French health insurance

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HOW TO GET HEALTH COVER IN FRANCE ?rong> rong>

EHIC     l     E106     l     E109     l     rong>E121rong>

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When, where and how to use your “E” forms 

 EHIC (E111)  European Health Insurance Card.

If you are resident in the UK and travelling abroad, the EHIC will provide sufficient cover for EMERGENCY services. 

This will not replace Travel Insurance and sometimes can be Topped-UP if the reimbursements come from your local French CPAM office if you are in France for longer per.o. alt='search this word'>r.o./a>ds of time.

If you are still in possesion of your EHIC (E111) and you are entitled to use it, you should be given a “Feuille de Soins”after your first medical treatment in France.

This BroWN form is to be taken to you local “CPAM” office (Caisse Primaire d’Assurance Maladie). The French “Sécurité Sociale” will issue you with a limited French Social security number “N° INSEE temporaire” starting with a “5” for men and a “6” for women.

 S1-E106 or S1-E121

 - LIMITED S1/E106 from the NHS. This document is RENEWABLE until your S1-E106 rights EXPIRE.

•S1/E106: Early retirement: 

 - No longer resident in the UK. 

 - Under state of origines retirement age. 

 - Up to date with National Insurance Contributions in last few years. 

 - Option also applies if looking for work.

 - A family member still works in the UK but SPOUSE/PARTNER and/or CHILDREN live in France and need health cover abroad.

 - The S1/E109 is only valid for the « dependents» of the per.o. alt='search this word'>r.o./a>n making NI contributions.

 - The EHIC will cover the other per.o. alt='search this word'>r.o./a>n when they are VISITING France.

 - No longer have any professional activity.

 - Dependent on Spouse or Partner S1.

•S1/E121: Long Term Incapacity

 - Benifits can be transfered to France.

ALD: Affection Longue Durée - ONLY 100% of treatments regarding existing conditions are covered by the ALD.

Any Dépassements d’Honoraire charged by specialists can be reimbursed by your Top-Up.

If you have a valid S1-E106 or S1-E121, this is to be taken to your local “CPAM” office, (Caisse Primaire d’Assurance Maladie).

It is advisable to make and keep copies. Once all other required papers have been given to “CPAM” (full birth certificate, marriage certificate, proof of residence, ID etc...) this will give you a provisional French Social security number “N° INSEE provisoire” starting with a “7” for men and an “8” for women.

For the S1-E121 holders and some S1-E106 holders you will receive an “Attestation à conserver” with your full Social security number “n° INSEE permanent” starting with a “1” for men and a “2” for women and eventually the “Carte Vitale”.

 S1-E121 “Ayant Droit”

If you are sharing an S1-E121 “Ayant Droit” with your spouse or partner, your rights for French Social security will be under the same number for both S1-E121 holders.

However, to save reprinting another “Carte Vitale” when the dependant reaches retirement age in their.o. alt='search this word'>r.o./a>wn right, the “CPAM” have decided to issue the dependant with their.o. alt='search this word'>r.o./a>wn “Carte Vitale” and their.o. alt='search this word'>r.o./a>wn “N° INSEE permanent” printed on it.  This has proven not to be such a wise move on their behalf as the information on the micro chip is the information regarding the S1-E121 holders.    Always remember to give the S1-E121 holder “n° INSEE” when the “Carte Vitale” is not swipped otherwise the wrong card number will be used and “CPAM” will refuse reimbursements as this number does not have any rights.

If you have none of the above or have lost the use of these facilities then you will have to replace CPAM by taking out Private Cover.

If you do not have any “r.o. alt='search this word'>r.o./a>.” (Régime Obligatoire) ‐ CPAM in this instance ‐ then you will not be reimbursed at all.

Please contact SOFICA’s rapidly in case of any changes to your social cover.

How to get cover without “E” forms

 If you work in France as a "salarié".

If you are salaried from a French company then it is up to your employer to obtain your “CPAM” rights by paying your “Charges Sociales”. This is to be negociated with your employer.

If you work in France as a T.N.S. (Travailleur Non Salarié = Self-Employed).

If you have your.o. alt='search this word'>r.o./a>wn business registered in France no matter how significant then you will have to register with “RSI” (Regime Sociaux des Independents) and pay your.o. alt='search this word'>r.o./a>wn “Charges Sociales”.  “RSI” is the organization that regroups all the “T.N.S”.  They will give you a choice of “r.o. alt='search this word'>r.o./a>” (Regime Obligatoire).  These organisations replace CPAM, among others = RAM-GAMEX, Matti Camons, UNTNS, Radiance etc.

"Télétransmission”

Before choosing your “r.o. alt='search this word'>r.o./a>” representative, verify that they have the “Télétransmission” for your “Top-Up”.  Some “r.o. alt='search this word'>r.o./a>.” covers do not have this facility and you will have to send medical forms called "relever de soins" to be reimbursed by your "Top-Up".  It is possible to accumulate your reimbursements up to 27 months.   Beyond this time the "Top-Up" and your "r.o. alt='search this word'>r.o./a>" are entitled to refuse the reimburcements.  If you are in this possition, it is possible to change "r.o. alt='search this word'>r.o./a>".

“Loi Madelin”

Some “Top-Ups” take into account your “T.N.S” status and thus your premiums are cheaper. Depending on your type and amount of work, you can claim back Tax with the “Loi Madelin”.  All of the SOFICA’s companies have the “Loi Madelin” possibility.  You should see with an accountant “comptable” if you need to use the “Loi Madelin”, if so please contact SOFICA’s, we can help you put it in place.

If you have none of the above or have lost the use of these possibilities then you will have to replace your “r.o. alt='search this word'>r.o./a>.” with “E”forms (CPAM) if you are entitled to one or by taking out Private Cover.

If you do not have any “r.o. alt='search this word'>r.o./a>.” (Régime Obligatoire) ‐ RSI in this instance ‐ then you will not be reimbursed at all.

Please contact SOFICA’s rapidly in case of any changes to your social cover.