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Healthcare in France: How to register an S1 when in French system?

When someone is in the French health system by residency and so are already in the system, the changeover should be simple. We explain

S1s come from the NHS Overseas Healthcare Services Pic: Mix Tape / Shutterstock

Reader question: What happens if you are in the French health system by residency, under Puma, and you reach state retirement age and get an S1 from the UK? 

Once you have reached state retirement age and obtained the S1 from the NHS Overseas Healthcare Services, you can register it with your local caisse primaire d’assurance maladie (keep a copy).

As you are already in the system, the changeover should be simple. Your social security number will not change and your mutuelle should not be affected – because your state reimbursements will not change.

However, Rachel Thomas-Bonnet, of Perfide Albion, who helps Britons in France with paperwork, said that she has sometimes known the caisse to send out a new carte Vitale.

She said the changeover is usually “relatively simple” if you present a copy of your S1, passport, proof of address and, preferably, a recent attestation de droits which can help officials identify you in the system. If you have an account at, you can download an attestation from your personal space under Mes démarches. You can also obtain them from machines at Cpam offices or request one on 3636.

Ms Thomas-Bonnet said, in her experience, there should be no disruption to your rights, depending on the efficiency of the officials in your local office.

If you were to experience temporary issues with your carte Vitale, however, you can ask doctors and pharmacists for paper feuilles de soins to apply for reimbursements from Cpam afterwards if you have to pay upfront.

In future, you should request a British Ehic (European Health Insurance Card) to use for health cover when visiting other parts of the EU (though not the UK).

Once you are covered by the UK for your healthcare, you will be eligible for exemption from French social charges on foreign pension incomes. You may also be eligible to pay a reduced rate of social charges on property and investment incomes, though French officials have yet to confirm if this right remains after Brexit.

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- Understand the French healthcare system, how you access it and how you are reimbursed - Useful if you are new to the French healthcare system or want a more in-depth understanding - Reader question and answer section Aimed at non-French nationals living here, the guide gives an overview of what you are (and are not) covered for. There is also information for second-home owners and regular visitors.
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