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Health in France

Early Retirees Gaining Access to Health System

Tuesday 11 March 2014

Although S1 cover for early retirees is to be abolished, there is growing evidence that existing holders of S1 certificates are being accepted into the health system.

We continue to immensely grateful to the many readers who write to us about the trials and tribulations they have sometimes endured in making application to access the French health system.

In the past much of the evidence from your reports was that the overwhelming majority of early retiree applications were being turned down by the local health authorities.

However, in the last few months there has been a noticeable change, with most of you now reporting that your application has been successful, sometimes not without expressions of exasperation about what you have endured, but a result nonetheless.

As there remain several thousand early retirees in France with S1 certificates due to expire in the next year or two this is an important development.

Such is the blanket of secrecy that surrounds the processing of these applications it is difficult to establish underlying reasons why the change has occurred, as there has been no change in French law.

However, the most likely reason is that the pressure being exerted on the French authorities by the European Commission is finally beginning to bear fruit.

Regular readers will recollect that the EU has commenced infringement proceedings against France for their refusal to allow early retirees from the EEA into the health system.

It was as a result of this pressure that last July the French authorities changed the application process for early retirees from the EEA, so that all such applications were forwarded by local health authorities to a central processing centre at Nimes.

At the time this process was established the Commission stated that:

"The Commission is hopeful that this new centralised system will resolve the problems of non-compliance with EU law, but notes that the 2011 Circular on CMU admission remains in place.

The Commission is currently monitoring how the new centralised system is working – no reports of refusals have been received so far."

We would echo those comments, for, although we are aware of a number of pending cases, we have also yet to hear of any application from an early retiree being refused by the Nimes centre.

Nevertheless, your mails indicate that not all local health officials are aware of this centre. Clearly, therefore, you would be well advised to bring it to their attention, and to express to them that you expect your application to be sent to Nimes for a decision.

Unfortunately, we are unable to provide you with any French government statement or documentation on the process, as the French authorities have consistently refused to supply any information to us on the operational arrangements. All that exists is the statement from the European Commission.

We do acknowledge that the application and appeal process can at times be most painstaking, but it is important you do not feel intimidated or disheartened by it. All the evidence suggests that while the French authorities may frequently appear to be unyielding, we believe they want to avoid litigation on this issue.

Only in a very few of the cases reported to us has the process of formal legal proceedings in the courts been launched by an applicant, but in each case, before the hearing took place, the application was accepted by the local health authority.

NB: The issue of S1s to those of retirement age remains unchanged, so those of retirement age are not affected by this discussion.

Do please continue to write to me on this matter, as the information you provide is invaluable in arriving at an overall assessment of what is happening on the ground. You can contact me at

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