Health care and PUMA

Hello everyone, I am seeking information and advice regarding my husband’s and my status here in France. He is a registered micro entrepreneur (sailing instructor). We both have Carte Sejours, carte vitales and topup mutuelle insurance. We would like to register with PUMA as inactifs as my husband can no longer sustain his M/E ( mostly due to covid). We DO NOT have pensions and are below pensionable age. We have rental income from the UK. No-one seems to have an answer as to how we can go about changing our status. Any information would be greatly appreciated. I hope this is okay to post.

Tribunal de commerce or chambre des métiers might be a place to ask.

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You still have the rights. Try looking on your AMELI to see if you can change his status. I would think that he will need to visit he Pole Emploi and some form of Medical Certificate will be needed at some stage. You know how the French love their bits of paper.

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Thanks David but he’s not looking for employment or unemployment benefits. We just want to find a legal way to stay in France that doesn’t involve him being a micro entrepreneur.

Very tricky when you are under retirement age, although if your rental income is sufficient then that must count!

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Hi, I’m fairly certain our rental income is enough. My concern is if we discontinue my husband’s M/E status and then apply to PUMA we may lose our health coverage whilst waiting for approval.

I would do it the other way round. Go to or book an appointment with your local CPAM, and tell them you are changing status and wish to shift your caisse to CPAM as inactifs. See what they say but it could be super-simple. Remarkably some things in France are!,

Alternatively go to your nearest France -Services.

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I believe micro entrepreneurs are under CPAM ithese days. They used to be under a separate caisse, RSI, but one of the promises that Macron kept was to do away with RSI which had been dysfunctional ever since it was set up and micro entrepreneurs were transferred to CPAM
So there is no shifting of caisses to be done. No doubt CPAM will be able to advise what if anything needs to be done. Perhaps they will require the usual application for heatlhcare that inactifs complete or perhaps not.

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I understood that if you classify yourself as inactif then you need to pay a certain amount/year to maintain the healthcare benefits - if my understanding is correct, does anyone know how much that is?

Thank you. Probably best if I just contact CPAM

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You pay a cotisation once a year to URSAFF. It is something like 8% of your income above €20,000,can!t remember precisely the amount. But we paid around €400 -500/year which seemed great value for quality of the health service.

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I think you should proceed with caution. Do you have a WA CdS? Are you very many years away from retirement?

Could it be worth trying to keep your actif ststus, even if the business isn’t doing very well, till you’ve worked everything out? Enquiries for inactifs are much more exhaustive and take much longer as a new application. If you are switching could be the same. I’d want to be really sure before I indertook any change.

Hi Karen, yes we have WA CDs. I am 54 and OH 56 and we have no pensions due to us from the UK. I have read as a M/E you can have 2 years of nil returns after that they can kick you out of the system.

Yes they do, I’d unsuccessfully tried to close my old one and then at the 2 year (and a few months) mark got a letter.

If you are on a 10 year CDS you are fine but yes if on a 5 year one I’d agree to proceed with caution in closing your ME. Certainly be sure all sorted with PUMA first!

Let us know how you get on.

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Just another thought - is there a minimum value that is needed to be earnt in a year to maintain the ME status, or does anything above ‘0’ allow you to maintain it?

So far we’ve been told there is no limit, that you only have to work 1hr per week to hold your status and a limit of 5000 per month. So with that conflicting information, who the heck knows!!!

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I’m sure many will be very interested to hear about any clarification that you manage to get - if 1hr a week allows you to keep the ME status and the benefits associated with that, then that sounds like at an attractive route perhaps.

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The ME is closed if you submit a zero declaration for 8 quarters in a row.
But if the ME earns very little, and you have a substantial income from other sources, then normally you pay the healthcare cotisation on the same basis as an inactif based on your other income.
I believe there are 2 thresholds for ME earnings. If you are below the lower one (which as I recall really is very low) then any cotisations you paid as an ME are discounted and you pay normal cotisations as an inactif, if you are between the 2 ceilings then your ME earnings are taken into account and offset in the calculation, so you do pay extra but not the full amount that you would have paid with no ME earnings. If you earn above the top ceiling then your ME cotisations are sufficient and your other income is not assessed.
It was explained to me not long ago by a friend who has set up an ME and I think I have got that right but I cannot remember the details.


I still think having a chat with competent people at the CCI might be a good idea.


The PUM-a system has been revised.
If your husband closes his micro-entreprise, your health care status remains exactly the same as long as you are permanent residents with a ‘carte de séjour’. You have absolutely nothing to do! No need to inform the CPAM, the CCI etc!! As permanent residents you have the right to PUM-a health cover (protection universelle maladie) and hence you have both been issued with your carte vitales.
When you file your annual tax return, you will provide the date the micro-entreprise was closed (cessation d’activité) and the tax office will forward this information along with your income details to URSSAF. If your rental income is above a certain threshold (20k for 2021 income) URSSAF will invoice you in November of the following year. You’ll be asked to pay an annual ‘cotisation subsidiaire maladie’ or CSM. The calculation is complex but depends on the amount of your rental income.
If your rental income is below the threshold, you pay nothing in return for free healthcare.
Here’s the link:

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