Free health top-up scheme reinstated for S1 holders in France

The subsidised ‘mutuelle’ for low-income UK and EU pensioners has quietly reappeared - time to reapply

CSS provides top-up cover free, or at a reduced fee, to residents on low or modest incomes

Published June 29 2023

France’s free healthcare top-up scheme for low-earners is once again available to UK and EU pensioners with S1 forms.

In a reversal of a 2022 change, which saw people whose healthcare is paid for by other countries excluded without notice, S1-holders can now have complémentaire santé solidaire (CSS) as before.

This was confirmed by reader Christine StClaire-Erskine, from Auvergne-Rhône-Alpes, who previously told us she was “panicking” and “hoping not to break a leg” after her CSS was cut off and she was unable to afford a replacement policy.

Read more: Explainer: the CSS, France’s free or low cost top-up health insurance

Why was CSS originally cut?

CSS provides top-up cover free, or at a reduced fee, to residents on low or modest incomes below certain ceilings.

As with ordinary mutuelle top-ups, it covers the part of healthcare procedures or supplies that is not fully paid for by basic state healthcare rights.

Last year, the French authorities started to apply a certain interpretation of the social security code strictly to stop payment to those for whom another country reimburses France for their healthcare. This includes EU states for their state pensioners, and also the UK, due to the Brexit deals.

Read more: What help is there towards top-up healthcare insurance in France?

Previous beneficiary not informed of legal U-turn

Mrs StClair-Erskine said: “My CSS has been reinstated. Apparently, the decision to cut off what they are calling ‘permanent migrants’ was reversed by a European court. You can have it reinstated on application and I have been given the free one.

“However, our Cpam hasn’t told any of us rejects that we are now back in the fold.”

Valérie Renault, of France Services for the Bocage Bourbonnais, said they had worked to gain the CSS back for her.

She understood the reversal to be based on a European Court of Justice ruling. We have not so far identified the specific case.

‘Internal decisions always kept secret’

Antoine Math of Gisti, a group supporting immigrants to France, said: “Following various interventions, the social security directorate recently informed us that it has finally decided to go back on its decision.

“It’s a good thing. We’ve had verbal confirmation only. There were probably internal instructions, first to block CSS and then unblock it, but these are always kept secret.”

Last year, Mr Math, whom we informed of the change, suggested avenues for readers wishing to lodge complaints.

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