Health care confusion again!

With a final move date in November my wife and I are retiring to the country we love dearly and have bought a house in Vienne, Poitou Charente to enjoy life.
Aged 58 and 51 respectfully ( she would love me advertising that !) we are in the enviable position of being able to live on my ( government ) pension and other returns thus not requiring to work. So we are, I believe "inactive
The big question for me is how do we enter the French healthcare system. Whilst I am aware of the basics my situation seems to engender many different solutions across a number of blogs and websites, usually ending up with advice to visit the local CPAM office for a definitive answer. Whilst that is sound advice I wonder if anyone can break down the basics for someone in my position and the likely route for us both to have the safe knowledge of healthcare should we need it ? All guidance appreciated thank you

https://www.ameli.fr/vienne/assure/droits-demarches/principes/protection-universelle-maladie

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Seems to me that you might need to have full health insurance (private) in place for whatever the period is needed (during which you prove that you are here and in a stable manner…) could be a one year contract…as it may take that time to get yourselves “proved”…so be prepared to pay out…:money_mouth_face: for that…

there is lots of chat, but seriously, face to face at CPAM really is a good option…

Thanks David. The theory I understand. The qualifying is confusing !

Thanks Stella, you would think there was some sort of standard measure that would satisfy that requirement !

But why would a one size fits all solution be the answer, when people’s circumstances are so different? France tends not to like “standard measures” and box ticking exercises, it prefers to look at the facts and assess each case on its merits, the spirit of the law rather than the letter of the law if you like - makes it more difficult for people to ‘play the system’ :wink: by meeting the letter but not the spirit, and also allows unusual circumstances to be taken into account. France, ie CPAM, will take a thorough look at your situation, they know what they are looking for and if you meet the residence criteria you will not have a problem, although you might have to wait a while for the wheels to turn. PUMA is designed to be fair and inclusive, and the rules are fully in line with EU citizens’ rights, so I think you’re worrying unnecessarily. And since CPAM makes the decision, they are the ones you have to satisfy so it really does make sense to go and talk to them! They don’t bite, although they do have an insatiable appetite for bits of paper.

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Quite agree Anna…so many variances…

@Dave951 … if you go to speak with CPAM when you arrive, explain your situation… they will tell you what they need … and when!. (may be long, may be short)… and they will tell you (politely) what you need to do (if anything) in the meantime…

They are not dragons… go in with all your personal info…and wearing a big smile…especially good if you can speak a little French…:relaxed:

Be aware though that cotisations are normally based on income from the previous year, ie 2017 cotisations are based on 2016 income. Not sure how they equate this to UK tax years which are April to April. But if you have literally just retired in 2017, and you apply for PUMA early in 2018 as soon as you have 3 months’ residence, you might find your contributions are assessed on your 2016-2017 income rather than your current pension income. It might still work out that PUMA is a better option for you than private health insurance, but it’s best to be prepared and put a bit aside, or alternatively delay applying until the years have caught up with themselves and you will be assessed on pension income. I’m just metioning this because bills are sent out retrospectively and it has been known for people to get a nasty shock when they see the amoun,t but at that stage if you’ve been using PUMA all year you have no option but to pay up.

At least that’s what used to happen under CMU. PUMA only started last year so the first PUMA bills, ie cotisations for 2017 based on 2016 income, will be issued in the next few months.

Thanks Anna, Yes I like the idea of assessing individual circumstances as they can then gauge the applicants intentions more readily. I also understand the possibility of people trying to circumvent or otherwise abuse the system. We are committed to a new life and I hope that shines through when we get to the face to face. Whilst our French may not be the most proficient as yet I hope our passion will be easily translated !!

Thanks Stella. Building my dossier as we speak and my French works in holiday situations so hoping we can show some enthusiasm and commitment.

Thanks Anna retired March 2017 so may be worth considering

Also considering utilising part of the house as a Chambre d’hote which I believe opens other possible options

Setting up a business or working part time is an excellent answer. That is what we did when arriving 16 years ago. We paid for our own medical insurance for a couple of years, then I worked part-time and as a result got medical cover for my ‘foyer’ of retired husband and 2 school-aged children. Now retired in France and draw a French pension, and thus CPAM cover continues…

You make an appointment at the local CPAM office and register for healthcare. When we first arrived we had to pay quarterly for this until I got my S1. This you get on reaching state retirement age. Currently the UK picks up the tab for your care. Post Brexit is in the lap of the gods.

Thanks Carol
Yes I think the appointment is the way forward

Thanks Sandra, it is something we considered when we were looking for a house. Either a gite or chamber dhote. If not for the income then for an additional activity to keep us occupied. I assume the healthcare benefits follow once registered ?

Hi Dave,
Sorry don’t know how long you would need to contribute either through your business or as an employee (both systems are different by the way) as in my case I reached French retirement age at 63 and took my pension then. In this case, cover continues for life.
I have to echo what a previous post said - they are actually very helpful when you visit and ask for information, so I would recommend that course of action.
Best of luck!
Sandra

PUMA? What is PUMA? Regret to say I have never heard of it (and Google does not enlighten me).

What I do know is that when I retired I went to see my local CPAM and signed forms that basically made the UK responsible for my health care costs. I claim through the French system and they bill the UK. It was all transparent and I didn’t have to worry … until last year when a massive tax bill arrived with no explanation.

It turned out that the French taxman had assumed that France was actually paying for my health care and suddenly I was paying social charges on my pension. Maybe this is the mysterious PUMA that Anna is talking about? Anyway a friendly accountant told me to get my Attestation de Droits from CPAM which had a code gestion of 70 on it, saying the UK was paying in the end. Once this was shown to the tax man the massive charges disappeared. The legal logic for it all rescaped me, I’m afraid.

It’s all here.
https://www.ameli.fr/vienne/assure/droits-demarches/principes/protection-universelle-maladie