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Who has to pay the Puma healthcare tax in France?

Early-retirees who move to France can join its health system but some have to pay for it

Early-retirees who move to France can join its health system but some have to pay for it Pic: nadia_if // Shutterstock

Puma stands for Protection Universelle Maladie (Puma) and is the principle by which anyone legally-resident in France long term may qualify for healthcare cover under the French system.

Puma was introduced in 2016 and guarantees universal healthcare coverage.

All salaried employees and self-employed people in France contribute towards their healthcare via social security contributions levied on their earnings. In the case of employees these are automatically deducted before they receive their salaries. It is the employer’s duty to collect these social charges from the worker’s salary every month.

However, some people who do not have work incomes may be required to pay a Puma fee, which is collected by the Urssaf agency.

Who is required to pay the Puma fee? 

Early-retirees who have ‘capital’ incomes over a certain threshold are the main group.

Workers with small wages but large investment incomes may also be concerned.

The threshold is calculated in relation to an annual figure called the PASS (plafond de la sécurité sociale), which was €41,136 in 2021 and 2022 and is €43,992.

Examples of capital income include property income from rents and non-professional furnished letting, income from shares and bank accounts, capital gains from the sale of property, and certain other rights that bring in income and are not directly linked to work. 

Retirement pensions, declared as such in your French income tax declaration, are not concerned. 

The Puma tax is officially called the cotisation subsidiaire maladie and it is collected by Urssaf (Unions de recouvrement des cotisations de sécurité sociale et d’allocations familiales). 

The amount of the contribution is calculated on the basis of the previous year’s income tax return, ending December 31. 

How is the Puma tax calculated? 

The Urssaf considers tax filings individually and, where applicable, calculates the contribution for each individual member within the household. 

People who were living in France in 2022 and who earned work income of less than 20% of the PASS (equivalent to €8,227) but who collected capital income, may be liable to the Puma fee and may expect a notice of assessment from the Urssaf in November 2023. 

Many people will however have nothing to pay as there is an allowance against the first €20,568 of capital income. 

This corresponds to 50% of the PASS. The basis on which the fee is levied (total amount of taxable capital income) is also capped at eight times the PASS (€329,088), meaning the fee can increase as a percentage of sums up to that amount of capital income, but not beyond.

The tax rate levied on eligible incomes after the allowance is 6.5%. Officials can also factor in lifestyle if it appears luxurious when calculating the amount on which the 6.5% is levied. 

Where both members of a couple are eligible to be assessed for a fee, the €20,568 is applied individually to each member’s part of relevant household incomes. 

Each part is calculated at 50% if a more precise share-out is not clear. Those with only a low level of work income from part-time work – but substantial income from non-work sources – have to pay a Puma contribution on their capital incomes at reduced percentage rates, on a sliding (reducing) scale up to work earnings of €8,227/year at which point there is nothing to pay. 

How can Puma payments be paid if required?

Payments can be made online via your personal space at the Puma website if you create one (ats.declaration.urssaf.fr/puma/accueil) or otherwise by cheque or bank transfer. 

Who is exempted from the Puma tax? 

Several groups are exempt from having to make contributions to Urssaf including registered unemployed people, state pensioners and students.

People on low incomes are exempt generally in view of the high allowance that is made against income. This will be determined by Urssaf upon examining their income declaration from the previous year.

People who have received a disability pension from France during the year for which their contribution was due are not liable for the Puma tax, in the same way as retirees who received a government pension. 

These groups are not required to take any specific steps. Since the system is still fairly new, people from exempt groups have sometimes wrongly been served with notices to pay, in past years.

If you have been asked to pay and believe you are exempt you will need to contact Urssaf to check and clarify the situation. 

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