In Brief
- Puma ensures coverage of health expenses without interruption of rights.
- It applies to individuals working or residing in France in a stable and regular manner.
- Adults are insured personally, independently of their parents.
- A financial contribution is provided for certain beneficiaries without employment under the law of December 30, 2025.
What is Universal Health Protection (Puma)?
Universal Health Protection (Puma) aims to guarantee a right to the coverage of health expenses, personally and continuously throughout life. This system helps avoid potential gaps in your rights, even in the event of a change in professional (e.g., job loss) or personal situation (e.g., separation).
Unlike previous systems, an adult can no longer be a dependent since the establishment of Puma. You are insured individually from the age of majority. This means you can:
- Receive reimbursements in your own bank account;
- Get your own reimbursement statement;
- Have your own Ameli account.
For minors, the status of dependent remains applicable. They are attached to one of their parents. However, it is possible to request to benefit from Puma personally from the age of 16. This dependent status ends in the year of your 18th birthday.
Who is Affected by Puma?
You are affected by Puma if you work or reside in France in a stable and regular manner. This affiliation is mandatory. Anyone who deliberately refuses to affiliate or continues to neglect the steps for their mandatory affiliation to a Social Security scheme is subject to 6 months of imprisonment and a €15,000 fine (or only one of these penalties).
Condition of Regularity of Residence
Two cumulative conditions related to the regularity and stability of residence must be met.
Regarding regularity:
- If you are a citizen of the European Economic Area (EEA) or Switzerland, you have the right to move and reside freely in France. An ID card or passport is sufficient.
- If you are a citizen of another country, you must have a residence permit and a civil status document.
Condition of Stability of Residence
This criterion depends on your professional situation.
If you are engaged in professional activity: If your Puma application is accepted, you are immediately affiliated with Health Insurance.
If you are not engaged in professional activity: Once in France, you must wait 3 months before your rights are activated. These rights remain open if you live in France for at least 6 months of the year.
Note: this condition of stability of residence (3-month waiting period) is fulfilled without delay for certain specific individuals, including:
- Refugees;
- Individuals returning to France after international volunteering abroad;
- Individuals receiving RSA (Active Solidarity Income) or AAH (Disability Adult Allowance).
New Financial Contribution (Law 2026)
The law of December 30, 2025, concerning the financing of Social Security for 2026, provides for the establishment of a financial contribution for Puma beneficiaries. This measure concerns individuals who simultaneously meet 3 conditions:
- Reside in France in a stable and regular manner;
- Be without professional activity;
- Not be liable for CSG, CRDS, and Health Insurance contributions under an international agreement.
A decree is expected regarding the amount of this financial contribution. An update of the official page will be made upon the publication of this decree. In the meantime, the information presented here remains valid.
How to Apply for Puma?
To submit your application for rights activation, you must follow these steps:
- Fill out the form: Complete the form titled "Request for Activation of Health Insurance Rights."
- Attach supporting documents: Gather the documents listed on page 2 of the form.
- Send the application: Return the completed form and supporting documents to the organization you depend on:
- To the Primary Health Insurance Fund (CPAM) if you are under the general scheme.
- To the Agricultural Social Mutuality (MSA) if you are under the agricultural scheme.
To find the exact address of your fund, you can use the online service "Local Pivot" available on service-public.fr by entering your city or postal code.
Declaration of Departure Abroad
Puma can be withdrawn if you no longer meet the conditions of stability of residence or regularity of stay. You must spontaneously declare your departure abroad.
To do this:
- Complete the form "Declaration of Transfer of Residence Outside France."
- Return it to the CPAM (general scheme) or to the MSA (agricultural scheme) according to your affiliation.
Help and Support
If you have a question or wish to be assisted in your procedures, you can directly contact your health insurance fund.
- If you are under the general scheme: Contact your Primary Health Insurance Fund (CPAM).
- If you are under the agricultural scheme: Contact your Agricultural Social Mutuality (MSA).
The site service-public.fr provides a tool to find the local contact corresponding to your address.
Official Source
The information contained in this guide is extracted exclusively from the official sheet "What is Universal Health Protection (Puma)?" published by Service Public / Directorate of Legal and Administrative Information (Prime Minister), verified on October 29, 2024.