Two British women who are both long-term residents in France have had their right to free or subsidised top-up healthcare insurance ended.
This is despite having permanent Withdrawal Agreement residency cards intended to preserve pre-Brexit rights.
From our research this comes due to a recent decision to enforce an existing law that had previously stayed on the statute books but had not been applied. It mostly affects retirees and those on long-term disability benefits, whether from the UK or a non-French EU state. Americans and other non-EU citizens are not affected as it concerns those with ‘S1’ cards for their health.
The subsidised scheme –known as the complémentaire santé solidaire (CSS) – enables people on low incomes to have a top-up policy for the non-state-refunded part of their French healthcare so they do not need to buy one.
This is provided for free, or at a charge of €30/month or less.
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It is based on residency in France, a low income, and being in the French health system.
Until now, British state pensioners with S1 forms who are affiliated to a local Cpam with a French social security number but whose care is funded by the UK, have been able to access it.
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‘You have no current rights to healthcare cover by Assurance Maladie…’
The S1 system also exists for pensioners of other EU states and was maintained with the UK by the Brexit deals. The readers received letters from their healthcare authorities saying: “You have no current rights to healthcare cover by Assurance Maladie. As a result, you cannot benefit from CSS.”
They struggled to obtain an explanation for this.
However, the British Embassy told us that Cnam (in charge of Cpams) has informed them it has, since April, started to enforce a rule that CSS is not available to people covered by a foreign social security system. The rule is said to have existed for some time in the Code de la sécurité sociale, but had not been applied.
Christine St.Clair-Erskine, 78, whose low income level should allow access to a free CSS (€9,571 for a single person or €14,357 for a couple), said “the situation is scary” after she has been left with no top-up.
“I’ve been quoted over €700 a year for a mutuelle and can’t afford it,” she said This was already for a low-priced deal.
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The retired secretary, who moved as a widow in 2007, said she had benefited from CSS, or its previous version CMU-C, in the previous seven years. She sought help from a France Services office – one of the state-run outlets which assist with paperwork – which asked her Cpam why she was no longer eligible. The refusal had come after she made her annual application to the Cpam in Moulins, Allier.
‘...hope I don’t break a leg. I’m panicking about it’
“France Services said it was because I’m a resident with a carte de séjour and an S1,” she said. “Without CSS, I will have to continue with no mutuelle at all and hope I don’t break a leg. I’m panicking about it.”
She wrote to appeal and was told the matter would be put before the Cpam’s next meeting, but has not heard back to date.
Valérie Renault, of France Services for the Bocage Bourbonnais, said the Cpam stated it was because she was a ‘permanent migrant’ and a law had changed for this group in April.
Fionna Bardwell, 73, who has lived in France for 19 years, reported the same with the Cpam of Poitiers in Vienne, in her case for the subsidised version of CSS. She said she has often benefited, depending on income which has fluctuated below and above the ceilings.
“My social worker said something changed this summer, though she hadn’t heard about it before. The letter didn’t explain. She has been told it’s because our pensions are from the UK.”
She contested this but was turned down and told her only recourse now is to go to court.
“I could understand if it was for new people coming in, or those here less than five years, but it doesn’t seem fair for us who have been here long-term to be cut off when we are meant to be treated the same as before.
“I’m looking at having to pay an awful lot more and it’s not a good time for anyone.”
Aim was that Britons established before Brexit should continue to benefit
The aim of the Withdrawal Agreement treaty was that Britons established before Brexit should continue to benefit from the same treatment, including with social security.
One of the administrators for the Rift group, for Britons in France, said: “It’s really distressing for those who relied on this, and the timing of the change is unwelcome, considering the cost of living crisis we are suffering.”
She wondered if “extra scrutiny” due to Brexit had resulted in the rule being enforced where it was not before. “Stopping this help for those who may have benefited for years may be considered as yet another indirect – negative – Brexit consequence.”
Britons might feel the effect more keenly than many Europeans, as their state pensions are lower than many, she added.
However, it remained to be seen if CSS is legally a form of protected social security under the WA.
We have asked social security officials whether it is fair for this change to apply to those with WA cards.
Mrs Bardwell said: “It reminds me of 2007, when they chucked people off CMU [then, a way for early retirees to join French healthcare] but had to backtrack because it wasn’t right.”
If the Brexit deals had not maintained the S1 system for long-term British residents in France who are UK state pensioners, they would have benefited from healthcare on residency grounds instead, via ‘Puma’, which is free of charge to those on moderate incomes – and would thus have remained entitled to the CSS.
Newcomer Britons since last year are less likely to be affected as they will usually have to prove incomes above the CSS ceilings in order to obtain visas and residency cards and low-income pensioners will not be able to move.
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