2. Health Insurance Cover in France
- 2.1. E106 Health Cover
2.2. Health Cover for Self-Employed
2.3. Health Cover for Cross-Border Workers
2.4. E121 Health Cover for Retired Persons
2.5. Health Cover for Early Retirees
2.6. European Health Insurance Card (EHIC)
2.7. Travelling Abroad from France
2.3. E101, E106 and E109 Forms: Health Cover for Cross-Border Workers
European Council Regulation 1408/71 underpins the right of EU Nationals to work in another EU State in keeping with the principle of the free movement of labour enshrined in the Treaty of Rome and subsequent treaties.
The free movement of labour can only be realistic if social benefits can also be transferred, including that health cover.
The E Form is a certificate of entitlement to health care in another EEA country, provided courtesy of the social security authorities in your home country.
The form means that you will not need to pay French health service contributions for the duration of the period stated on the form.
Below is list of the main E Forms that are available to different categories of worker. These enable you to take advantage of health arrangements in France whilst maintaining social security contributions in your home country.
Table: E Forms for Cross-Border Workers
| E101 - Issued to those who are employed or self-employed, working on a temporary basis in another EU state for a maximum of 12 months.
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| E102 - If an E101 holder unexpectedly needs more than 12 months to finish a task then an extension of up to a further 12 months can be applied for via this form.
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| E106 - Issued to those who are resident in one EU State but work in another.
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| E109 - Issued to a family resident in one EU State when the spouse works and is resident in another EU country.
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| E110 - International transport workers (see below).
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| E119 - Issued to those in receipt of UK Jobseekers Allowance who seek work in another EEA State.
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| E128 - Issued to students studying in another EU state. |
Issue of such E Forms is not automatic, and each case is judged on its merits. Care must be taken in completing the application form.
We know from e-mails we have received from some readers that your own experiences may well have been different to the rules stated here. This is often because of the way the forms have been completed by applicants, and the manner in which officials have interpreted the application.
Health cover is restricted to that of any other French resident and, therefore, only a proportion of health costs are covered (typically 70%).
These notes are written mainly for those relocating from the UK, as the precise rules vary from country to country.
The final decision on which form to use lies with the Department of Work and Pensions, or more often the HM Revenue and Customs.
There are special rules for civil servants and mariners, which we do not consider here.
We can distinguish a number of different circumstances:
- i. Working in UK and Resident in France
- ii. Working/Resident in the UK - Family Resident in France
- iii. Temporary Assignment in France
- iv. Transport Workers
2.3.1. Working in UK and Resident France
If you and your family are living in France, but one of the spouses commutes across the border to the UK to work, then an E106 is normally available for health cover in France for a year at a time, renewable if circumstances do not change.
Accordingly, you will continue to pay your social security contributions in the UK, who will provide you with health insurance cover in France through the E106.
You can download an application form for an E106.
2.3.2. Working/Resident in the UK - Family Resident in France
Where one of the spouses works and lives in the UK, whilst the family is resident in France, then the E form normally used is the E109.
You are eligible to obtain an E109 from HM Revenue and Customs or (sometimes) the DWP Pensions Office. The form should be presented to your local Caisse Primaire d’Assurance Maladie (CPAM) in France.
The use of the Form E109 will enable your family to obtain continuing medical cover in France, whilst you continue to work in the UK, where you will continue to be covered by the NHS.
We are aware of readers in these circumstances who have been issued with an E106, despite the fact that this is more properly a form that provides health cover for someone resident in France, but working in the UK. Practice seems to vary between individual cases as to whether you are issued with an E106 or an E109. Sometimes applicants are issued with an E106 at the outset, and then later transfer to an E109. It often depends on what is said on the application form, and how officials interpret it.
The key difference between the E106 and the E109 is that the E109 only covers your family in France, so you would need a European Health Insurance Card (EHIC) for your visits to France.
Nevertheless, once again, practice does not always match the theory, for we do know of cases where the breadwinner has also been included in the cover under an E109 by the local French Caisse Primaire d’Assurance Maladie (CPAM), so we cannot be definite on just how your own case will be treated!
No health care contributions will be payable in France, as you will pay social security contributions in your home country.
You can download an application for an E106 or E109.
2.3.3. Temporary Assignment in France
If you go to work in France for a 'temporary' period (up to say two years), whether you are employed or self-employed, an E101 Exemption Certificate is needed.
The E101 grants exemption from the payment of social security contributions in France. It does not grant access to the health system.
You will normally be covered for health in France through European Health Insurance Card.
It normally only last for twelve months, and so if you with to continue to be covered, your employer (or you if self-employed) needs to make application for an E102.
You can download an application form for an employee.
You can also download an application if you are self-employed.
2.3.5. Transport Industry
If you are engaged in the road, rail, or air transport industry, and travelling to France, then you will be covered for health in France under UK regulations, provided your employer has their registered office in the UK, and you have your main home in the UK.
As this is a special category of worker, there is no single E Form that covers all persons. It can be, for example E110 or E106. Explanation of individual circumstances to HMRC (Centre for Non-residents) will result in the appropriate form being issued.
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