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Must I pay social charges if I have private healthcare in France?

We review what if any exemptions from healthcare contributions are possible

Social charge deductions are detailed on payslips in France Pic: alinabuphoto / Shutterstock

Reader Question: I recently arrived in France from Australia on a one-year working visa. I took out a year of private health insurance in advance, but noticed I was still charged social security deductions on my payslip. Can I opt out from these?

Everyone who works in France will have social charges (known as cotisations sociales, charges sociales, or prélèvements sociaux) deducted from their salary.

These charges go towards France’s welfare system and include specific payments towards different ‘pots’ for unemployment (chômage), pensions, family benefits paid by the CAF (caisses d’allocations familiales), and others.

There are also payments specifically made towards healthcare services, which you will see on your payslip under the Santé heading.

Your employer also pays social security contributions, based on your salary, and you can see deductions on both the employee and employer side on your payslip (bulletin de paie).

In exceptional circumstances, such as working in France but receiving your pay from a foreign country, you may be exempt from some of these charges.

In your case, however, you told us that you are working for a French employer and are based in France. 

Therefore it is mandatory for you to pay these social charges, which are deducted at source – i.e from your gross salary, before you receive your pay. 

The rates of these charges can vary, depending on your role and whether you are self-employed, but there is no exemption from paying them while employed by a company.

However it may be possible for you to opt out of your company’s top-up health insurance, or mutuelle, if you have private cover from elsewhere. 

What do you pay towards state healthcare in France?

If you are employed by a French company, the Santé section of your payslip has two or three further subheadings. 

The first is titled Sécurité Sociale Mal. Mat. Inval. Décès (Social security charges for sickness, maternity, invalidity, and death). 

These payments go towards the cost of the state providing (as expected) sick leave, parental leave, some disability payments, and payment upon death. 

The payment is made to Urssaf which manages social security contributions, but is forwarded to your local Cpam (caisse primaire d’assurance maladie). 

This is payable by your employer and is fixed at 7% of your salary, unless you earn more than 2.5 times the minimum salary, in which case it is 13%. 

Even if you have comprehensive private health insurance, you are still entitled to paid-for/reimbursed healthcare under the usual state system. 

Read more: How to get a social security number and carte Vitale in France

There is another line on your salary slip titled Complementaire Santé, which shows the rates of payment for the complimentary subsidised top-up insurance (mutuelle) that your company must provide for you (remember social security only covers 70% of healthcare costs).

Your employer must pay at least 50% of the cost for this insurance but can pay anywhere between 50% to 100%, depending on your contract. 

Any remaining costs that are paid for by you will be shown on this line. 

There may be a third line called Complémentaire Incap. Inval. Décès which relates to additional cover from your top-up insurer, although this is not always present. 

Read more: Are more people dropping top-up health cover in France as prices rise?

Can I avoid paying for top-up health insurance? 

Unlike the mandatory social charges, you can be exempt from paying any contributions to a mutuelle under the 2016 ANI law.

This regulates how employers must offer top-up insurance to their employees.

People can be exempt from paying these additional charges if they already have adequate complementary health insurance, either from private cover or from being covered by a partner’s or parent’s insurance.

You must send your employer a letter, explaining that you wish to abstain from the top-up insurance, as well as provide proof of your alternative cover (in this case, your private insurance). 

You must also acknowledge that you have been informed of the consequences of the refusal (loss of employee’s cover, as well as the loss of portability rights which see employees continue to benefit from top-up health cover even in some cases of unemployment and retirement). 

You will then be removed from the mutuelle, with these payments no longer deducted from your salary. 

Related articles 

How to get a free pair of glasses in France

Claiming free or cheaper top-up French health insurance to get easier

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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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