The rules may be tightly drawn, but those on a low income are entitled to assistance with health service charges and insurance premiums.
Those readers who have some familiarity with the French health system will be aware that it is not free at the point of use, as is the case in the United Kingdom.
You pay a charge for each treatment, for which you need to apply for reimbursement, although for many people the process is automated, so little or no cash changes hands.
However, other than for certain serious, long-term illnesses, the State only reimburses (or pays for directly) a percentage of your health costs, generally up to 70%.
As for the balance, you either need to pay these charges from your pocket at the point of delivery, or take out a complementary (voluntary) 'top-up' insurance policy, called assurance complémentaire santé.
In order to assist those on a low income there are there is assistance towards these costs, either directly, or as a contribution towards your complementary health insurance policy.
i. Couverture Maladie Universelle – Complementaire (CMU-C)
If you are on a modest income you may be entitled to free affiliation to the French health system, as well as payment of most of your medical costs.
This assistance is provided through the Couverture Maladie Universelle – Complementaire (CMU-C).
If you run a small business and you are on a low income, you would also be able to obtain 100% recovery of your costs through the CMC-C. Separately, you also pay a reduced health cotisation, although this does not apply to those registered for business as a micro-entrepreneur.
There has recently been a substantial increase in the maximum income thresholds that grant access to the CMC-C. The new thresholds depend on the size of the household but for a couple the maximum income is €13,085 pa.
There are particular rules that apply in the calculation of your income, as a supplement is added if you do not rent or have a mortgage.
You can read more in our Guide to the CMU Protection Complémentaire (CMU–C).
ii. Aide au paiement d'une Complémentaire Santé (ACS)
If you have a complementary ‘top-up’ health insurance policy you may be entitled to assistance with the insurance premiums.
The assistance is available by the L’aide à l’acquisition d’une complémentaire santé (ACS).
The level of the assistance depends on your age, but it is €550 per person for a couple aged at least 60 years, equivalent to €1,100 a year!
Entitlement to support is subject to a test of resources. Your income cannot be greater than 35% of the CMC-C income thresholds. So the maximum income for a couple is €17,532, but higher if you have dependants.
Again, particular rules apply over the calculation of your income and only those who take out insurance through a small number of accredited complementary insurers are able to benefit from the scheme.
You can read more in our Guide to Aide au paiement d'une Complémentaire Santé (ACS).