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  1. 1. State Health Insurance in France Information about the state healthcare system and French health insurance requirements... All residents in France are obliged by law to have health insurance. Most qualify for thestate health insurance (sécurité sociale); in local terms, this means affiliating to the CPAM(Caisse Primaire d'Assurance Maladie). Those who do not qualify will have to take out private health insurance. CPAM French Health Insurance Advice Line (English-speaking) open Monday to Friday 09:00-18:00 o Tel: 0811 363 646 (from France) Comprehensive information from CLEISS (Centre des Liasons Européennes et Internationales de Sécurité Sociale) Ameli (Assurance Maladie en Ligne) Expatriates who have come to live in France need to prove their income to CPAM. This is most easily done with a French tax return. However these tax returns are submitted one year in arrears, in May each year, so those who have not declared themselves as tax residents need to show evidence of income. This can be another country's tax return, or evidence of income such as pay slips, pension statements, or earnings from capital such as bank deposits, coupons from government bond holdings or share dividends. For more information from Service Public: Click here (in French) Joining French Social Security Visit a local CPAM office and ask for affiliation. Affiliation should then take place that day either as attestation provisiore if not all the documents are available, or as attestation d'affiliation. Claims from that day forward are covered by CPAM to the percentage appropriate to the applicant's status. The following may be needed when completing the form N° Cerfa : 60-3406 (declaration en vue de l'immatriculation d'un pensionné, ou de sa veuve, ou d'un orphelin): Proof of identity: passport or Titre de Séjour Details of place of birth (and for partner and children) Proof of address in France with proof of ownership (deeds) or rental agreement Date of permanent arrival in the departément
  2. 2. Proof of having lived in France for at least three months (three months' utility bills, rent statements, or mortgage payments or a notarised statement of home purchase) Marriage and birth certificates, if partners are to be included A RIB (Relevé d'Identité Bancaire) provided by the bank Evidence of income for at least the previous 12 months, whether in France or elsewhereor an avis d'imposition or latest French tax bill The Carte Vitale Once affiliated to the social security system, a Carte Vitale (green card) is issued. The Carte Vitale is the national insurance card issued to anyone eligible aged 16 and over. It gives evidence of membership and rights to French health insurance - an affiliation to CPAM. It contains all the administrative information necessary for the refund of care: Social security number Details of health insurance scheme and top-up insurance Details of the relevant health insurance office Full name and date of birth of the card holder and their dependants Details of any exemption or reduction that apples to payments or entitlement to supplementary universal cover The Carte Vitale does not carry personal medical information. The Carte Vitale should be handed over at every health appointment (doctor, clinic, hospital, pharmacy) that is equipped with a computer able to read it. The patient will generally receive reimbursement for treatment or medicines directly into their bank account within five days. Reimbursement is made according to income level and the Tarif de Convention (or "approved treatment cost") currently in force. A Carte Vitale has no expiry date but must be updated annually inserting it in the green box which can be found at all CPAM offices and some hospitals and pharmacies. A person without a Carte Vitale eligible for state health insurance will receive a feuille de soins(a brown receipt form) from the doctor, pharmacist or hospital staff. This is recognised by CPAM as a legitimate medical payment. It should be signed and posted to CPAM (along with the doctor's prescription if medicines were issued) for reimbursement. For more information about the Carte Vitale: Click here (in French) The new Carte Vitale
  3. 3. The "nouvelle Carte Vitale" is a new, upgraded version that is being issued to card holders across France. A form is sent, to which a recent identity (ID) photograph must be added, the form signed and returned in the envelope provided, along with a copy of ID (resident's card or passport). < Health System Private Healthcare > Related Information Health System State Health Insurance Private Healthcare Hospitals & Pharmacies Finding a Doctor Registering with a Doctor Psychology & Therapy Social Security Jargon EU Health Card (EHIC) Health Care Abroad Emergencies Weather Warnings Flu Pandemics Dengue Fever Pregnancy & Birth Giving Birth Registration & Nationality Postnatal Care Family Organisations Termination & Abortion People with Disabilities Disability Benefits Support Groups Death & Dying Medical Terminology Useful Contacts EU Factsheets: Healthcare Health Systems General Organisation Sickness Insurance Family & Benefits Unemployment Insurance Health Card E-forms
  4. 4. 8/06/2010 Card offering discounts for big families in France French families and families from EU countries legally residing in France with at least three children under 18 years old can benefit from a card offering a range of discounts. The card is called a ‘Carte Familles Nombreuses’. Under the scheme, each member of the family has their own card. The management fee for processing applications comes to €19, which the family must pay. This amount stays the same however many cards are issued to the family. Card began with discounts on train journeys When the card was created in 1921, it gave cardholders discounts on journeys using the French national railways. Families with six children or more benefit from a 75% reduction, those with five children from a 50% reduction, those with four children from a 40% reduction and those with three children from a 30% reduction. Parents who have or have raised five children at the same time benefit from a 30 % reduction on second class tickets. A poll in 2009 showed that one cardholder in four uses the card at least once a month to take the train, 26% to go on holiday or for a long weekend by train, 31% more rarely and 17% never. One family in four uses it at least once a month to benefit from commercial partners other than the French national railways. More and more commercial partners offering discounts The card was opened up for commercial partners to give discounts in 2006, with 22 partners joining the scheme that year. By May 2007, there were 44 partners and by January 2010, there were 93 partners.
  5. 5. So now cardholders can benefit from a range of other discounts, including national museums, supermarkets, shops and fun parks. In May 2007, the French Health Ministry reported that over three million people held the card out of a maximum possible of seven million people. It added that cards should be issued within an average of ten days of reception of an application. The French national railways in charge of processing applications. Online applications since 2007 Those applying for a card no longer have to go to train station ticket offices but can, since 2007, apply for one online. They can start their application for a card by going to, going to the ‘train’ section at the top of the screen, clicking on ‘cartes et abonnements’ and then scrolling down to ‘cartes pour la famille’. If they click on ‘demande’, a form will appear. The French national railways will then send them a kit to apply for a card. The kit comprises an application form, an explanation of what the card is for, a pre-paid envelope and a sleeve for identity photographs. The card is valid for three years, after which the family needs to apply for a new card. For parents who have brought up five children or more, the card is valid for six years. For further information Contact: French Ministry of Labour press service