Health & Social Security Rights in France
Wednesday 01 July 2009
New official guidance has been issued on the health and social security rights of expats from Europe living in France.
The guidance makes clear that ‘inactive’ expats do have a right to social security benefits, provided they are legally resident in France.
Who is 'Legally Resident'?
The notion of ‘legal residence’ in France for an inactive person from within the European Community requires that they have: (i) a minimum level of resources, and that (ii) they have health insurance cover.
The health insurance cover may be through 'E' form certification, private health insurance policy, or registration with the state health system.
The two conditions do not apply to those who have lived in France for an uninterrupted period of five years, as under European law, no test of resources or obligatory health insurance is necessary for such persons.
Accordingly, those from with the EU who have lived in France for a continuous period of five years have a right of access to the French social security system, including state health insurance cover (as well as an unconditional right to remain in France).
Neither do the two conditions apply to someone from the EU living in France who is here to look for work, or in gainful employment or business in France.
Thus, the tests of sufficient resources and health insurance for legal residence do not apply to someone who operates a business in France, even though the income from their business (together with their other income) may not be sufficient to bring them up to the minimum level required for ‘inactive’ persons.
It is, therefore, a mistake to assume (as we know some of you believe) that a minimum income is required in order to obtain a right to live in France. The rule only applies to those who enter France as ‘inactive’ persons, and remain so.
Even in these cases, the French authorities are not going to deport an EU citizen from France, simply because their income may be below the minimum income level for legal residence! And, of course, as we state above, no test of resources is required after 5 years residence.
If you relocate to France in search of employment, then under European regulations, you have no obligation to fulfil even these criteria, although in theory you could be required to prove that your search is realistic.
The new guidance says very little on the issue of the health and social security rights of those who take temporary employment that ceases, or who start a business but later close it because it did not prove to be successful.
In fact the legislation itself is clear, but only up to a point; the denial of social security (including health) rights to those from the EU only applies to those who enter France as ‘inactive’ persons, and who remain inactive.
Temporary employment, or starting a business that is later closed because it did not prove viable, would break the cycle of inactivity. Even though a person then became 'inactive' they would have an automatic right to social security and health benefits.
The nature and duration of your social security rights would depend, in some degree, on the level of the insurance contributions paid during your employment or business activity. If you have worked for less than one year, then they will be for a limited duration of six months (or up to one year for business professions), but they can be renewed with further periods of temporary employment or business activity.
Indeed, it is arguable that the right to health care continues indefinitely, irrespective of any new employment. This is because, while entitlement to some benefits is linked to employment record, access to health care (and certain other benefits) is not to be linked to insurance contributions or the duration of employment, beyond a minimum three months employment or business activity. Once your right to access the health care system through employment or business activity expires, there is right of access to health care through the Couverture maladie universelle (CMU).
We hope in due course there will be a legal adjudication that will shed some light on this point as we are aware from your e mails that officials are interpretating the law in different ways; some appear to offer a generous and helpful response, whilst others choose to interprete the law in a narrow and strict sense. It will be interesting to see how it all develops in the coming years.
What is an 'Accident of Life'?
There is also another important exception to the five year rule on legal residence, and, thereby, access to health and social security benefits.
This exception relates to those who have suffered an ‘accident of life’, which causes them to lose their resources or right of access to the health system. This would cover those persons whose partner dies, divorcing couples, or those who involuntarily lose their employment.
It also covers those who are refused private health insurance due to a serious illness, not known at the time they relocated to France.
If you fall into one of these groups, you are exempt from the requirement to have lived in France for five years before you can gain access to the state health system and social security benefits. However, each case is considered on its merits, and you would have to make application to your local health authority (CPAM) to obtain exemption.
What is the Minimum Level of Resources?
In order for an 'inactive' person with less than five years residence to be legally resident, they are required to have a minimum level of income so they are not a burden on the French social security system.
The minimum level of resources that complies with the legislation is the subsistence figure used to calculate entitlement to the revenu de solidarité active (RSA), or to the allocation de solidarité aux personnes âgées (ASPA) for those over 65 years of age.
The monthly level of RSA is revised each year, and varies according to the size of the family, as follows:
|Single Parent||€778 (+ €194 each add child)|
In relation to the allocation de solidarité aux personnes âgées (ASPA) the maximum allocation is currently €8,125 a year (€677 per month) for a single adult, and €13, 765 for two adults (€1,147 per month).
If your income is below the RSA/ASPA thresholds, and you entered France as an 'inactive' person and remain so, with under five years residence, then you have no entitlement to health or social security benefits. You could only quality to do so under the 'accident of life' provisions.
However, provided you achieved the income threshold, you would be entitled to apply for a range of benefits, notably assistance with school benefits!
This is because the income threshold for assistance with certain social security benefits is higher than the RSA/ASPA subsistence income threshold.
You would not, however, be entitled to access the state health system, until you had completed five years residence, unless you were otherwise covered through an E106/E121 health insurance certificate.
The new guidance appears to have been prepared in order to assist French social security agencies on the interpretation and implementation of existing legislation.
It is clear from the evidence we receive, and the stories we hear from other sources, that there has been considerable uncertainty amongst officials on the regulations.
From what we hear, expat cases are now being examined with a far higher degree of scrutiny than was the case in the past, primarily because of past abuse of the system. The French social security system is no pushover, and neither do we think it should be. However, if you do feel officials are not acting in accordance with the legislation, then we would be keen to hear from you.
You can read more in our guide to the French Health System.