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Social security chiefs answer your queries

We put questions from readers to the office of Thomas Fatome, director of social security. Several relate to Puma, which replaced CMU de base for people such as early-retirees who have not worked in France.

My husband and I are a British retired couple in France. He worked for years as a commerçant, but I have not worked, so I am his ayant droit (dependent) for my healthcare. Now that this ayant droit status is being abolished, do I have to do anything? What will happen to my rights in future?

If you were already known as your husband’s ayant droit at the end of 2015 you may keep this status until December 31, 2019. At any time you may ask to be attached to the assurance maladie on a personal basis by contacting your healthcare caisse. By the end of 2019 at the latest, the assurance maladie will undertake measures to update your dossier and attribute rights to you personally and no longer as an ayant droit. This change has no affect on healthcare rights.

I understand even though the ayant droit is being abolished, people whose spouse works [as long as they earn more than 10% of the plafond annual de la sécurité social, PASS, ie. €3,923] will still have no Puma payment to make. Please can you confirm that this will still be the case in 2020, after the ayant droit status has been completely abolished?

Yes, that is correct.

The rules for the Puma cotisation refer to your ‘income from capital’. We have British private pensions, but not state pensions. Will this be taken into account as part of our income for calculating our Puma contribution or not? Secondly, the cotisation is calculated on sums above €9,807 [25% of the PASS] – does this figure apply individually for each member of a couple, applied on half the household income for each?

According to an initial analysis it appears that yes, this kind of income may be taken into account. On the second point, this amount applies for the couple’s income and not individually.

It seems there were no payments for the CMU de base in 2016 and that the first Puma cotisations will only be at the end of 2017, based on 2016 income – is that right?

Yes, that’s right. The official name of the PUMA payments is cotisation subsidiaire maladie.

After Brexit, would Britons be able to access Puma?

In theory yes, if they are in legal residence, by payment of a Puma cotisation on their revenu fiscal de référence. But the rules on the right of residence would have to be modified.

After Brexit, will British people with French pensions be able to continue to benefit from health reimbursements in the French system?

Today, whatever someone’s nationality, in the EU the French state healthcare system takes charge of someone’s healthcare if they are only pensioners of a French regime or if they are also pensioners of another EU state’s regime and live in France. As yet we cannot say what the social security coordination rules will be when they UK is a third country, as negotiations have yet to take place.

What will happen to Britons in France with S1 forms who currently pay no Puma cotisation?

Logically today a British person with an S1 form pays no PUMA cotisation because it is the UK that pays for their healthcare in France. It is impossible to know the outcome of the negotiations. If in the future our social security systems are not coordinated then British pensioners will still be linked to the British social security system but EU regulation 883/2004 on social security coordination will not be applicable. In which case healthcare outside the UK would be reimbursed by the NHS according to British legislation.

There were some disputes with doctors over le tiers payant généralisé (system of patients not having to advance money for doctors’ visits). Is everything in place now as planned?

Work to roll out le tiers payant is well under way as intended in the laws.

I have a question about the De Ruyter reimbursements that have been made to some people who paid social charges while being affiliated to another country’s social security system. There was a change in the way the money is used, so they have continued to be levied. So, why are you still levying CRDS (Contribution pour le remboursement de la dette social), which is still used for paying off the debt of the French social security system?

Since January 2016 the sums are used for the Fonds de solidarité vieillesse, which finances non-contributory benefits. This also includes the CRDS, which is now being used to reimburse debt on non-contributory benefits [ie. ones that all residents may access, whether or not they have worked in France and paid into the system].

I had a micro-entreprise in France as a translator and my main client was a translation agency near Paris. I am closing my micro-entreprise and returning to the UK. I will continue to work for the agency – but will I have to still pay French social charges?

All income from self-employed work in France is subject to cotisations sociales in France (art. L 131-6 of the Code de la sécurité sociale), including if the worker does not live in France. However that is assuming the person is not also working in the UK. If that was the case then they would be considered a cross-border worker and regulation CE no. 883/2004 (art. 13) applies to determine the applicable social security regime, for example if the person has salaried work in the UK and self-employed work in France, they are affiliated for all of their income to the British regime, and the French income would be subject to contributions according to British rules.

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