S1 and RSI

Good morning, I know I don’t post very often … but I would appreciate some advice.

I am affiliated to the RSI via AE and my husband is my ayant-droit. He has now obtained an S1/E121 from Ireland and I emailed RSI to ask them what he should do (I thought he would now have to be affiliated to CPAM instead of RSI) and this is their reply:

_""Pour répondre à votre demande, le fait que votre mari touche une retraite provenant d’Irlande ne signifie pas qu’il doit être repris par la CPAM._
_Votre Mari reste donc inscrit sur votre dossier en tant qu’ayant droit, son dernier régime de rattachement étant le RSI.""_

I don’t think this is correct : has anybody else come across this situation ?

Thanks in advance for your help,


Hi Dominique

I’ve always found the CPAM folk very helpful… why not go to their office… armed with paperwork… and ask them direct… :wink:

Thanks Stella, this is probably what I will end up doing.

Our CPAM in Lyon is big and not terribly helpful, in fact, no help at all, they are just overwhelmed by the amount of people they have to deal with every day, I suppose.

I had terrible problems when our daughter was sick and hospitalized in Lyon and the clinic would not originally accept her EHC; CPAM told me they could only reimburse her into a French bank account !

I did ask how they could expect tourists to have a bank account in France, but they had no answer, except to ask her to come in and do some paperwork so I could be refunded instead but she only got out of hospital fo fly home, so you see what I am up against.


Hi Dominique… best of luck… suggest you try and make an appointment. Here, normally, it is first come first served and can take ages… but the appointment option is a good route to follow…once, when I did make an appt… it went very well… the Clerk was relaxed and very helpful…

I know that one of the improvements that PUMA is designed to offer over CMU, is that it’s more flexible in that you don’t actually need to change caisse every time your situation changes, and couples who were previously under different caisses can now opt to be under the same caisse even if that’s not the one that would traditionally have dealt with them.
So it could be that RSI are correct, on the other hand it could be that they have the wrong end of the stick. Myself I would have thought that they are correct in saying that he can stay with RSI and does not have to switch to CPAM (although I think this is your choice to make), but incorrect if what they’re saying is that they’re going to ignore his S1 and keep him classed as your ayant droit.
Best to delve a bit further I think… there may be advantages in being officially classed as an S1 holder (e.g. exemption from certain social charges)…

Dominique-Do you have a smaller local office? Our main CPAM office is Perigueux but there’s a smaller office in another town. Much more helpful there than the main office. May be worth googling to check? Just a thought.

Thanks; from the reply “Votre Mari reste donc inscrit sur votre dossier en tant qu’ayant droit, son dernier régime de rattachement étant le RSI.”, it looks as if he will stay as my ayant-droit, which is wrong as far as I understand the legislation.

The problem with PUMA is that I think there will be contributions to be paid if your income exceeds a certain level, and these can be quite high, whereas an ayant-droit is insured by “piggy-backing” on the insured without additional contributions. (that’s my understanding anyway)

Did I read somewhere that CPAM reimburses costs better than RSI ?

I think I will investigate further before sending the S1 to RSI.


Good idea ! thanks


The idea is to phase out ayant-droits and to provide everyone with health cover in their own right. As the application needs access to your household financial situation I’m sure that those who were covered by their partner before will not be expected to contribute extra through PUMA.

If you have an S1 you don’t pay contributions because the point of an S1 is that your healthcare is funded by the UK. Of course this may change after Brexit.
Equally the ayant droit status will be phased out at the end of 2019 so after that date he’ll need to be covered in his own right, but probably nothing to pay:
"Personnes exonérées de la cotisation maladie subsidiaire
Sont exonérées de cette cotisation :
les personnes percevant des revenus d’activité supérieurs au seuil de 10 % du Pass ou dont le conjoint, marié ou pacsé perçoit des revenus d’activité supérieurs à celui-ci ;
les personnes ayant perçu une pension de retraite, une rente ou une allocation de chômage au cours de l’année. Il en est de même, lorsqu’elles sont mariées ou liées à un partenaire par un pacte civil de solidarité, pour l’autre membre du couple."

I don’t think it’ll cost you anything either way, I think the S1 should take precedence but if France wants to pay his costs even though they don’t need to, then I’m sure the NHS will appreciate it.

Hi David, this is not what I understand : PUMA replaces the CMU, the CMU is means-tested, therefore I assume that going from the status of ayant-droit of an insured person (me) which required no additional contribution from my husband, to PUMA/ex CMU, will involve a contribution after a certain level of income.


Hi Anna

Ireland in our case so I don’t have to worry for the time being, unless Ireland decides to do a what would it be called ? IREXIT, as well !

Do you know what “seuil de 10 pour cent du Pass” means ? I have never heard of “Pass”:

I’ll check out the link in your post, but half the time I don’t understand a lot of the French stuff, I left France when I was 17 and my parents used to deal with all this (I remember my dad sticking the “vignettes” on the “feuilles de soins”.


Hi again …

Just saw a message to do a single reply to posts : apologies for cluttering the page.

Anna : re : PASS : just had a look at the page De la CMU de base à la PUMa, and sure enough I don’t understand much and certainly not how the contributions are calculated !


I think that it benefits Dominique for him to stay affiliated with RSI, and I also believe that they are correct in their response.

Good afternoon,

re : [quote=“Harriet_Wallace, post:14, topic:15724, full:true”]
I think that it benefits Dominique for him to stay affiliated with RSI, and I also believe that they are correct in their response.

I am curious why you think I am better off with RSI ?

I don’t think the RSI reply is correct as he will not be my ayant-droit any more since Ireland will cover his medial expenses.


Just a quick observation on this thread which may, or may not, be helpful.

I too am classified as ayant droit to my wife’s RSI account. Until recently, I was included on her Carte but then - out of the blue - was asked to complete forms and confirm details previously done when her RSI account was set up. I also had to provide an approved certified copy of my birth certificate (although they had previously accepted a non-approved version.

In time, and without much drama, I received my own CV - although my account is still connected with my wife’s account.

As it presently stands, I don’t see it as a big deal although I did worry about it at the time as I was receiving medical treatment but the change over did not (has not) impacted on that.

I’m also a S1 holder. If the French authorities don’t claim back what they are entitled to from HMG, it doesn’t (or seems not to have affected) affect me.

Just saw this.
Pass = Plafond annuel de la sécurité sociale
Currently 9 654€ I believe, so 10% of Pass is very little (though of course that’s profit not turnover, so turnover would have to be proportionally higher).
But you probably figured that out already.

Good morning,
As an update on this, RSI have now confirmed that I need to send the S1 to CPAM and not to them; I phoned CPAM who confirmed this.