Health cards needed instead of EHIC card

We have had a house in France for some years, but only been for a few weeks annually hitherto.

NOW, we are here and intend to stay this year till October, 2019 . One of us is working, the other retired.

We have EHIC cards, but wonder what we should have instead of this, or in addition to this, now that we are staying much longer.

Further, what kind of “top up” health insurance insurance should we have?

We would appreciate advice.

Thank you.

@fabien maybe you can help?

What nationality are you? As if you are British then things could be a bit complicated. All is still uncertain, but it is possible that after March unless you immigrate formally in the next two months you may find that you only have the right to stay here for 90 days in every 180.

EHIC cards are only valid for stays of up to 90 days.

So if you plan to stay here for 9 months every year then you need to become a french resident and carry out the admin procedures necessary for tax, health care, car registration and so on. And give up your UK residency,

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I’m not sure I understand what you mean by that…

You can’t be resident in two countries. And it seems that up to now people have been able to blur this boundary.

Jane, thank you. I have an NON British EU passport, but my husband is British. Our car has been on French number plates for some years because we were working in Istanbul, before going to Brazil.

You are right about my husband possibly/probably having problems in the future. Are you saying that one can only be here 180 days a year, but you can take them in one block. Or do you have to split them up into 90 here, 90 away, 90 here and so on?

Btw are you saying that during the 90 days validity of the EHIC cards validity, you don’t need health insurance top ups? And that if you stay here for 180 days without having residency you need top ups?

Also if you do just stay 180 days, must you apply for residency. I am not sure what the advantages with our without residency.

It all seems very complicated.

Anyway, thanks lots. It is good starting to get to know some more about it although more questions seem to have come up…


The trouble is that until decisions are made about Brexit nothing is certain. Things could change massively in the next 9 weeks.

What the current plans seem to be - and I repeat this is just guesswork right now - is that UK visitors will be able to spend a max of 90 days at a time in the Schengen area. And as a visitor you can use your EHIC card to get access to health care like any french national (ie usually about 70% paid for) but it will be your choice whether you take out private travel health insurance to top it up. There is likely to be an equivalent to EHIC cards after March.

But if you are European you won’t have that restriction.

It seems that there will be some form of long stay visa, but I don’t know much about it. Perhaps others will.

But the general principle is that no matter what your nationality if you stay in France for more that 3 months you are considered to be a resident, and should therefore register for tax and so on. Because France is the only European country that hasn’t up until now required visitors to get a residency permit (carte de sejour) a lot of people haven’t bothered. However it may get more difficult to do that in future, especially if you are British.

Presumably the one of you who is working, is paying social security contributions? So should be covered for heathcare via that route?

I think maybe a good place to start would be by reading up about Freedom of Movement. Then you’ll understand more about how to exercise FoM correctly, the different statuses and what conditions apply to each status, etc.
You’ll find a lot of info on this website about living and working / retiring in another EU country, healthcare, etc.

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Hi Karen

Whatever health cover you have in place … here in France you will be expected to pay a percentage of your Health Care out of your own pocket.

If you wander down the threads on the Forum… you will see this point discussed again and again.

It is up to the Visitor/Resident to decide how much they are willing to gamble on staying fit and healthy.

Travel Insurance +EHIC … for Visitors/Holiday makers… (90 days)

Residents need to look at a Mutuelle (top-up) insurance… which pays a part of what is NOT covered by EHIC (or the French State)… according to the level of cover the Resident chooses to subscribe to.

some folk have to provide full health cover… it all depends on their situation…

@fabien will be able to advise you on all Insurance matters…

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Absolutely. We always pay for the 25€ for the doctor, and whatever there is to pay for medicines etc which is how it is in all countries we have lived in. Re the EHIC I was wondering in connection with visitors and how to advise them.

And wondering what other insurance we should have . If you have any advice about the mutuelles, what to look out for etc. I suppose a start would be to go to an AXA office, for example.

Anyway, thank you for your advice.


Karen, before you can take out mutuelle cover you need to have a French social security number. Mutuelles work hand in hand with the French health service. They don’t work with other countries’ health services, not even via EHICs.

I still think you should clarify how your position reconciles with freedom of movement. Clearly you have moved around a lot so you have experience, but it’s not quite as simple as, buy a house in a country you don’t live in, and decide how long you’ll spend in that country. There are strings attached, and especially if as you mentioned, one of you has worker status.


As Stella already said, ask Fabien


Karen… I would advise you to discuss Health Insurance with @fabien .

He is our tried-and-tested Advisor… ask him… no strings attached… he is so helpful… what have you to lose ??

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Thank you.

We will.

Thank you

Karen, if you’re intending to stay in France for more than half the year after Brexit, I think you’ll become tax resident here even if your principal source of income is from outside France and will need to submit a French tax return this summer (if you already pay taxe d’habitation, you’ll already have a tax number). Also no matter what the outcome of the Brexit negotiations, unless TM removes her red line on free movement, it seems UK residents will only be able to spend a much shorter time in France each year. So, you may need to decide which in which country you are going to be tax resident (if you’re well advised, this doesn’t necessarily make much difference financially).

Apropos health: if France becomes your primary country of residence and one of you is retired, and in receipt of a UK State Pension, you need to obtain an S1 form from the UK Pensions authority (I think you can do this online) and begin the process of acquiring a French Carte vitale to transfer the UK pensioner into the French system. You can get by temporarily on your European Health card, but by the time you have your interview for a carte vitale, I’d advise you to also have a French health insurance package to cover the 20/30% of treatment in France which will not be paid for by the NHS (lots of companies do this - we’re with AXA). This can be paid monthly and either obviates the need for upfront treatment or promptly reimburses you for small items like prescriptions.

If you’re married, the younger partner can currently piggyback into the French system on the back of their pensioner spouse. However, whilst not wishing to induce panic, I strongly advise that you intiate this process as soon as possible, before the end of March. There’s lots of advice on the UK government website and on French Connexion (maybe on here too).

Good luck, but get going immediately!

PS Hang on to your European Health card as you may still need it if you require treatment while visiting the UK, or other EU countries.

PPS. I’m a Doctor of Philosophy, not Medicine, but all the above advice is based on direct personal experience, as over the past eighteeen months my non-pensioner wife and myself went through the same process.

Sorry Mark, but I disagree with you. Our experience is that France considers you resident after 3 months here. France & UK are not in sync, as for UK the threshold is 183 days.

And paying taxe d’hab does not necessarily give you a tax number. There are loads of non resident second home owners who pay taxe d’hab and don’t have a numéro fiscal, just a reference number. When we finally moved here it was changed after our first tax return.

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Hi Jane,

I used the term ‘tax resident’, which as I understand is very different to being considered what you describe as ‘resident in France after three months.’ The latter is merely the first official step in a lengthy process toward securing ones permanent French residency and at present certainly doesn’t automatically confer any permanent residential rights (though we’re getting lots of reassurance from both govs on that ).

On the other hand, tax residency is an international definition that applies to where one spends the greatest, or greater part of the year and thereby determines ones status as a resident of that country for that year, or otherwise. In other words you can be regarded as a (temporary) resident of France after three months, but as I’m sure you’re well aware, permanent residency through the current carte de sejour system (or applying for French nationality) requires five years residency. Prior to this one can get a carte vitale via an S1 form before submitting a French tax return, but both (and more) will be needed for a carte de sejour.

If you’re paying local taxes on your property, I think your tax number should be on the bill. We had a second home here for six years before moving across permanently and from the beginning our current number was on the bill. Possibly it varies from one dept to the next…

However, the most important aspect of my post was the advice to get into the carre vitale system ASAP if you want to spend more than half the year in France (with an EHIC card, you’ll still be eligible for NHS treatment if you’re in the UK).

That’s just not right - it’s not a day-counting game! Tax residency is predominantly determined by (amongst other criteria) your centre of commercial activity or worth.

PS - on a point of order (again!) - there is no ‘Carte Vitale’ system. The Carte Vitale is quite simply an automated payment card linked to your CPAM and, if applicable, your Mutuelle provider. It facilites paperless payments and reimbursements - that’s all. In itself it doesn’t afford you any rights.


Sorry Simon, not an accountant, but I disagree, as far as I understand, whereas one can pay taxes in several different countries (we make four different national tax declarations each year), ‘tax residency’ is based on where you spend the most time, not your greatest source of income.

I’m tax resident in France because that’s where I spend the greater part of the year. However, I’m taxed at source in the UK on a university government pension, but am obliged to declare my UK state pension and private USS (Universities Supernanuation Scheme) to the French tax authorities. We also have investments in Ireland and South Africa, so although France is my primary country of tax residence I make tax declarations in three other countries

However, I’m a tad concerned that the last two replies to my post have been about supposed fiscal inaccuracies in my advice, whereas the thread’s actual subject is Karen’s request for practical information on a pensioner and their spouse’s interaction with the French health system. It might be more useful to return to proffering help on that original subject.

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