What are the pros and cons of holding an S1 form for healthcare in France?

The Connexion often receives queries relating to holding an S1 form for your healthcare in France and the effects this can have on taxation, in particular. There are several benefits to having your healthcare via this scheme and few disadvantages.

The tax benefits revolve around you not being considered a ‘burden’ on the French social security/health system.

Who can obtain an S1?

The most common scenario is a person who is a pensioner of the UK’s or an EU/EEA/Swiss state system who moves to France, or a person who lives in France and starts to claim a pension from these countries. Other examples include posted workers on a temporary period in France, certain ‘frontier’ workers (living in one state and working in another) and people who claim ‘exportable’ disability benefits from their country of origin.

Read more: Are all S1 form-holders exempt from French social charges?

The right to S1s was maintained for those in the UK system, under the Withdrawal Agreement (WA) for those living here before 2021 or the Trade and Cooperation Agreement (TCA) for those moving after.

How are S1 forms obtained?

S1 forms can be obtained via the health/social security authorities of the country paying your pension/benefits. In the case of the UK, you can speak to Overseas Healthcare Services (+44 191 218 1999). If moving to France, you can apply for an S1 90 days before moving and may request it be sent to your UK address.

You can use the S1 to register with your local Cpam state health insurance body. You may obtain a French social security number and carte Vitale health card and will be reimbursed up to the same level as an ordinary member of the French system and may take out ‘top-up’ insurance for the remainder if you wish.

A few years ago, France stopped allowing access to its free/subsidised top-up scheme for those on modest means, to people with S1 forms. However, access was restored following queries we made and discussions between French and European authorities.

What are the tax benefits of holding an S1 form?

There are two main benefits. Firstly, if you have foreign pension income, this should be paid to you without social charges. You should supply a copy of your S1 to the tax office to request this. Some tax experts also advise selecting box 8RP/8RQ on the income tax declaration as a reminder of this status.

Secondly, if you make property or investment capital gains or have income from renting out property, you pay a reduced rate of 7.5% social charges on these instead of 17.2% and should select box 8SH/8SI.

Read more: Ceam or Ghic: Which health card is right for Britons in France?

Note that if you have a French pension then you are not entitled to an S1 or these tax benefits. In some cases it is possible, if the French pension would be small, to renounce or not claim it.

Are there any disadvantages?

There is one disadvantage to the S1, in that for healthcare on trips outside France you should obtain a European health insurance card from the country paying your pension/benefit. 

However, a UK Ehic card cannot be used in the UK itself. 

Pensioners whose S1 rights derive from the WA may still use UK healthcare free of charge despite this. However, there is no provision for those who left the UK post-Brexit, who should, therefore take care with travel health insurance for trips.