Low income but refused free French top-up health insurance? Next steps

We explain why you may no longer get the complémentaire santé solidaire (CSS) benefit and how to appeal

Readers have been affected by the stoppage of ‘free’ or subsidised healthcare top-up benefit for those on low incomes
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Several more readers affected by the stoppage of the complémentaire santé solidaire (CSS) – the ‘free’ (in some cases subsidised) healthcare top-up benefit for those on low incomes – have contacted The Connexion.

Following reports of the problem from readers, the British Embassy in Paris told us the French social security authorities had confirmed that since spring they have been enforcing a rule that people covered by another country’s social security system may not benefit.

Readers report formerly benefiting from CSS – and in some cases benefits it replaced in 2019 – despite being ‘attached’ to the UK system.

Read more: Pre-Brexit free health mutuelle rights lost by UK pensioners in France

The latter is due to being pensioners with S1 forms for health, meaning the UK (or an EU country) pays France for their care.

The French authorities have cited several sections of the social security code in support, notably article R111-3.

The current text of article R111-3 is from November 1, 2019, coinciding with the merging of the former aide à la complémentaire santé (ACS) and couverture maladie universelle - complémentaire (CMU-C) to form the CSS.

Similar wording existed relating to CMU-C dating from 2017.

No explanation on recent enforcement

One reader who has lived in France for more than 30 years, wrote: “We have just been refused the assistance with our mutuelle, which was due for renewal at the end of September, and cannot afford to pay the full amount.

“My husband is 90 and I am 81, so good healthcare is essential to us.”

The French authorities have not replied to our questions about why this was enforced only this year.

If the EU’s S1 system had not been retained in the Brexit deals, Britons such as our reader would still qualify.

Steps to take

Antoine Math of Gisti, a group supporting immigrants to France, believes an argument could be made against this based on EU principles of equal treatment with French people, especially, in the case of those with secure residency rights such as Britons living in France pre-Brexit and benefiting from a permanent residency card under the Withdrawal Agreement.

More recent arrivals are often subject to means tests.

He suggested those concerned make a recours amiable contesting the decision by registered letter to the Commission de recours amiable (CRA) at their Cpam’s address.

At the same time, they could apply to the Défenseur des droits.

If the CRA refuses, or does not respond, it would be possible to go to court, with or without a lawyer, he said.

The Comede association might also be able to advise.

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