Your interactive family guide to France as recommended by local mums | Last updated 7 months ago

Healthcare, social security & pensions

Healthcare, social security & pensions


Emergency Numbers:
Medical Emergency - (SAMU) - 15
Police - (Gendarme) - 17
Fire - (Pompiers) - 18
Sea or Lake Rescue - 1616
Europe-wide Emergency Number - 112

The French healthcare system is very efficient and waiting times for appointments are usually very short. The state pays for a proportion of the cost if you are resident and have paid into the tax system with any extra cost being met by the patient, either from their own funds or through an insurance policy (mutelle). If you work, you should pay into a mutelle through your work. If you do not work, you can pay a mutelle every month for only a few euros. It is definately a must and it is best to look around before deciding beacause some companies do not cover everything.
The system varies depending on whether you are a resident or not, although you will receive exactly the same treatment. . Remember also that if visiting, travel insurance policies will not normally cover medical items that can be dealt with via reciprocal health arrangements within European countries.

• The cost of any treatment must be paid upfront, regardless of whether or not you can claim it back.
• A typical consultation fee with a GP will cost you between 22 and 28 Euros (for young children).

UK visitors
Before you leave the UK, obtain the new plastic European Health Insurance Card (EHIC) which replaces the old E111 and E128. You can get these from your local post office. Both children and adults will need one of these cards each.
The EHIC entitles you to the same treatment as a resident of the country you are visiting.
Make sure you take out the appropriate health cover or insurance, as full costs of treatment are not normally reimbursed in France, and any cost required to repatriate you will not be covered.

The cost of treatment is rarely fully covered, and if you are covered by the French System, you will normally only recoup around 75% of what you have paid out, depending on the treatment. You will need a Carte Vitale to enable you to claim back anything from the French healthcare system.
In order to get a Carte Vitale (whatever the circumstances) you will need to take proof of residence, copy of passport, birth certificate and marriage certificate to the Caisse Primaire Assurance Maladie (CPAM) along with the relevant form.
Residents will need to choose and register with a primary doctor (Medecin Traitant), and this will help ensure the maximum refunds are obtained.

Social Security

Sickness Insurance

The general health insurance scheme covers employees, the unemployed and students.

If they are not working or are not covered themselves by a mandatory social security scheme, the dependants of the insured persons are also covered. Dependants means spouses, live in partners, common law partners under a PACS agreement, children (up to the age of 16, or 20 if they are studying).

Insured people receive a Vitale card from their local CPAM (Primary health insurance body), which must be shown when they visit the doctor in order to be refunded quickly for care received and, if necessary, for a third of the cost due (the insured party does not pay the part reimbursed by the sickness insurance company).

In order to adhere to the referral procedure, the insured person must choose a GP who will refer the insured person to a specialist. Treatment received from a GP other than the one with whom the person is registered or from a specialist consulted without a referral from the chosen GP will be refunded at a reduced rate, except in exceptional circumstances (e.g. emergency care) and visits to certain specialists.

In addition, employees are eligible for cash benefits (payment of daily allowances) in the event of work related sickness and accident (or occupational disease), subject to certain conditions.
Ameli France will be able to give more information.

Maternity Benefits

Mandatory prenatal examinations carried out after the declaration of pregnancy are covered in full up to the basic health insurance ceilings. From the 6th month of pregnancy, all care received is covered 100%.
Maternity leave lasts at least 16 weeks for a single birth and 34 weeks for a multiple birth. During this statutory period of leave, the insured person receives a daily maternity allowance equal to her basic daily earnings calculated on the average of the three months preceding prenatal leave. To receive the benefit, the insured person must have been registered with social security for at least 10 months on the expected date of the birth and have paid contributions based on a specific wage level.
You can get more information from your local CAF.

Family Allowances and Benefits
There are a number of allowances and benefits available to those who have children in France. Under Section L. 512-1 of the Social Security Code any French or foreign person residing in France with one or more dependent children also residing in France, is entitled to family benefits for those children.
Family benefits are awarded for legitimate, illegitimate, adopted and foster children as long as they are dependents of the person claiming benefits. The majority of benefits are available until the child is 20 as long as they do not have earnings over 55% of the minimum wage. However the maximum age for the payment of family income support is 21 years old.
All family benefits are calculated as a percentage of a monthly family benefit base (BMAF) which is decided by the French government.

Family benefits include;
Maintenance Benefits
Flat rate allowance, Family income supplement, Family support allowance, Infant Accommodation Benefit (PAJE)
The PAJE consist of several benefits which have been merged for simplicity. The PAJE is payable for children born after 1st January 2004 and consists of;
• Birth/adoption grant
• Basic allowance
• Free choice of childcare supplement - this is paid to a family who employ a registered childminder in their own home. The benefit covers both the childminders wage and a payment for all or part of the social security contributions payable as an employer of a childminder.

Special Purpose Benefits
Educational allowance for a disabled child , Back to school allowance, Daily parental attendance allowance, Family housing allowance , Moving allowance
Ask your Local Caf for more information.

Retirement arrangements in France are not uniform but are organised according to the sector of activity, i.e. there is:
• one scheme for private sector workers,
• special schemes for public sector workers,
• schemes for the self-employed (liberal professions, craftsmen, shopkeepers and farmers).
Retirement scheme for private sector employees

Private sector employees must all pay into the old-age pension system regardless of their earnings. The general scheme is managed by CNAV (National Old-Age Pension Fund), and all private sector employees are also obliged to join a supplementary pension scheme organised by AGIRC (general association of pension institutions for managerial staff) or ARRCO (association for the supplementary retirement scheme for non-managerial staff). Since January 2009, employees have had to pay an additional three-month period to be eligible for a full retirement pension (complete pension). The term of the insurance required will increase by one three-month period until 2012, to reach 41 years of contributions. This may change with the change of president!
If the pensioner dies, the surviving spouse may be eligible for a survivors’ pension if they are over 51 and their personal resources do not exceed a certain threshold. This survivors’ pension may attain 54% of the amount of the old age pension received by the deceased spouse, and may be increased if there are dependant children.

Disability Insurance
In France, the amount of the disability insurance varies according to the degree of disability. Like all health insurance allowances, disability pensions are only available to persons who can prove that they have made the necessary minimum contributions.

The compulsory legal schemes
The French social protection system consists mainly of a set of compulsory schemes;
• The general scheme covers employees and their families (approximately 80% of the population). It is managed, nationally, by the Caisse nationale de lassurance maladie des travailleurs salaries (National health insurance fund for salaried workers) (CNAMTS) and, locally, by the Caisses régionales d’assurance maladie (regional health insurance fund) (CRAM) and the Caisses primaires d’assurance maladie (Primary health insurance fund) (CPAM).
• The agricultural scheme covers farmers and agricultural employees, as well as their families (approximately 9 % of the population). It is managed by the Mutualite sociale agricole (Agricultural social mutual fund) (MSA).
• The independent scheme covers craftsmen, shopkeepers, members of the professions and their families (6 % of the population). It is managed by the Caisse nationale dassurance maladie des professions indépendantes (National health insurance fund for independent professions) (CANAM).
• The special schemes are for certain specific categories (such as the military, the SNCF).
• The supplementary contribution schemes (ARRCO and AGIRC) are compulsory for all employees coming from the general scheme or the agricultural scheme.
• The unemployment insurance scheme is aimed at all salaried employees.
As soon as an employer takes on an employee in France, he is obliged to make a declaration prior to hiring the person to the Union de recouvrement des cotisations de sécurité sociale et dallocations familiales (social security contribution collection body) (URSSAF) to which he belongs. This declaration in particular enables registration for social security, if the employee is not already registered, and inclusion in an unemployment insurance scheme.

People who do not belong to any compulsory scheme, either as insured parties or as entitled claimants, are compulsorily covered by Couverture maladie universelle (universal sickness cover) (CMU) which gives you Free treatement.

Unemployment Insurance
Anyone who has lost their job can benefit from the unemployment benefit scheme, if they have already worked and paid contributions. All active jobseekers can register with a Pôle emploi agency by showing some identification or a residence permit and work permit if the jobseeker is not French.
In addition, persons wishing to claim return to work benefit (ARE) must also present the following;
• one or more certificates from employers,
• a copy of their social security registration card,
• a statement with their bank or postal account details.
Once registered, Pole emploi will send the jobseeker a jobseeker’s card.

To receive unemployment benefit, recipients must;
• have worked for at least 4 months during the last 28 months (or during the last 36 months for employees aged over 50),
• be registered as a jobseeker with Pole emploi,
• not have left their job voluntarily, except in the case of legitimate dismissal,
• be under the age of 60 and 6 months (61 in 2010), unless the unemployed person has not worked the 160 three-month periods to receive a retirement pension at the full rate. In this case, the benefits are paid to him until this ceiling is reached or he has reached the age of 65
• be physically fit to work
• be actively and permanently seeking work (jobseekers will be called each month by Pole emploi to check that they really are seeking employment).
E Forms
E forms allow you to retain your social rights (sickness, accident, maternity, retirement pensions, unemployment benefits and family allowances) when you come to France. These forms serve to add up and/or transfer your rights between your country and France.
The main E forms are;
• The E100 forms concerning your benefit rights in case of sickness, accident or maternity
• The E300 forms concerning your rights to unemployment benefits
• The E400 forms concerning your rights to family allowance
It is imperative that you obtain these from each relevant department in your country before your departure.
As regards jobseekers, there are 2 important forms of which you should be aware;
• Form E301 is a form which provides evidence of the time over which you have been paying contributions in your country of origin. This allows you to add up your periods of contribution between two countries. It is only useful if you have contributed to the French unemployment scheme. This form is to be requested from the public employment service in your country before your departure.
• Form E303 allows you, if you have unemployment rights in your country of origin, to transfer your rights to France for a limited period of 3 months. This form is to be requested from the public employment service of your country before your departure. You have to have been registered as a jobseeker for more than 4 weeks to be able to request one. Once this form is dated, you have 7 working days in which to present it to the French public employment service Pôle emploi.

Thank you to Geraldine Mcdougall for her contribution to this section