EHICs, S1s, E121s and confusion

IN JANUARY’S issue, a reader sent in a query about health systems in UK and France and quoted a Form E121. I was given to understand that Form E121 no longer exists and that Form S1 has taken its place so I shall refer to Form S1.
I have been in France since last June and am in the throes of claiming back expenses incurred via my European Health Insurance Card during this period.
My health problem looks as though it will be ongoing, therefore I shall keep with my cover from the European Health Insurance card for the time being.
However, as I am considering living in France, could you advise me what the difference would be in my applying to NHS in UK via Form S1 for a switch to the French system or applying to the health authorities here in France with an S1 for a carte vitale.
If there is no difference, can you let me have the address of the French health authorities so that I can apply for a carte vitale. I am living in Salies-de-Bearn, Department 64. I am 77. I am confused as to what exactly I should be doing. B H-J

THE ISSUE is a little more complicated than you state in your letter. A country’s health system is only available to the residents of that country.

Europeans visiting an EU country can use their home country rights to obtain healthcare in another EU country through the use of the EHIC arrangements.

If you wish to join the French health system, this is a consequence of you changing your country of residency, but it will have have ramifications on all sorts of other things, mainly taxation.

Through moving to France you may be entitled to join the health system here, but this is not possible for the first five years of fiscal residency, meaning you will either be required to have fully private health cover or apply for the S1 (the old E121) certificate, which then transfers on a permanent basis your health rights to France.

The carte vitale is nothing more than a means of automated payment from the state to the medical service or product provider; it, in itself, is not a right to anything.

Technically, you need to register with your local tax office, and then apply to your local caisse primaire d’assurance maladie (CPAM) office to transfer your S1 rights to France. For the nearest office, the best thing to do is to either check for CPAM in your yellow pages, or on the internet, for your address, and then see which of them deals with your area as there are several CPAM offices around you.

Irrespective, your file will be dealt with by the main office at Pau, and so it is probably best to see them there directly, especially for a new subscription to the health system: CPAM, 26 avenue Lilas, 64000 Pau.

The central telephone number is 3646, then enter your department two-digit code.