AFFILIATION TO "CAISSE PRIMAIRE ASSURANCE MALADIE" (CPAM)

Introduction

This section is concerned with affiliation to CPAM. It is based on current French legislation and practical and personal experience of the registration process. This should not be regarded as a definitive document. There are differences between regional CPAM offices in the processing of individual applications.

Legislation

There are two pieces of legislation that came into force on 1 January 2000 that underpin the rights and obligations to register with CPAM. They are the "Couverture Maladie Universelle" - Law 99-641 CMU of 27 July 1999 and Law DDOS of 4th February 1995.

This Law provides for basic and obligatory health cover to all those who:

•Have no entitlement to state healthcare.
•Have been resident in France without interruption for at least 3 months. Evidence of this is usually accepted in the form of an EDF (electricity) bill.
•Comply with legislation in respect of residence eg; hold a residence permit "carte de sejour" (if applicable).
•Have a Law DDOS of 4th February 1995 further provides penalties of fines and imprisonment to those purchasing or providing insurance policies that would be an alternative or substute for the cover offered by CMU. TOP UP POLICIES ARE NOT AFFECTED BY THIS LEGISLATION AND CAN CONTINUE TO BE SOLD.

Forms E111, E106 and E121

There are certain people to whom these laws do not apply and the largest group of these is those who are holders of E Forms. Holders of these forms, who by definition are EEC/EEA nationals, can benefit from reciprocal health arrangements that exist within the EEC/EEA.

Click on the navigation bar to find more information on forms E111, E106 and E121.

Financial Contribution to CMU

For those registering with CPAM by virtue of CMU legislation there is a contribution to be made over and above a standard threshold.. The threshold is €6965. and is PER HOUSEHOLD not per person. Above this amount 8% of the excess is payable.

Annual Income (less allowances) €11083

Less threshold 7083 = 4000

Annual Contibution 8% of €4000 = €320 (Payable in 4 quarterly payments of €80).

This threshold is adjusted annually.

The fiscal year in France ends on 31 December. A person affiliating to CPAM in June 2007 would have his contribution based on his revenue for year ending 31 December 2005 NOT 31 December 2006.

Remember this will only give the state cover that any other French citizen would have and a top up insurance would be required to cover the difference between what the state pays and the total bill.

Click on the navigation bar for more information on the insurance options.

This is a summary of the registration procedures and cannot start to address individual circumstances. The whole subject and definition of residence as it relates to health cover in France can be less than clear. For example: there will be those who fulfill the residence criteria but who have not yet completed a French tax return.

This subject is explored in much greater detail in "Healthcare in France - A Guide for the Expatriate

Tel/Fax: 0033 4 94 85 15 50
email: enquiries@expathealthdirect.co.uk