2. Health Insurance Cover in France

1. 2.1. E106/S1 Health Insurance Cover
2. 2.2. Health Cover for Self-Employed
3. 2.3. Health Cover for Cross Border Workers
4. 2.4. E121/S1 Health Cover for Retired Persons
5. 2.5. Health Cover for Early Retirees
6. 2.6. European Health Insurance Card (EHIC)
7. 2.7. Travelling Abroad from France

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2.4. S1 Health Cover for Retired Persons

For the purposes of this section we define a 'retired person' as someone of the age of retirement of their country of origin, who exercises no professional activity, and who is in receipt of a State Pension from their home EEA country.

We also include in this category those persons under the age of retirement, but in receipt of long term incapacity benefit.

If you are relocating from within the EEA and you are retired and in receipt of a state pension, or you suffer from long term incapacity then, in order to register with the French health system, you will need to bring with you Form S1 from the social security authority in your home country.

This form should be presented to your local French health authority, the Caisse Primaire d’Assurance Maladie.

Those from the UK should contact the International Pension Centre, Tyneview Park, Newcastle Upon Tyne, NE98 1BA, United Kingdom.

The use of the S1 does not mean you will get 'free' health care in France. It means simply that you will not need to pay into the French social security system in order to obtain health cover.

As the French social security system only covers a percentage of basic health charges, ranging from 35% at the bottom end to 100% in some limited cases, if you wish to cover those charges not met through the social security system you will need to take out voluntary ('top up') health insurance.

Even then, you will be responsible for paying some residual costs that are not picked up by either the social security or most voluntary health insurance systems.

So do not assume an S1 picks up all your health costs. It does not, although most costs are covered.

If one of partners to a household works, or is in business, in France, while the other is retired and in receipt of a State Pension, then social security contributions for health and other benefits continue to be payable, and the household is insured through the employment or business status of the working partner.

2.4.1 Long Term Incapacity

The rules governing entitlement to UK long term incapacity benefit are in the process of change, with the abolition of Incapacity Benefit and it's replacement by 'Employment and Support Allowance (ESA)', a transfer that is being carried out between 2010 and 2013.

The early indications from the British Government are that the benefit will be exportable to France, although future claimants will be required to demonstrate a satisfactory national insurance record, and all claimants in France will be required to go through a periodic 'Work Capability Assessment' by a French doctor.

A person on long term incapacity benefit is likely to be entitled to receive full reimbursement of all the medical costs relating to their condition, provided it is classified as a Affection de Longue Durée – (ALD) by the medical authorities.

Similarly, anyone who suffers from a long-term or major illness is likely to find that 100% of costs in relation to the treatment of this illness are covered by the French social security system, provided it is also on the list of affections de longue durée – (ALD).

2.4.2 'Dependent' Spouses

The definition of just what is regarded as being 'dependent' includes all those in a married relationship or in a civil partnership. Thus, even though your spouse may have an independent source of income, they would be admitted as a dependent.

Only in the case of those not married, or in a civil partnership, would it normally be necessary to prove financial dependancy.

The decision as to who is dependent is not made by the French authorities, but by your country of origin. Some local health authorities in France have been known to contest dependency status, but the cases have been rare, and generally not upheld.

In the event that the holder of an S1 dies before their 'dependent' younger spouse reaches retirement age, then the surviving partner should continue to retain health cover through the S1 for 12 months.

However, use of this arrangement may not be necessary, as you would normally be granted automatic and permanent access into the French health system through 'accident of life' provisions. You can read more about this rule at Health Cover for Early Retirees.

You would be required to pay health contributions, but these would be related to income, and those on a low income are entitled to free cover.

On this basis, a dependent younger spouse of a retired person should always be able to obtain State health cover in France.

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