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Access to French health system for non-EU nationals

Posted: Wed 12 Oct 2016 18:12
by NigelS
Hi,

Now that Brexit is underway, my wife (German) and I (English) need to know whether I could access the French health system through her if we moved to France. How does it currently work for mixed (EU & non-EU) married couples?
Thanks in advance.

Posted: Thu 13 Oct 2016 22:33
by Ariègeoise
It used to be that one person could piggy-back onto a spouse's health care, but that was stopped in January this year for new entrants (and will be phased out gradually for those of us already in the system), meaning that each person now has to have their own way in to the system.

So, there are various ways in. You can be employed or self employed and pay cotisations (contributions) that way. If you're getting UK retirement pension, you'll have a form S1 which at the moment will get you in - though nobody yet knows how that may change after a Brexit. If none of these apply, anyone who has lived in France for 3 months - EU or non EU - can apply to join the PUMA scheme - Protection Universelle Maladie - which is a baseline scheme designed so that nobody living here should be without access to health care (it's a replacement for the previous scheme, CMU-B). It's contributory - 8% of your taxable income above around 9600€ and can be a bit of a headache to get for the first time because of the usual paperchase, but it's there. For the first three months, if you don't have access to health care in any other way you'd need to take out private medical insurance (this would be checked when you applied for PUMA).

Sorry - answer longer than question. But that's French bureaucracy!

Thank you

Posted: Fri 14 Oct 2016 11:34
by NigelS
Thank you so much for that helpful and concise answer.

Topping up health insurance

Posted: Sun 16 Oct 2016 20:40
by NigelS
Hi Ariegeoise,
May I also ask, if PUMA is a baseline scheme, can people top up to a medium level of health insurance cover and, if so, roughly how much does this cost for a man in his sixties?
Many thanks for what you have told me so far.
Nigel

Posted: Sun 16 Oct 2016 22:06
by Ariègeoise
Hi Nigel

PUMA will cover you to the fullest extent possible within the French health care system - ie you'll only pay the non-covered percentage (which varies according to what the treatment is). To cover that part, you'd need to take out a mutuelle or top-up insurance with a private company, just as any French person must do. I'm afraid I'm the wrong person to ask about the costs of that though as I've always chosen not to have one (I haven't visited a doctor in over 35 years and don't plan to any time soon, though I have a contingency plan in case of an unforeseen emergency!).

Posted: Sun 16 Oct 2016 22:50
by NigelS
Thanks very much for your answer Ariegeoise.
Nigel

Income assessment for PUMA

Posted: Tue 18 Oct 2016 14:19
by NigelS
Hi Ariegeoise,
I hope I'm not inconveniencing you will another follow-on question.
In assessing the income for PUMA payments, is it only through one's personal earnings or does one's partner's earnings get included too?
Best regards,
Nigel

Posted: Tue 18 Oct 2016 16:59
by Kate
On the subject of Mutuelles, it is worth shopping around and getting several quotes, and most importantly choosing a mutuelle that is suited for you. Some are 'modular' and you can choose for example to get more reimbursement on dentistry and less on glasses if you know you eat a lot of sweets but your eyesight is good.
Below is a basic info article but if you choose a good insurer, they should give you tailor made advice.
In all circumstances, it should cost you significantly less than a private health policy in the U.K....and usually doesn't pénalise you for existing illnesses.

http://anglophone-direct.com/health-ins ... -france-2/

ENGLISG SPEAKING INSURERS IF YOU NEED THEM
AXA, Céret and Saint Genis
AVIVA Céret and Prades

http://anglophone-direct.com/listing-ca ... insurance/

thanks

Posted: Wed 19 Oct 2016 14:25
by NigelS
Great, thanks very much Kate.

Posted: Wed 19 Oct 2016 15:01
by tia
Hi. I have just rung CPAM for a friend and asked about the PUMA route for health care. Reply was that this does not conceen Europeans . Has anyone here actually done it and if so what paperwork did you have to provide?

Posted: Wed 19 Oct 2016 20:08
by Ariègeoise
Oh (sigh) ... what a lot of rubbish some fonctionnaires do spout ... :roll: PUMA is available to everyone, French or non French, European or non European

Haven't applied personally but know several people who have - justificatifs always depend on individual situations, how long in France etc etc (and of course which CPAM is dealing with the application ...).

Basic info here: http://www.ameli.fr/assures/droits-et-d ... aladie.php

(Sorry - this is a bit of a brusque reply but I really should be somewhere else at the moment!)

Posted: Wed 19 Oct 2016 20:23
by NigelS
Thanks Ariegeoise - hope you get to where you should be on time.

In assessing the income for PUMA payments, is it only through one's personal earnings or does one's partner's earnings get included too?
Best regards,
Nigel

Posted: Wed 19 Oct 2016 20:36
by tia
Payments would definitely be based on all household income. When you file your tax return it would be for both of you together.
I thought the same about PUMA so will be making the trip to CPAM about it.