Official CFE representative
CFE alone, CFE top-up or first-euro insurance?
The CFE keeps you in the French system, but abroad it only covers part of your real medical costs. Alea, official CFE representative, helps you join and choose the right top-up.
Free advice from French-speaking advisors
The CFE top-ups and insurers we compare
What the CFE really pays back in your country
Since the 2019 reform, the CFE pays back a share of your real costs that depends on your country's zone. Hong Kong, Singapore, the UK and the US are in zone 5, China in zone 4.
| Care | Zone 5 (HK, SG, UK, US) | Zone 4 (China) |
|---|---|---|
| Hospital stay (medicine, surgery) | 19% of real costs | 31% of real costs |
| GP or specialist consultation | 21 € | 21 € |
| Imaging, MRI | 15% of real costs | 20% of real costs |
| Vaginal birth | Flat 3,164.11 € | Flat 3,164.11 € |
| Caesarean | Flat 3,573.64 € | Flat 3,573.64 € |
Example: a standard room at Gleneagles Hong Kong costs HKD 1,000 to 1,200 a night, before doctors' fees, theatre and medicines. The CFE pays back 19% of it.
Sources: CFE 2026 guarantees (decree of 17 December 2025), CFE country list, Gleneagles Hong Kong room rates from 1 July 2026.
Three ways to get covered abroad
There is no single right answer. The best choice depends on your age, your health, your country and whether you plan to move back to France.
| CFE alone | CFE + top-up | First-euro insurance | |
|---|---|---|---|
| Medical questionnaire | No | Yes for the top-up, depending on the insurer | Yes |
| Age limit | None | Depends on the insurer | Depends on the insurer |
| Hospital stay in HK, SG, UK, US | 19% of real costs | The top-up pays the rest, within its limits | Real costs, within the plan limits |
| Hospital direct billing | Not in these countries | Depends on the insurer | Often, depending on the network |
| Moving back to France | No waiting period | No waiting period | Up to 3 months before French Social Security |
You can also keep the CFE for your pension only and choose a first-euro health plan. Our advisors explain each option.
How Alea helps you with the CFE
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Living abroad with the CFE? Sounds familiar?
19% paid back in hospital
In Hong Kong, Singapore, the UK and the US, the CFE pays back 19% of real hospital costs. The rest is yours.
The Alea Difference
We compare top-up plans that pay the share the CFE leaves, so a hospital stay does not empty your savings.
A doctor visit paid 21 €
The CFE pays 21 € for a GP or specialist visit, whatever it really costs in your country.
The Alea Difference
We find the plan whose outpatient cover matches how often you and your family see a doctor.
You pay the hospital upfront
In Hong Kong, Singapore, the UK, the US and China, the CFE offers no hospital direct billing: you pay the clinic, then claim.
The Alea Difference
We check which plans can settle the bill directly with your hospital, so you do not have to advance large sums.
Frequently Asked Questions
Is the CFE compulsory for French expats?
No. Joining the CFE is voluntary. It does not replace the compulsory scheme of your country of residence, where one exists.
Is there a waiting period with the CFE?
Not if you join before leaving France or within 3 months of settling abroad. If you join later, a waiting period of 3 months applies under 45, and 6 months from 45.
Does the CFE cover pre-existing conditions?
Yes. There is no medical questionnaire and no age limit, and the CFE cannot exclude you. Top-up and first-euro insurers can apply medical underwriting.
How much does the CFE pay back in Hong Kong or Singapore?
Both are in CFE zone 5: the CFE pays 19% of real costs for a hospital stay and 21 € for a GP or specialist consultation (2026 rates).
CFE top-up or first-euro insurance: which should I choose?
First-euro cover often suits younger expats in good health. The CFE with a top-up often suits older expats and people with a medical history. An Alea advisor compares both for your situation.
What happens when I move back to France?
You return to the French Sécurité sociale with no waiting period, and the CFE keeps covering you for the 3 months after your return.
Can my spouse and children be covered?
Yes, with the family option: your spouse and your children up to the age of 20.
Why go through Alea for the CFE?
Alea is an official CFE representative. Our service is free: we help you join, then compare the top-up or first-euro plan that fits you.
