Getting Health Insurance Cover in France
Tuesday 04 August 2009
Many of you still seem unclear about the rules governing access to health care for EU early retirees to France, notably on termination of employment or business.
Just to recap on the starting point. If you are under the age of retirement, and you have a satisfactory national insurance payment record from your home EU country, then you are entitled to up to 2.5 years of health cover, provided through a E106 health insurance certificate.
When your E106 certificate expires there are a number of possible scenarios, other than private health insurance.
i. Medical Condition
If you have a medical condition that prevents you obtaining access to private health insurance (or to private health insurance at a ‘reasonable’ cost), then you can apply to your local health authority (CPAM) to be allowed into the health system. If you are successful, the whole family living with you is then covered.
ii. Accident of Life
If you have an ‘accident of life’, such as death of spouse or divorce, you are also entitled to make application to join the state health system. From the cases that have been brought to our attention, cover seems to be given without too much difficulty, although you should anticipate the usual paperchase to process the formalities.
You can also start a business or enter employment. Running a business grants automatic access into the health system.
Setting up a business is not complicated or expensive. As we have stated previously, buying and selling from time to time on eBay as a registered professional seller grants you business status, and as an auto-entrepreneur, you only pay on the basis of your turnover.
The French health system provides for continuing health insurance cover for those who become ‘involuntarily unemployed’, either because of a lack of business success, or because of termination/expiry of your contract of employment.
The minimum entitlement is access the health system for at least 12 months.
For those aged at least 57.5 years of age the health insurance cover continues for an indefinite period.
This rule applies as much to those who take a short–term fixed term contract that comes to an end, as to anyone who may otherwise lose their employment due to redundancy, although you need to have completed a minimum number of hours on an employment contract.
It also applies to those who cease their business, either because it was not profitable, or simply not profitable enough. If you have any doubt as to whether your insurance fund will continue to support you if you give up the business, then you should discuss it with them.
In either circumstances, if you are at least 57.5 years of age you are exempt with the requirement to search for work, and you maintain indefinite health cover, as the French government point out on their health website:
'Vous êtes âgé de 57 ans et demi ou plus:
Vous continuez à bénéficier du remboursement des soins en cas de maladie ou de
maternité sans limitation de durée et sans avoir à justifier d'être à la recherche d'un
Indeed, even if you are below the age of 57.5, provided you continue to be registered unemployed and in search of work, you maintain your rights to health insurance cover:
'Si vous êtes toujours à la recherche d'un emploi et inscrit au Pôle emploi:
Vous pouvez continuer à bénéficier du remboursement des soins en cas de maladie
ou de maternité sans limitation de durée. Vous devrez régulièrement en fournir la
preuve à votre caisse d'Assurance Maladie (déclaration sur l'honneur attestant que
vous êtes à la recherche d'un emploi, lettre de candidature, etc.).'
As we have pointed out frequently on this site, the rule that requires early retirees to take out private health insurance cover only applies to those who arrive in France as ‘inactive’ persons, and who remain inactive.
iv. Voluntary Work
If you are unable to take up the idea of business or employment activity, you can undertake voluntary work as a volontariat associatif, under which you are given health insurance cover.
Not all voluntary organisations offer such a contract, so it might be worth making enquiries of your local mairie in the first instance.
When you reach the age of retirement, you have entitlement to an E121 which grants you automatic access to the French state health insurance system.
In all cases, once you have completed five years residence in France, or you reach the age of retirement, you are automatically entitled to affiliation to the health system.
You can read more in our guide to getting Health Insurance Cover in France.