by Sarah Vincent
This is the second article in our series about how to access health care in France. The first focused on those who have a UK issued S1. This article focuses on how to apply for health care when you are not yet retired, are unemployed, or from a country that does not have reciprocal health arrangements with France.
In France, the universal illness protection, known as PUMA (Protection Universelle Maladie) was put into place in January 2016. PUMA grants an automatic and continuous right to health care in France to those who are legally resident in the country.
To apply to join the health system, whatever your country of origin, you need to be ‘legally resident’. This means you must have;
- the appropriate Visa or Residency card (carte de séjour) based on your nationality.
- been resident in France for at least three months;
- a minimum level of income;
- private health insurance.
In relation to the last point, this means you may need to temporarily take out a private health insurance policy, while your application to the French health system is being processed.
You should apply for admission into the health system through your local health authority, your Caisse Primaire d’Assurance Maladie (CPAM).
To do so, you will need to complete the application form S1106 (formerly 736) Demande d’ouveture des droits à l’assurace maladie/Application for membership in the French health system’
Print it off, complete it, and include all the necessary documentation with it.
If you have children, you also need to complete Cerfa 16002. You will need to provide their birth certificates.
You will also need to provide:
- A recent utility bill (less than three months)
- A copy of your passport
- A copy of your birth certificate
- A RIB (relevé d’identité bancaire) giving details of your bank account
- Details of your income/resources, normally for the past 12 months.
Once CPAM have this information they can study your dossier/file and request more documents if needed. The process can take several months.
The calcuation of your charge for affiliation to PUMA, called the Cotisation Subsidaire Maladie (CSM) is simply extracted from your income tax return.
You will receive the request on the 4th term of the year based on your tax declaration. To know more about the calculation you can look directly on the Urssaf website.
If you choose to cease residency and leave the country, you must inform CPAM of your departure to avoid being charged CSM in the future. You cannot export your health rights if you leave or benefit from your French rights if you are no longer a resident.