Early retirees and health care

We are due to move to France this year as early retirees - as early as possible in view of December deadline.
Could anyone with recent experience and in the same position please verify our understanding of the procedure.

1.Register as permanent residents after taking out a >3 month rental agreement on a place to live.

2.Apply for PUMA which will cost 8% of income over 9k Euro. (not sure how this works with us both living on my private pension). We need to have private health cover to show to PUMA at this point. - PUMA gives us Carte Vitelles

3.We get Mutuelle cover. No idea of cost.

4.When I reach UK state retirement age I apply for S1 and my younger spouse is covered by my entitlement. We no longer pay for PUMA.

Are we correct? I would be grateful for any clarification/confirmation.

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Not sure what your 1/ means.
Unlike Spaiin for instance, France has no registration procedure for new EU arrivals.
In due course you will need to apply for a carte de séjour, maybe this is what you meant? But it’s nothing to do with obtaining healthcare so I think you can cross it off your “healthcare” to do list . CPAM has its own procedures for checking your eligibility for PUMA. One thing they will need is confirmation that you are no longer entitled to health cover in the UK, so you will need to inform DWP that you have left the UK - there’s another job to add to your list :wink:

We are in the same situation, but a little bit ahead of you in the process, having applied and awaiting a decision. No real idea how long that may take…

You don’t need to have formal residence status to apply, just as well because we now can’t apply for a carte de sejour until June at the earliest according to the latest info. However you do have to prove you’ve been living in France for at least 3 months. Note: this means already here 3 months, so a brand new tenancy agreement isn’t enough.

You apply via your local CPAM office, in our case in Tours. However, they don’t process your application, they pass it on to a specific office (CREIC) in Nimes, although they may also ask for more documentation. The application form is straightforward enough, and in theory tells you everything you need to supply with it, but in our experience they’ll come back to you for yet more information. Some of which is difficult to supply - for example they asked us for proof of entry into the country - which we don’t have as up till now passports aren’t stamped (this may change!). However, we’ve written to explain this and so far it looks like they’ve accepted our explanation. Time will tell.

CREIC specifically deal with applications from non French applicants, and historically mainly non EU. You can write, or ring them (on a chargeable number), but frustratingly not email them.

You may need to pay an 8% cotisation depending on income, we don’t yet know ourselves, although like you we are living at present on my pension alone. Obviously this aspect depends on personal circumstances, but even 8% is a load cheaper than private health care.

According to the French govt website, at the moment an EHIC card is sufficient for the first 12 months, so no health cover is required. This of course will change by December, so private cover may be needed by then. I haven’t had to test this in practice…

Initially, you should get a letter of attestation - the Carte Vitale comes later after some as yet undetermined period of time. The letter is all you need to get you started with doctors etc.

A Mutuelle is optional - however most people will get one as it tops up the state provision, and allows you to claim back the costs not covered by the state. How much it will cost is a bit like how long is a piece of string, because it depends what level of cover you choose.

I’m 58, so I have another 9 years to wait for my UK state pension- I very much doubt if S1 will exist by then so I’m not counting my chickens. Time will tell!

Hope that helps a bit, as I say, we’re part way through applying, so maybe soon I can update with progress!


Richard, I was hoping to hear from people like yourself - further along the queue as it were. The 8% is I believe on income after the first 9k. There must be a lot of Brit early retirees in France and I would hope that the S1 process continues. My main fear is what the UK government will do in the transition period to upset the rest of the EU. I will only have basic language skills when we apply for our PUMa. Hopefully translation tools will help us. Thanks for the clarification. A great help.

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For us we applied to CPAM once we hit the 3 month mark, and it was CPAM who processed everything. I think there might be regional variation… We just did an attestation sur l’honneur for the date we became resident. And we were never asked whether we had had private health cover for that 3 month period, or indeed even whether we had EHICs! Again regional variation.

It was quite straightforward, and took a few weeks to get the attestation that we were covered, and many more weeks to get the actual card. Simple one page form, not much language skills needed.

Here tax is done as a couple (unless you choose otherwise) so each person’s health payment will be levied on 50% of your overall income as a couple.

We were in good health, (with only major issue covered by the ALD system with 100% cover) so didn’t bother with a mutuelle to start with. We then took one out, and ended up paying out over 1000€ more a year than we got back. So now we have hospital only cover which is 50€/month for us both.

And 4. yes, if it still exists (which is what has been promised…) but even better than not paying your health cotisation is reduction in social charges!

Bear in mind that PUMA is relatively new system. The rules on who pays what have been tweaked every year since it was introduced and probably will be again. The object is to share the burden as fairly as possible and so far the changes have tended to reduce rather than increase payments for most people. But, you can’t take the current rules as being set in stone for the foreseeable future. France is far more reactive than the UK and rules do change all the time.

Work on the basis that the PUMA is contributory in principle, and inactifs may be required to contibute a certain percentage of income above a certain threshold, but don’t cling to the 8% or the 9k because the exact figures and the exemption categories may be different next year.

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There is no regional variation because, as stated, all applications from inactif British citizens are handled by Nimes. One bit of good news is that it’s not 8% of all income over the threshold, income from some pensions is exempt.
Getting health cover is an important part of the jigsaw as you will need health cover before you qualify for a CdS but cannot apply through PUMA until you can prove three months stable residence.

Not all go to Nimes
“Processing of your application may take several months. Applications from EEA early retirees are referred to the Nimes CPAM, where the assessment process and registration takes place, although we are aware that some CPAMs process such applications locally.”

Maybe since 31 Jan, ones from Brits now all go there? But they haven’t done up till then.

I think they do now Jane.

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Just hope they’ve learnt the lesson from centralising driving licences to Nantes…2 years and still waiting.

There were backlogs at first but seems to be on track now. :wink:

Please read what I wrote. I purposefully wrote that all inactif British citizens are processed through Nimes.
Nimes have been processing those applications since about 2014, long before the driving licence applications were centralised so there’s no need to learn from their mistakes.

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Well they didn’t process those of a couple I know who arrived in 2016/7…

IIRC what happened was that in 2007 or thereabouts France stopped giving cmu to EU inactifs; there were complaints and it went to court and the EU ruled France was in breach of EU law, France appealed and lost and in 2011 or thereabouts France had to start taking applications again. The system got overloaded and CPAMs didn’t know what crieria they were supposed tp apply and for a year or two it was total chaos. CREIC was set up as a solution and eventually it started to work.

I remember trying to get my head round that as it was when we were planning to move | had completely forgot the court case. But OH applied in 2013, and I did in 2014 and neither of us were processed by CREIC then - and neither was local’ish couple in 2016/7. Mind you, could well something like our department having so few cases that no-one in local CPAM remembered the memo.

Apologies if I am jumping in on someone else’s question, but this information is really useful Anna thank you. So can I “assume” and yes I know what that makes me LOL, that my OH and I should apply to CPAM first for French healthcare, before applying for the Carte de Sejour on the new system in June?

If you’re self supporting early retirees you can apply for healthcare as soon as you’ve been in France for 3 months. You might as well apply as soon as you can, because why wouldn’t you. It can take quite a while for your application to be processed, you don’t walk into the CPAM office with an application form and walk out again ten minutes later with a carte vitale :wink: - not sure what the wait is these days but probably several months, longer if they ask for additional paperwork. But if you still haven’t had a reply by July and you are desperately keen to get on with your CdS application, you can. You would probably have to explain that you’re still waiting to be accepted onto PUMA, and they will probably want to know what health cover you have while you’re waiting.


Thanks Anna - appreciate the advice :wink:

As an update to my earlier post, I have now received my letter of attestation, which is great news. Presumably the Carte Vitale will follow on at some random future point.

What the letter doesn’t say is what to do next. I presume I need to find and register with a GP locally, and a dentist too.

Best of all, so far they haven’t asked for any money.

Yes, now you register a medecin traitant.

Bills for the calendar year are sent out in December.

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