Moving over as an EU or British state pensioner

If you are a EU or British state pensioner you are entitled to an S1 form from your country of origin to use for your healthcare while living in France.

Your country of origin will financially compensate the French social security system for the costs of your care.

S1s may also be available to those who have ‘exported’ a long-term incapacity pension or certain disability benefits. However rules on this changed for Britons moving post-Brexit and it is in most cases no longer possible to export these benefits and thus obtain an S1 under this heading if you move to France. Britons already living in France with a relevant exportable benefit from the UK should still be entitled.

The UK states that holding an S1 in this case entitles you to free or reduced costs for treatments and prescriptions on the same basis as a French-insured person with the same disability and/or chronic illness.

A few years ago France stopped allowing people with S1 forms to qualify for the CSS system for subsidised ‘top-up’ cover (see page 19), based on a certain, strict interpretation of passages of the French social security code relating to people for whom another country reimburses France for their healthcare. After we raised this with the European Commission, it discussed the issue with France, and a decision was taken to reinstate it. This applies to people from EU states as well as people covered by the UK.

What are S1 forms and how to request one

S1 forms are used across the EU. They are also still issued by the UK as part of the Brexit Withdrawal Agreement.

All eligible EU citizens who relocate to a different EU country may request an S1 form from the national health body in their country of origin. They must then later register this with the health authority in their new country of residence. In general France expects EU citizens moving over to show proof of three months’ residency before applying to register their S1 unless the person is working and registered for healthcare coverage through their work.

When an EU citizen stays longer than three months there is a presumption they are moving to France and will no longer be an ordinary visitor. Britons moving post-Brexit with UK S1s and long-stay visas should, however, not have to wait.

Once the S1 is registered, the claimant becomes a beneficiary of the French system. Dependants (spouse, civil partner, minor children...) can be listed as beneficiaries.

Post Brexit the UK continues to deliver S1 forms for a limited number of categories of people who have been allowed to maintain their S1 entitlements.

Who is entitled to receive a UK S1?

The Withdrawal Agreement (WA) maintains the S1 form scheme for Britons who fall under it – this is mainly those who were living in France on or prior to December 31, 2020. Close family members joining them later may also be concerned.

This covers UK state pensioners and claimants of ESA (former long-term incapacity benefit). It also covers recipients of UK disability benefits that remained ‘exportable’ under the WA (Disability Living Allowance, Personal Independence Payment, Carer’s Allowance, Attendance Allowance) but only if their S1s were issued before 2021.

Continued eligibility

UK state pensioners moving to France post-Brexit can also continue to use the S1 system under the EU/UK Trade and Cooperation Agreement.

If you or your spouse receive a UK state pension, you can apply for an S1 form to entitle you to healthcare in France.

Britons working cross-border (eg. living in France, working in the UK) or posted (eg. sent from a UK firm to work in France) also maintain eligibility for UK S1s.

The UK pays France for the French healthcare of S1 holders up to the standard rates for an ordinary French resident.

There are two ways that EU states may be reimbursed for the healthcare costs of S1 holders from other EU states/the UK who live in their territory. France bills for the actual cost of the care whereas the UK bills a fixed average amount per person. This provides basic French state reimbursement cover (eg. 70% for a GP visit).

Beneficiaries of other UK benefits

Recipients of UK disability benefits (DLA, PIP etc) can no longer obtain an S1 since 2021. However it is still possible for recipients of widow/ers’ and bereavement benefits, maternity allowance, industrial injuries benefits and statutory sick pay for as long as the person is eligible for these.

Pensioners who in addition to their UK pension also receive a pension from France are not entitled to an S1 form. People with a non-French EU pension must seek the S1 from the country where they contributed for the longest.

To claim an S1 form from the UK you must contact NHS Overseas Healthcare Services. See contact details below. If you claim via your spouse then your entitlement will change to being via your own pension rights if and when you start to claim your own UK state pension.

Where to apply for an S1 form?

Britons wishing to apply must contact the Overseas Healthcare Services on +44 (0)191 218 1999 or email s1applications@nhsbsa.nhs.uk. This is required among the documents required when applying for a French visa.

Then, when in France, the holder registers the S1 with their Cpam. They should receive a temporary social security number by post in around one to three months and then a document called an attestation de droits à l’assurance maladie. The latter confirms their right to French state healthcare.

Once a definitive social security number is given they can apply for a carte Vitale. The process can take around six months. People can access healthcare with just an attestation de droits but will have to pay upfront and ask for a feuille de soins to claim repayment from their Cpam.

UK officials say pensioners should use Provisional Replacement Certificates while waiting to be properly registered in the French system. In theory, a private health insurance policy is therefore not needed.