Tuesday 2 February 2010

Registering with the French Health System (CPAM, RAM, Mutuelle Action, etc)

I always advise my British clients to contact the NHS (Tel. 01912 181 999 - overseas) before relocating to France in order to apply for the necessary documents to get into the French Health Service. You need to apply for a S1. This document can take a while to come through so it is best to apply for them just before moving to France.

Once it is in your possession, visit your local CPAM (Caisse Primaire d’Assurance Maladie). Your local mairie will be able to give you the address of the local branch. As the French love their paperwork, always carry with you for the 6 months following your move to France your passport, birth certificates, marriage certificates, and a proof of address (phone, EDF or water bill) with you The CPAM office will also need your bank details. It is called a RIB (Relevé d’identité bancaire). Your French bank will supply you with several RIB when you open a French bank account but if you require more just ask your bank, they will print some more for you. You can also find one in your cheque book.

Once you are registered it will take a while for you to receive your Carte Vitale but in the meantime you will get a proof of your registration called “attestation”. Carry this paperwork with you all the time. I always advise my British clients to copy it and keep a copy in their hand bag, wallets and glove box of the car. Emergencies can happen anytime! The doctor, dentist, chemist and any other practitioners and healthcare specialists will ask for the attestation. Once you’ve received your Carte Vitale keep the attestation in your file. It will be handy to have if you lose your Carte Vitale.

You will then have to register with a doctor (médecin traitant). You are free to choose the one you want and can change anytime. You will have to send a new “Déclaration de choix du médecin traitant” each time you decide to change. Those forms can be picked up from the CPAM or you ill find one online by visiting www.ameli.fr.

For the expats arriving in France and who are not officially retired or employed in France they will have to take up private health insurance until they reach retirement age or have lived in France for 5 years. Many insurance companies offer private insurance. Shop around and budget for it now as it can be pricy!
If you are self-employed, you won’t have to register with CPAM. Where you register to pay your health and social charges will depend on what professional activity you have. This information will be given to you on registering your business.

It sounds rather complicated – I know. When I first moved back to France (I lived in Jersey in the Channel Islands for 8 years) I was facing the same procedure as any expats. If you are employed in France and become self-employed (or vice versa) make sure you contact the new social security.

Don’t assume because you are paying social charges (charges sociales) that you are covered!

Don’t assume the ‘old’ social security will inform the ‘new’ one about you!
When I set up my business I had 2 Cartes Vitales, one from CPAM and one from Mutelle Action both showing that I and my partner were insured in France. However following an emergency at the hospital I was facing a 125 euros bill that none of the social securities wanted to reimburse! I had to write to both and explain the situation. I did get my money back but I couldn’t understand how suddenly they didn’t know although I had 2 valid Cartes Vitales!

Registering can be long but it is worth it. Remember: the French healthcare service is one of the best in the world, offering a wide choice of general practitioners and healthcare specialists!

If you need any assistance with registering with the French Health System, don’t hesitate to contact me. I will pleased to help.

Please drop me a line if you find this post useful.

28 comments:

  1. Rachel, what do you think would happen to a person who was living in France and paying the RAM, CPAM and all that, but then left the country for good with an outstanding bill? I do not have a French cheque book anymore and I would rather not pay the remainder of my RAM invoice, considering I did not live in the country for the amount of time they are billing me for!

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  2. First, you need to write to RAM, CPAM, etc to let them know you have left France with a precise date. They will update their records and stop sending you bills.

    We pay social charges (cotisations) in arrear so you probably do owe them some money. By ignoring bills, you will get reminders with extra charges for late payments. After a while, you will receive letters from a debt collector – so more fees to pay!
    Eventually they will find you and you will have to pay not only the bill but the extra charges. I would advise you to pay what you owe even if you have no plans to come back to France.

    If you don’t have a cheque book, I am sure you can transfer the money to them.

    If you need any assistance with drafting letters you can contact me.

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  3. You may know and be able to advise. I am an Australian but with an EU citizenship (Swedish), I'm living in France at the moment. I'm not sure if I'm a candidate for private insurance or insurance provided by government. Also about Social Security, how do i obtain this? Do I need this to obtain government health insurance? Thank you.

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  4. Rachel!

    I am French and had lived in California for the past 20 years. I am married and have my Green Card. We have 2 daughters (11 and 9). My 2 girls and I are coming back to France for a year. They are going to go to school there and learn French! I don't know what happened to my social security card I got when I was in University in Nice(06). How do I renew my Social Security card,... What are my rights as a French citizen? What are my soccial prestations? Who should I contact to get my social security number back? Thanks!

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  5. Hello

    Thank you for your message.

    If I were you, I would contact the CPAM of the area where you are relocating to. Send a copy of your birth certificate so they can identify you and find your social security.

    I don’t know the agreement between America and France. I guess you will have to apply for the CMU. Check this link for more information:


    http://www.ameli.fr/assures/soins-et-remboursements/cmu-et-complementaires-sante/cmu-de-base-une-assurance-maladie-pour-tous/votre-affiliation-et-son-renouvellement.php

    As you are French it shouldn’t be too hard for you to understand.

    You have to be a resident in France for 3 months before you can apply for the CMU, in other words you won’t be covered for the first 3 months. Your children will be covered under your social security number as “Ayant-droits”.

    Let us know how you get on!

    Rachel

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  6. Dear Rachel
    After a long process, we have attestation status for my husband (retired - living in France) as a beneficiary of myself as the "assure" - I am resident and work in the UK, and have secured a form S1. CPAM has now requested a certified translated copy of my birth certificate before finalising our application and issuing a Carte Vitale. Does this have to be done by the British Consulate or is any suitable legal entity (i.e. our local bi-lingual advocat) deemed appropriate. I only have the original of my birth certificate - which I presume is what they are looking for. Any advice much appreciated.

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  7. Thank you for your message.

    You need to have the translation done by a “traducteur assermenté.
    Ask your mairie or your nearest Tribunal, they will have a list of translators.
    You can also email me directly and I will give you details of someone who can help.
    http://www.anglofrenchcommunication.com/contact.php

    Voilà!
    I hope this helps.
    Rachel

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  8. I need advice about moving to France from the UK with only my state pension to live on, would I qualify for the free healthcare in France via the CMU? I speak French well enough to try to talk to a department or office but don't know who to contact. Can you help?
    My email is jp@regis.plus.com

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    Replies
    1. Hi Judith,
      i have emailed you directly months ago and we spoke over the phone about your move to France.
      Do let us know how you get on with your new life in France!

      Rachel

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  9. Hello Rachel,
    I wonder if you can give us any advice. Basically we bought a house in France in 2005. My husband lived here permantly from July 2005 and I joined him in December 2007. My husband is 60 and I am 57, we do not work but have lived off money from the sale of our house in the UK and from our very small pensions. The house money dwindled away three years ago, so we have just our pensions which amount to about 200 euros a month. We have survived so far by selling our possessions and from family and friends who have lent us money.

    Neither of us has been ill or needed to go to a doctor, dentist etc. and we do not have any medical insurance and have never registered with CPAM or any other authority/department.

    We do not have any English friends and do not speak french so are unsure of what we have to do to register for a cartle vitale. Can you give us any advice please.

    Thanks.

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  10. Hello. Thank you for your post.
    Registering with the CPAM is a legal requirement. If anything happens to you or your husband, one day at the hospital in France will cost you over €1000 and they won’t let you out till you have paid…
    Have you contacted the NHS? Can you get a S1?
    Here is the phone number:
    00441912 181 999

    Do let us know how you get on with the NHS first.
    Then we will see what we can do.
    Rachel




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  11. I'm not sure if this posting is finished but I am filling out forms sent by CPAM relating to pensions, they are forms S1103 and AS461-14. My problem is, I've filled in the forms with the correct information, and printed out birth certificate, pension provisions etc. and will register with a doctor this week. However, at the bottom of the forms there is a space which on one says; Certifie exact a..... and on the other Fait a........ (certified true at......and Made (form filled in) at.... I don't understand what information they want here. I first put my signature, then realized that goes somewhere else. Now I've put my address, but on the yellow form they already asked for my address. Thank you very much if you can help. Gillian

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  12. Hi Gillian
    Fait à: write the name of the place where you are, ie Paris.
    Usually it is 'fait à' .. 'Le' (you have to write todays date).
    Or if you have 'certifié exact' you then sign the form.
    You can scan and send it to me if you wish.
    My email address is info@anglofrenchcommunication.com

    Rachel



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  13. Hi
    Another question if I may, Wife, 2 kids (under 18) and I have lived in France for 7 years. I work in UK, live in France, wife and kids 100% in France. Tax paid in UK and declared in France. I also work from home (for the UK company). Now UK NHS are saying they wont give me a new S1 (although I have paid into UK system) and local CPAM say I must get a S1 form....Is there anyone else I can talk to to get some definitive agreement ?

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  14. Dear Joe,
    It usually depends on the working situation (contract or PAYE) and the NI contributions.
    You can email me directly and I will be able to point you to the right direction.

    info@anglofrenchcommunication.com
    Rachel

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  15. Hi Rachel,

    Could you please let me know after sending the all the related document to CPAM office (Nanterre). how much time they will take to process if all the document are correct.

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  16. Hi
    Thank you for your message. It can take a few weeks to get an attestation from CPAM, then a few months (2 or 3 !) to get your Carte Vitale. However, you are in the system so keep all the bills (chemist, doctors, dentist, etc), you will be able to claim your money back as soon as you get an insurance/social security number.
    I hope this helps.
    Rachel

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  17. Dear Rachel,
    I hope you can help me. Myself and my husband bought a house in France two years ago and it is currently being renovated. We plan to move over there next year with our baby son. We are self employed in Ireland and pay tax here ( rental income from property). When we move to france we will be able to support ourselves on this income . Would we be eligible for cpam/ carte vitale or would we have to pay for health insurance. I would greatly appreciate your advice,
    Many thanks
    Niamh

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  18. Hi Niamh,
    Thank you for your message.
    What part of Ireland do you come from?
    Rachel

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  19. Hello Rachel, my partner and 3kids are in the process of relocating from Dublin Ireland to France find work.My partner is fluent in French n I don't know a word of French, but i intend to learn. We are both currently unemployed and on the dole. Do you think we will qualify for the carte vitale? And what would you advise we do?

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  20. Hi!
    If you work in France you will be automatically in the health system so you will get a Carte Vitale.
    Best wishes
    Rachel

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  21. Hi I wondered if you can help. I am a UK citizen (but not resided in UK for many years). I am planning on moving back to France (after 6 years in SE Asia). The plan is to work in Geneva Switzerland and live as a frontalier in Haute Savoie. Can I register with CPAM in this instance an get a carte vitale for the family or do we need to get private healthcare? Thanks

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  22. Hi. I wondered if you can help. I am hoping to move back to France after several years in SE Asia. I am a UK national but have lived outside the UK for the past 18 years. I plan to work in Geneva, Switzerland and live in France as a frontalier. Do you know if I can still register at CPAM if I am a frontalier or would I need to purchase private health insurance?
    Many thanks
    Trudi

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  23. Hi Trudi
    Thank you for your query. I had to do some searches to answer your message following some recent changes.
    You need to register with CPAM, you will pay 6% of your Suisse income to CPAM. In 2016, it will go up to 8%. You and who ever lives with you (it could be your wife, girlfriend, Mother, children, etc will be covered too) so you won’t need any private insurance.
    Good luck with your move and contact me if you need assistance with your relocation (water, phone, CPAM etc).
    I hope this helps.
    Rachel

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  24. Hi. I moved to France, from the UK six months ago. I have retired early and have a private pension. Because I am not of retirement age can I apply for CPAM or do I need private health insurance? Thank you, Jennifer

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  25. Hi Jennifer, Yes you need private health insurance.
    Contact me if you require assistance with your cover. Kind regards
    Rachel

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  26. HEllo!
    I am an American working in Paris with an internship for 6 months. I have a long stay visa titre de sejour. How do I go about registering with CPAM? Do I need to fill out a certain form before going there in person to apply for social security number? Many thanks

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    Replies
    1. Hi Alanah, you are in a funny situation!
      Have you tried to get a private cover from the States?
      Please email me direct. Thank you. http://www.anglofrenchcommunication.com/contact-location/

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