Health cover - my head hurts

Lovely people, I am confused. Here’s a hypothetical situation for you. Imagine a couple aged 47 & 58 want to move to France. They can manage to prove the minimum income of €820 per month as ‘inactifs’, but they are both too young for the S1 forms. How would they go about getting into the health care system? I keep reading wildly differing things and I am utterly confused.

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You would have to prove that you would not be a charge on the French health care system
You can do this two ways, firstly by starting to work and paying your cotisations or by taking out a Mutuelle to cover you privately.


That’s odd advice. I’m an inactif and, like the majority of people in my position, my health care is covered through PUMA.

Hi David. Are you in receipt of an S1 or not?

No, do some research on PUMA, it is available to everybody.

Thanks David. I’m getting very conflicting advice. There’s websites telling me that everyone is eligible to apply after three months, however, the say you aren’t eligible until you have five years residency. You can see why my head hurts! I just want the right answer!

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You do not need five years’ residency.

From the PUMA “English” site

"You are living in France for less than 5 years, you do not have a paid activity, you are under retirement age and you do not benefit from any rights from a European country.

You can apply for a PUMa health cover after 3 months of residency in France. If your claim is accepted, you will have to pay a contribution to the Urssaf (Union de recouvrement des cotisations de sécurité sociale et d’allocations familiales). If it’s rejected, you will have to find and pay a private insurance.

If you are not eligible to get a S1 form, you can’t claim for the PUMa’s benefits under 5 years of permanent residence unless your situation has changed while you’ve been living in France (change of income, divorce, long term disease, etc.).

For all further information, please contact us on 0033 (0) 811 36 36 46 (Monday to Friday, from 8:30 a.m. to 5:30 p.m.).

Can anyone explain the paragraph I have highlighted… PLEASE.
(I understand you can apply to pay into the system after 3 months… but what does the next bit mean…) I admit that even I am getting a bit confused by this all… now… arrghhh

Me too because as I understood it, France was told by the EU they were not allowed to do this in 2014…someone pass me a G&T please.

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I’m giving up on this subject for today… I’ve been dipping in and out…

and in between…

I’m trying to translate into French… a 1978 Corvette Owner’s Manual… which is written in American :scream::flushed::crazy_face: so you will appreciate why I cannot think straight any more…



I think you need the g&t lol :smiley:

I learnt something today, there is an Ameli English language site! However it does not give the same information as their main site and I know which one I trust. I know that you do not need to have been resident for five years to join PUMA because I know many people, including myself, who have done so. I can only presume that the contradictory paragraph on the English language site is incorrect. If the five year rule still existed, which it does not, the main site would state that too.

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I would suggest that the OP phones the number given.

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Cheers David. Oddly enough I can read French with little difficulty until I get near anything official and then I go into full on imposter syndrome and have a wee meltdown!


Maybe there is a difference in residents from the EU gaining access bu those outside the EU have to wait for 5 years??:thinking:

Is that a visa issue to do with regular and stable residence?

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As I understand it, after 3 months residence you can apply to join PUMa and as long as you meet the conditions you’ll be accepted, but it’s not automatic. Thereafter you will remain covered provided you continue to meet the conditions. If during your first 5 years you stop meeting the conditions for some reason, say you lose your income, then you will (potentially) lose your entitlement to PUMA. But after you’ve continuously met the conditions for 5 years, your PUMa entitlement is no longer subject to meeting any conditions, because once you’ve clocked up your 5 years continous legal residence you have an automatic right.
So basically, up to 5 years then you have to prove that you currently meet the conditions each time they decide to review your rights, probably on an annual basis. After 5 years you have to prove that have clocked up your 5 years, and after that you won’t (in theory) be asked again.
Hope that helps.


Great help Anna… thanks

So, is the worst-scene scenario to be prepared to pay for 5 years’ worth of full Private Insurance Health cover… until PUMA must accept you…??

After that you pay PUMA a percentage of your income and take out Top-Up Health Insurance…???

Hi Helen

Hope I can offer some recent personal experience.

My wife and I arrived in France in March 2016 ( having had a holiday home for 12 years ).

We are both inactif and are in our early 60’s so do not have an S1. We have an income in excess of 1000 euros and private pensions that we are currently not drawing.

On arrival we contacted our local CPAM office ( or whatever it’s called now ). They advised us that we could apply for our carte vitale after we had been resident for 3 months, and told us what documentation was required.

After 3 months we returned , documents in hand. The lady went through the forms to check we had filled the forms in correctly. Job done.

We had no health insurance in place at this time.

After 3 months we had heard nothing so went back to the office who chased up our dossier and found it was in process in Nimes.

After another month we received a communication from Nimes asking for shed loads of financial information. 16 Euros of photocopying later the information was dispatched.

Our Carte Vitales then duly arrived 4 months later.

We found the people at CPAM extremely helpful, though the was a degree of confusion as the system had changed in January, and there was a degree of uncertainty about certain documents.

Hope that helps.



Glad it turned out so well for you… your situation obviously ticked all the right boxes…you got accepted… and you were fortunate not to need medical stuff during those months when you had no cover whatsoever :relieved:

Have you now taken out a top-up Insurance of some sort… ?