3. Protection Universelle Maladie (PUMA)
- What is the PUMA?
- Application Process for PUMA
- Free Health Insurance (CMU-C)
- Assistance with Voluntary Insurance
3.4. Assistance with French Health 'Top Up' Insurance Premiums
On the previous page we considered your potential eligibility to the CMU Protection Complémentaire (CMU–C).
If your household income is no higher than 35% of the thresholds that grant eligibility to CMU-C you may be eligible for a contribution towards the cost of your voluntary ('top-up') health insurance, if you have such a policy.
The scheme of assistance is called Aide au paiement d'une Complémentaire Santé (ACS).
One of the significant limitations of the scheme is that only those persons who have top-up health insurance with a rather limited list of 'accredited' health insurer are eligible, which in 2018 is the following insurers, who are not necessarily the least expensive insurers.
The assistance comes in the form of a certificate of entitlement that you need to present to your complementary health insurer. In addition, you should also be exempt from supplementary charges often imposed by consultants, called dépassement d'honoraires.
You are also exempt from the participation forfaitaire of €1, which is not paid by the State or complementary insurers.
The level of the assistance towards your insurance policy depends on your age, as follows:
- €100 for those aged less than 16 years;
- €200 for those aged 16-49 years;
- €350 for those aged 50-59 years;
- €550 for those aged 60+ years.
Accordingly, a couple aged 59 years would be entitled to a total contribution of €700.
In no case can the rebate be higher than the cost of the insurance cover itself. If it is greater then the complementary insurance premium will be zero.
The thresholds for eligibility for these rebates are set out below.
Accordingly, if your income as determined by your local Caisse (normally the Caisse Primaire d’Assurance Maladie) is no higher than the applicable threshold figure (but see below), then you would be entitled to assistance.
Table: Income Thresholds - 2018
If you do not have a mortgage on your property an additional sum is added to your income to calculate your entitlement to CMU-C. This sum is called the forfait logement.
For 2018 the level of this figure is €793 per year for a single person; for a couple it amounts to €1,388 per year; for a family of three or four persons it is €1,666 per year.
Accordingly, as an owner-occupied couple without a mortgage, if your income in the reference year was €10,000, the authorities would assess your notional income as being €11,388, simply because you have no accommodation charge to pay.
The reference period for determining your income is the previous twelve months preceding your application.
If you think you are eligible then application should be made to your CPAM, or to your caisse if you are self-employed, eg RSI. You can download the application form.
If you do not hold a voluntary health insurance policy you can still make application for the assistance, which remains valid for six months, during which time you can take out such a policy.
February 2019 - There are changes planned in the ACS, which you can read about at Help with French Health Costs. We shall be updating this page in due course.
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