Are top-up medical insurance premiums tax deductible in France?

Are top-up medical insurance premiums – or Puma healthcare contributions – tax deductible in France?

With regard to mutuelle top-up healthcare policy premiums, the answer is that it depends on the type of policy.

In the case of an ordinary top-up policy that you chose and took out yourself the premiums are not deductible.

However, if you are an employee and belong to a scheme proposed by your employer and to which the employer contributes, then your own contributions towards part of the cost are deductible from taxable work income.

In most cases, however, if this applies, then check your payslips, as your employer has probably factored this in already with regard to tax you have paid at source.

If this is not the case then check with your employer as to the amount you may claim on your tax return (in most cases it will be the total of your premium payments, though there are certain, high, ceilings to how much may be claimed in a given year).

If necessary, these amounts should be declared in box 6DD ‘autres déductions’ (on 2042C on the paper form) and you should write in the box next to this the ‘nature’ of the deduction, eg. cotisations de mutuelle déductibles.

The other situation in which top-up premiums are deductible is if you are a self-employed worker with a ‘loi Madelin’ health insurance policy that allows for deductions to be made, again within certain high annual maximums.

As for the ‘Puma’ fees paid by certain early-retirees for membership of the French health system, there are two factors to consider with regard to income tax.

Firstly, that information from your tax declaration will be shared by the DFGiP with social charges body Urssaf to see if you owe a Puma fee this year or not and, if so, at what level.

Secondly, the question of whether the Puma fee itself is a deductible expense from income earned in the year you paid it. This was previously stated to be the case on the website of Urssaf, but appears to have been edited out.

It is also deductible according to several tax lawyers, on the basis that the Code Général des Impôts, article 156 – II – 4 states “payments made under the heading of social security cotisations are deductible from the overall [taxable] revenue”.

Experts consider that the Puma charge would fall under this description.

Only a small minority of people are concerned by this charge but if this impacts you we suggest checking with the tax office and/or your Urssaf branch, or deducting it but completing a mention expresse to the effect that you have done so based on the article of tax law cited above.

We have more on the Puma system in our help guide to healthcare in France.