Obtaining an 'S1' from the UK

Can anyone help please? I recently tried to obtain affiliation into the French Health Care System. They informed me that I need an 'S1' form or certificate from the UK to be included in my application. My problem is that no one at HM Revenue and Customs appears to know what I am talking about and I am being passed from pillar to post. Has anybody else had this problem? Am I talking to the right people in the UK?

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Les, it's the Overseas healthcare Team as Maria said , the number is the same BUT I did have another number, that letter has mysteriously disappeared!!! Sorry about that Les.Keep trying the number Maria gave you, I always find early morning best. If you have no luck I will try and find the other number for you. Hubby's S1 came through yesterday.

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Les,I have just read this and have just done the same thing for my hubby. We received the S1(old E106) forms this morning. I will post the tel no you need in the morning...can't go downstairs at the mo, hubby watching footie with Irish friends. I get up early in the mornings and will give you the very number you need ;)

Thank you Tony. A really helpful contribution.

Here is an article from my web site, I hope it helps.

What S1 form should I ask for?

•S1/E106: Working abroad:
- Employed, self-employed or have a student status in the UK obliging you to move to France.
- LIMITED S1/E106 from the NHS. This document is RENEWABLE until your S1-E106 rights EXPIRE.

•S1/E106: Early retirement:
- No longer resident in the UK.
- Under state of origins retirement age.
- Up to date with National Insurance Contributions in last few years.
- Option also applies if looking for work.

If you have already lived out of the UK for a certain period of time and your rights to your S1-E106 have expired then you need to ask for a document to this affect. One in English and one in French to prove to the French authorities, or perhaps your private insurance that you no longer have state cover out of France.

If you live in France and have fallen in to the trap whereas your S1-E106 has run out, you have not lived in France for five years, you are inactive and not yet of retirement age then you will have to replace your state R.O (Régime Obligatoire) by Full “Non Assujettis” cover. Non Assujettis suggests that a person is not recognised by an R.O and the policy has been especially designed to provide adequate cover to stay legal in France. ie: Non financial limits and percentage based like the CPAM. No exclusions or categories of illness.

•S1/E109: Family abroad:
- A family member still works in the UK but SPOUSE/PARTNER and/or CHILDREN live in France and need health cover abroad.
- The S1/E109 is only valid for the « dependents» of the person making NI contributions.
- The EHIC will cover the other person when they are VISITING France.

•S1/E121: State retirement:
- State of origins retirement age.
- No longer have any professional activity.
- Dependent on Spouse or Partner S1.

•S1/E121: Long Term Incapacity
- Benefits can be transferred to France.
ALD: Affection Longue Durée - ONLY 100% of treatments regarding existing conditions are covered by the ALD.
Any Dépassements d’Honoraire charged by specialists can be reimbursed by your Top-Up.

If you have a valid S1-E106 or S1-E121, this is to be taken to your local “CPAM” office, (Caisse Primaire d’Assurance Maladie).
It is advisable to make and keep copies. Once all other required papers have been given to “CPAM” (full birth certificate, marriage certificate, proof of residence, ID etc...) this will give you a provisional French Social Security number “N° INSEE provisoire” starting with a “7” for men and an “8” for women.

For the S1-E121 holders and some S1-E106 holders you will receive an “Attestation à conserver” with your full Social Security number “n° INSEE permanent” starting with a “1” for men and a “2” for women and eventually the “Carte Vitale”.

•S1-E121 “Ayant Droit”
If you are sharing an S1-E121 “Ayant Droit” with your spouse or partner, your rights for French Social Security will be under the same number for both S1-E121 holders.
However, to save reprinting another “Carte Vitale” when the dependant reaches retirement age in their own right, the “CPAM” have decided to issue the dependant with their own “Carte Vitale” and their own “N° INSEE permanent” printed on it. This has proven not to be such a wise move on their behalf as the information on the micro chip is the information regarding the S1-E121 holders. Always remember to give the S1-E121 holder “n° INSEE” when the “Carte Vitale” is not swiped otherwise the wrong card number will be used and “CPAM” will refuse reimbursements as this number does not have any rights.

It is recommended to seek professional advice through companies that specialize in the expat community. Only a handful of “HEALTH INSURANCE SPECIALISTS FOR EXPATS” really exist.
Help and information provided is FREE OF CHARGE regarding the state “Sécurité Sociale” and how to obtain it. This information is to help the SFN members as I know many are existing clients and you are NOT obliged to take out a Top-Up or FULL insurance or even receive a quote.


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Thank you Carolyn. It's useful to know the time scales, and, yes, I know about the top-up insurance required. I will keep plugging away at it.

sorry sticky key board causes lots of typing errors!

As everyone has said, but if you are not working in France it only covers you up to 2 years. If you have earnt more than £5k in the financial year starting Aprill 2011 to March 2012 you will be cover to something like Jan 2014. If however you did not earn £5k you will only be covered for up to one year. That is how they explained it to me when I caled them in October.

They say they will get it to you within 28 days og contacting them, but do keep an ey on it and chase them if it doesn't arrive - it took 7 weeks to get to me. You then take it to the scoial security office in your area. Apparently it can then take the French system several weeks to exchange this for the card you need to say you are covered in France.

You probably know that you will also need a "top-up" insurance too.

Hope that helps. Good luck.

I know Bob, but all routes are leading to the same point where I seem to be hitting a brick wall. I was going in via the national insurance route.

Thank you Maria. I do have this number and as yet, no one has answered the phone. I will keep trying.

Same answer as you were given back in July last year. The department for work and pensions deal with healthcare rather that revenue and customs who deal with import stuff in the UK.

Thanks so much for all the useful information listed below.
However, I would like to complete (update) the information somewhat.
If you:
• need health care cover
• have recently left the UK
• aren’t working you should contact the Department for Work and Pensions at the following address:

Department for Work and Pensions
Overseas Healthcare Team
Room MO135
Durham House
NE38 7SF

Phone: +44 191 218 1999

Just got my E106 (S1) all sorted out within 15 minutes on the phone (call the number above).

I hope that this also helps someone else.

Cheers Alex


A lot has happened in 5 years - in particular, residual S1 cover was withdrawn in 2014. Cross border workers and people in receipt of a UK age pension (or certain other benefits) are still entitled to an S1 (issued by HMRC for workers and DWP for retirees), but as from 2014 S1s are no longer issued to early retirees.

Hi there, I I’m really struggling here, any help welcome. My fiancé passed away and I became unwell, I came to live with my parents who had retired to France after being signed off work, I then had to sell my flat in the uk for the estate, lost my job because of my illness. My parents became ill and now almost two years later i have had to make the decision to stay here. The UK stated they will not give me an S1 but also wouldn’t put it in writing, and although I have the money to pay into the system in France myself CPAM won’t allow it and I’ve been bounced from pillar to post with this and don’t know what to do anymore?? I would be so very grateful for any help.

Sorry to hear all that Naomi, it must be time for something nice to happen to you.

Why will CPAM not accept you? Have you filled in the application form and submitted it with the supporting documents and been turned down, and if so did they say why? Because without knowing what the specific problem is, it’s not really possible to advise an effective solution to it! There are certain criteria that you need to meet in order to be accepted into the French healthcare system as an EU inactif, which basically involve proving you have lived here for at least 3 months (which from what you say you won’t have trouble proving) and proving that your income is above the minimum threshold (you say you have money to pay so presumably you can prove that), but they may also want you to prove that you have had health insurance for the 3 months you’ve been here (because that’s one of the criteria for legal residence). It sounds as if perhaps that’s the one you can’t prove, is that the problem? If so, one way round that would be to take out private insurance, wait for 3 months and then apply again.

It is very much a box ticking exercise, so whichever box you haven’t ticked, that’s the one to work on - because ticking all the boxes is the only way to get accepted, that’s how it works.

Hi Naomi

If it helps we have just gone through the process of entering the French System.My wife and I are both under retirement age and are therefore inactifs.

We arrived on a permanent basis in March 2016, having had a holiday home for 13 years.

We made our first application to Cpam in June 2016. We were advised that the process could take several months. Having not heard anything by Sept we called into the CPAM office in Avranches to be told there was a massive backlog. The staff checked our application and said it had been processed in Avranches, passed to Granville for further processing, and had been sent to Nimes for final processing.

We then received a request from Nimes for a complete financial breakdown of our affairs. Which we supplied (15 euros of photocopying at La Poste).

During this period we had no health insurance cover.

Finally in March we received our Carte Vitales.

I think that the lack of health insurance may not be an issue, but the proof of your financial position may be the stumbling block ?

Hope this helps


Alex, you made my day!! Thanks so much! I spent 2 months chasing this S1 form and all was sorted out in 5 min thanks to your post.
Good luck to all other souls trying to survive France :stuck_out_tongue_winking_eye:

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Hello! Here again an s1 issue. My husband and I moved from uk to France. He’s working, I’m not. I ve been asked an s1 or to an ‘end of rights’ document. No idea who to contact or how to get it. But also, I need to remove an implant within the next 2 months. It’s OK for me to have that done in uk, but I don’t think I could have it done after my end of rights. I won’t be able to have it removed here as it will take several months before I will be covered by French insurance. The papers for me and my husbands need to be sent together, which means that if I wait to request and send the s1, he won’t be covered by French insurance in the meantime, while apparently I’m still covered by nhs. We have a person from my husband’s company who is helping with all the papers, but nonetheless I’m struggling to find a way out. Do you please have any suggestions? Many thanks

Is your husband workimg in the UK or France? If it’s the UK then he might be entitled to a worker’s S1, and then you would be covered as well. If not, then are you in receipt of the UK state pension? As that’s the other reason to get an S1.

You need to contact the DWP overseas health team, who will tell you if you can get an S1 or provide you with the end of rights letter.

Phone: +44 191 218 1999
Fax: +44 191 225 2131 Email: Overseas.Healthcare@dwp.gsi.gov.uk
URL: http://www.nhs.uk/Healthcareabroad/Pages/Healthcareabroad.aspx

The other key question is when did you move to France? As if more than three months ago then you can apply to join the french health service straight away as a main criteria is that you have lived here for 3 months. The difficulty will be that they may ask how your health care has been covered since you left england, as it is expected that you will have taken out private health insurance for the 3 month period. The formal position is that as soon as you become resident in France you are no longer entitled to NHS treatment.

One solution might be for you to return to England, have the treatment, and then come back to France and apply to join the health service here 3 months later. I don’t understand why you say that the papers for you and your husband need to be submitted together as health care is now individual - the old system of “ayant droit” where one of a couple could be included in the other’s application no longer exists.

The other solution if you have been here for 3 months is to get your skates on and apply to join. The minute you have confirmation that the application has been accepted you can go ahead with the operation. You will probably have to pay upfront, but will be able to claim back a percentage of the costs.

And the third solution is just to pay for it to be done…

Thank you Jane. For some reason I just saw your reply, which is very helpful. I called the Department for Work and Pensions but they said I’m not entitled (not in employment, not retired). They said a legislation letter might do but then I had to call back as I didnt have my NI number with me, and the last operator said that the only thing I could do is just send them the link to the nhs page to show that I’m not entitled to that document. My husband is now working in France. He ha the support from the Company but apparently his paperwork is following another route. They don’t want an S1 nor any other form or letter from him, but they asked an S1 from me. I didnt personally contact the French healthcare, as we have a lady who is doing all of this for us but that’s taking ages, and information comes in bits. We physically moved in September but it’s been up and down from France to Uk these months. We didnt have the time to apply with the private insurance yet but we’re going to do it anyway. I sorted my treatment in Uk, 15 minutes and done. If it wouldn’t have been possible I would have gone back to Italy and paid to remove it over the Christmas break.
It’s all quite annoying because it seems that the paperwork to enrol the French system should be done for the family but since my husband is following a different procedure his paperwork is stuck because mine is stuck. That also means that he cannot be on sick leave in case he needs to, since he doesn’t have the numero de securite’ sociale, I’m guessing. He was supposed to receive a temporary one but never did.
Thank you for all your kind and useful information.
I’ll try to contact the support team from the Company and explain the situation. Maybe they’ll find a way out.