Your S1 means that you do not have to join ‘Puma.’ ‘Puma’ is a residence-based right to healthcare which involves an annual fee if your income is over a certain level.
Instead you have a right to French healthcare, up to the usual standard reimbursement rates, funded by the UK. For this you must apply with your S1 to your local caisse primaire d’assurance maladie (Cpam).
Tweaks that France made to its health system involving ‘Puma’ in recent years have not affected the rights of S1 holders as this is an EU-wide scheme.
A spokeswoman for Direction de la Sécurité Sociale, in charge of social security, said: “If the reader is receiving a British old age pension (and only a British one and not also a French state pension), it is the British health system that takes charge of his healthcare in France. He should present his S1 to his local Cpam. His wife – as a member of his family – can then, in view of article 24 of EU regulation 883/2004, benefit from the same health cover if she is no longer otherwise affiliated due to her work”.