Health authorities pass buck on cover

Question

WE HAVE been in France since 2006 running a chambre d’hôte/gite business and pay our taxes and social charges. We were told we could no longer use the form E106 [the entitlement to free healthcare in another European country for a limited period of two and a half years] as we are working and resident in France.

We received a letter from the Caisse Primaire d’Assurance Maladie (CPAM) telling us not to use our carte vitale as we were no longer in the system – we were told to register with Régime Sociale des Travailleurs Indépendants (RSI).

RSI said that, unless we were on the taxe professionelle regime and earning more than e23,000, we should be looked after by the CPAM.

CPAM replied that we would need to get letters from the national insurance office in the UK and from RSI saying we were not in either scheme – and as we had only been registered for healthcare since 2007 we would need to wait five years to qualify. They basically told us to go and get private healthcare.

Who should we be registered with? S.M.

Answer

NON-WORKING expats who are below the retirement age and arrived in France after November 23, 2007 must ensure they are not a financial burden on the state and should arrange private health insurance until they have lived in France for five years or are eligible for a state pension. They will not be able to have a carte vitale.

Most early retirees use the European E106 form to access the health service – Britain pays the costs – but as you are working, paying your taxes and your social charges and are not earning e23,000 (which would bring you into the RSI regime), you should be registered under the CPAM regime.

Secondly, as you have been in France since 2006 and holding a E106 this would also mean you should be entitled to healthcare cover through CPAM, as the social security website makes clear in its guide to affiliating to the couverture maladie universelle (CMU): non-working residents from other EU countries can join the CMU on expiry of their E106 forms if they were living in France on or before November 23, 2007.

The CMU is free for those with an income below certain thresholds (e9,020 per household). Above this you must contribute at a rate of 8% of the difference between income and the ceiling.

Non-working, non-French people who have lived in France for more than five years (with private health insurance) can apply to the Service des étrangers at their prefecture for a permanent carte de séjour, with proof of their five years’ residence – they are then deemed to have acquired the permanent right to live in France and right to the CMU.

The situation is different if you are an early-retiree, ie. not working, but not of state pension age.

Until 2007, non-French people in this category were regularly moving to France, usually with a European E106 form allowing them a limited period of healthcare (up to two and a half years) owing to previous social security contributions in their country of origin, and then moving on to the CMU after the E106 expired.

In 2007, the rules changed and such people can now only apply for the CMU under two conditions.

The first is if they suffer an accident de la vie, ie. an unexpected event that lowers their income so they cannot afford private healthcare. Examples include the death of a spouse, divorce, a sudden serious illness which private healthcare providers will not insure etc.

The second is that they have been in France for five years. You can check the up-to-date position on the social security website – in French – at http://tinyurl.com/cmufacts or you can put in a call to the CPAM’s English-speaking helpline 08 11 36 36 46.

To make sure you have all the forms necessary, you can contact your national insurance office in the UK, which will send an E108 form for the CPAM explaining that you are no longer in the UK system and if you can supply the CPAM with an avis d’imposition for 2008 – a French tax form – then they should have all that they need to process your application. However, there is a large measure of inconsistency in the way the rules are being applied.