bit silly that an S1 will be ok for visa application, but then have to go through registration with CPAM once one gets here. I’m not sure what people do, as have not read whether the French authorities accept date of S1 as start of entitlement. In which case one could just collect the brown feuille de soins receipts and claim back later.
(A mutuelle is a choice, not an obligation)
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My experience was pre-Brexit but CPAM accepted my S1 as entitlement from the day I submitted it to them, although it took ages to come through and I just collected the brown feuilles de soin and claimed it all back later as you say…
My understanding is that a S1 certificate is valid from the date in the ‘valid from’ field. If that date is from one’s arrival then no need for private health insurance. As @JaneJones points out, you may have to pay in full initially, but will then claim the 70% odd back once set up with CPAM.
Edit - and as Angela kindly confirmed!
We arrived pre-brexit 2020 with S1’s, took a while to get to CPAM with them (covid) - when the attestation de droit’s came through they were for the start date of the S1.
And when we went to get vaccinated in next April (?), though still not CPAM processed, we just showed the S1’s and that was fine. Also accepted once at the dentist too.
I also suspect that showing S1’s might also work in a hospital emergency because when I asked for my S1 generated EHIC the help desk said even if I wasn’t in possession of it I could phone the UK emergency health cover number and they would provide a cover statement for the hospital.
Of course, that’s only what they said, fortunately I haven’t tested this but one could phone the NHS and query what might happen.
Note the NHS / DWP seem to know about my HMRC issued S1 - there must be a central register /database of all of them…
Hope that helps.