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

Reader question: I’m a retiree on very low income. The price of my private health insurance mutuelle keeps going up, is there a cheaper alternative in France? Thanks

Alongside their basic rights under France’s state health system, which comes with membership of French social security, most people opt to pay for top-up insurance to pay for costs not covered by the state.

However, France has a ‘free top-up’ system to help those on modest means, called the complémentaire santé solidaire (CSS).

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

Who is eligible for CSS?

Eligibility to the CSS is determined on the basis of your income level and membership of the French healthcare system.

Unfortunately, last year the French stopped eligibility for CSS for people (mostly pensioners) whose healthcare is paid for by another EU state, or Britain, under the S1 health certificate scheme. There has been speculation that scrutiny of the rules post-Brexit may have played a role in this being enforced at this time whereas it was not in the past.

An association helping foreign people in France suggested that the change could be argued to be discriminatory and suggested people concerned who apply and are refused should seek to contest this. However, we have so far heard of no change to the policy.

Otherwise, for those eligible and earning the lowest incomes, the CSS is free, for others whose incomes are not deemed to be sufficiently low, a financial contribution will be required but lower than the full cost of taking out an ordinary mutuelle.

Read more: Explainer: French healthcare terms that are useful to know

The calculation for this contribution takes into account the claimant’s income level and age.

Beneficiaries of the government’s CSS programme are required to pay a modest contribution if their income reaches a certain level. If so, contributions are calculated on the basis of income and age levels.

The CSS contribution is guaranteed not to exceed a maximum amount of €1 per day and per person.

What are the income ceilings to benefit?

A single household with an annual income of €9,571 or less will receive CSS coverage at no charge while a single household earning up to €12,921 can receive CSS coverage at a cost.

Meanwhile, a household of two people with an income of up to €14,357 can receive CSS coverage at no charge and couples with an income of up to €19,381 are eligible for coverage at a cost. The ceilings rise accordingly for larger families.

These figures relate to members of your household including spouses, civil partners, unofficial long-term partners and dependents.

Entitlement is based on actual amounts of money received in the previous 12 months before the application is made but does not include some forms of income such as certain social welfare benefits (see the form link below for more on this).

How can I apply for CSS?

You can apply for the CSS online through your Ameli account under Mes démarches or in person at your local Cpam.

To apply for the CSS, you should fill out the Cerfa form nº 12504*08 which describes your household and your family income.

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