CCSS health insurance in Monaco: coverage, cards and reimbursement

What is CCSS?

The Caisse de Compensation des Services Sociaux (CCSS) is Monaco's compulsory health insurance fund. It is one of five funds under the Caisses Sociales de Monaco umbrella — the others handle pensions and the self-employed — and it covers sickness, maternity, invalidity, death and family benefits for employees working in the Principality, their dependants, retirees drawing a Monaco pension and Monegasque nationals. It operates separately from the French system.

Who is covered

You are generally covered by CCSS if you fall into one of these categories:

• Salaried employees working for a Monaco-based employer (your employer registers you)
• Dependants of a covered worker (spouse, children under 18 or under 25 if studying)
• Retirees receiving a Monaco pension
• Monegasque nationals
• Certain categories of self-employed workers registered in Monaco

If you are not covered by CCSS (for example, if you are a resident who works abroad or is not employed), you will need to arrange private health insurance.

Your carte d'immatriculation assuré

Monaco has no carte Vitale, and a French one is not valid here. What you receive instead is a carte d'immatriculation assuré issued by the Caisses Sociales de Monaco, carrying your matriculation number, your card category, your date of birth and your beneficiaries.

Since 2025 it exists only in digital form — paper cards are no longer distributed. You reach it from your personal space on the CSM website or the CSM mobile app, under Documents › Ma carte d'immatriculation, and it can be saved to a phone wallet or shared with a family member.

The card also carries an FSE code (feuille de soins électronique). Give that code to a practitioner conventioned with the CSM and the claim is transmitted electronically — faster reimbursement, nothing further for you to send. Where the practitioner is not connected, a paper feuille de soins is used instead: sign the attestation d'activité on it, attach the prescription and the itemised bill, and send it to the Caisses Sociales.

How reimbursement works

CCSS reimburses medical expenses based on official approved tariffs:

• General practitioner consultation: 80% of a reference tariff of about €34.10, giving roughly €27.28 back
• Specialist consultation: 80% of a reference tariff of about €45.60, giving roughly €36.48 back
• Prescription medication: reimbursement rate varies (35% to 100% depending on the drug category)
• Hospital stays: approximately 80% of approved costs
• Laboratory tests and imaging: approximately 80%

The portion not reimbursed by CCSS is the ticket modérateur — usually 20 per cent of the reference tariff, though it varies by category. Holders of a carte verte, issued for long-term conditions, are exempt from it.

Complementary insurance (mutuelle)

To cover the ticket moderateur and any costs above the approved tariff, most residents take out a mutuelle (complementary health insurance). Many employers offer group mutuelle plans. Private mutuelle policies are also available from insurers operating in Monaco.

A mutuelle typically covers:

• The remaining 20% not covered by CCSS
• Dental care beyond basic coverage
• Optical expenses (glasses, contact lenses)
• Some alternative therapies

Practical steps

1. Starting a job: your employer declares you to the Caisses Sociales — see Registering with Monaco social security
2. Activate your digital card: you are emailed when it is available in your personal space
3. Choose a mutuelle: through your employer's group plan or independently
4. Visit a doctor: give your FSE code so the claim is filed electronically
5. Reimbursement: most reimbursements are processed automatically to your bank account within a few days

Using healthcare in France

CCSS coverage extends to healthcare providers in France, which is particularly useful for residents who see specialists or visit hospitals in Nice or other nearby French cities. You advance the cost and claim it back from CCSS, attaching the prescription and the itemised bill to a completed feuille de soins.