Healthcare Access

Does anyone have the answer to these questions please?
I am English,62, full time resident in France. I pay UK tax on my teacher’s pension but will have to wait another 4 years to claim my state pension. I have a small income here as an Auto-Entrepreneur but the RSI have yet to take any contributions from me.

  1. Is it correct that my healthcare is covered for 2 years by my EHIC? My card expires in May. I will have been here for two years at the end of July. Is it possible that I could apply for another, I think not.
  2. If not or in the interim, how can I obtain access to healthcare here until the RSI get round to taking contributions? My wife is French and contributions have been taken from her, so she now has a Carte Vitale.
    and 3. What if I stopped working? Would I have to take out private insurance until my UK state pension was due?

As far as I am aware your EHIC only covers you as a tourist not a permanent resident. And can’t you just apply to PUMA( CPAM as was) for cover? An American friend fwho doesn’t work here did and got her CV within 3 months. She has paid no contributions at all this year and only put in 1 tax form here on which she had nothing to pay. Early retirees can apply . I don’t understand why you haven’t just put your dossier in-unless there’s something I’m not understanding in your post.

Thanks for your reply.
I did put a dossier in to PUMA but as the payment they wanted was based on my last three years earnings in the UK (as a teacher), it was ridiculously high (I earn next to nothing here). I was therefore advised to continue to use EHIC.

If you have registered a business your healthcare will have been transferred to RSI. You can’t apply for PUMA because you’re not an inactif, and you shouldn’t be using your EHIC because you’re not a UK resident.

Not sure what you mean by “I have a small income here as an Auto-Entrepreneur but the RSI have yet to take any contributions from me”. If you have an income, presumably you’re submitting your decarations to URSSAF as required, either at the end of every month or the end of every quarter (even if it is a nil return you have to submit it, to avoid the fine) and paying the appropriate cotisations. You don’t wait for the RSI to “get round to taking cotisations”. There’s a set schedule for submission of declarations and collection of dues, and it works like clockwork, I’ve never known URSSAF be so much as a day late in debiting the dues from my bank.

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Contributions paid for PUMA should be based on the previous year’s income. This is usually only an issue in the first year of an early retirement when the payments are based on the salary received while working not on your TP pension. As stated the EHIC (except for S1 holders, students and some other groups) is residence based and a UK issued card cannot be used by a French resident. I’d always understood that AE was a straightforward route to French health cover. If they have not asked for any payments or provided you with a CV I suggest you find out why.

Hello Stephen,

Forget EHIC.

RSI should be sending demands in respect of your business income. You would have had to have declared how often you wished these demands to be. Mine are every three months. I became registered with them last June. I have not yet got any income, so I declare zero. However Every time I go to the hospital or doctor it is RSI that pays that portion which was previously paid by CPAM. I am not an inactive, but a British pensioner, and had S1 working for me before.

You must find out where your RSI office is, and which organisation you chose to operate the RSI. I had a choice of several, and I chose UMCAPI, There was no special reason for the choice.

My whole business was set up during a meeting with the local Chamber of Commerce, and I would suggest that you make an appointment with them, and sort everything out.

Had you been registered as a Professional LIberal, you would have been paying cotisations to URSSAF despite having no income from the business.

Best wishes.

Just out of interest why would a U.K. OAP with an S1 give that up to become a ME with zero income?

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I was wondering that too. But didn’t like to ask!

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Well I had been promised a lucrative contract starting in February, teaching English in the home to French business execs. I still haven’t got the contract. Though I have spoken to the company again today,and it seems to simply be slow in materialising, if not I will have to do a bit of unweaving, maybe.

However, if I am employed here, with even a small income, I am covered medically? If Brexit means that the S1 will no longer function, I could still be covered?

Your educated opinions on this premiss would be appreciated.

Oh yes, you’re still covered, though obviously sooner or later you will need to earn something in order to remain covered.
If you’re expecting to make a good solid income - enough to cover the cotisations and business taxes, and also any social charges on unearned income from the UK that you may now be liable for, that your S1 would have exempted you from - and still come out well on the winning side, of course it makes sense. It just sounded odd that you’ve been registered for 6 months plus with no income, but I think that under current rules you can make nil declarations for 8 trimestres before they take you off the régime.

I was just interested as I’d always heard that the benefits of being on an S1 were worth having and I’d never heard of someone who had one giving it up. Good luck with the teaching, hopefully the firm will get its act together soon.

You can’t be covered twice in France. If you have already applied to RSI tou won’t be accepted for PUMA

Hi Stephen - it is ridiculously confusing. I went to my local public health bureau (3 times) and they told me the same thing I must rely on my EHIC until it expires in Nov this year and if I prove I’ve lived here 3 months will reimburse 100% medical fees incurred in the meantime. Their answers make a mockery of the whole top up insurance system…but only when the EHIC expires will they process a carte vitale for me. I do not understand why they cannot give me a carte vitale now.

If you are employed your health cover will be provided through that employment regime. If you are British and inactif ask the DWP for ‘the’ letter confirming that you are no longer covered by the NHS. At that point the health bureau (sic) will realise that you cannot be covered by an EHIC.

Imagine you are an organisation with a limited and very stretched budget, and people keep coming along and asking you to agree to meet the cost of their healthcare from now on. You’d probably want to check first whether it is actually your responsibility to pay for that person’s healthcare or not before you agree, wouldn’t you?

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Huh? If you’re living in France (and not in receipt of an S1) then your UK issued EHIC card is invalid.

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Hi Simon - Thank you more confusing information I’m afraid. It doesn’t help when 3 times I’ve been to sort this out at my health office and they will not accept my request application form (d’ouverture des droits a l’assurance maladie formulaire)!

No I do not agree Anna, 3 times is ridiculous, yet the Tax Office are more than keen to have my returns in contrast! They will not even “check” anything at the Health office.

The EHIC is residency based. You cannot use an EHIC in your country of residence.
I’m sure that your problem lies with the fact that you have registered as an AE. Your health cover should be provided by that. If there are problems with RSI get those problems sorted out and the health cover should be straightforward. Your wife is French so you should not encounter any language problems.
Who exactly are the health office/health bureau you refer to?

Did the contract ever materialise??

I do hope so…

Let us know how things are going on…