You Mean French Healthcare Isn’t Free?

by | Jan 19, 2018 | Finance & Legal, Healthcare in France | 7 comments

You Mean French Healthcare Isn’t Free?

If you filed French income taxes in 2016, you may have recently received a letter from URSSAF asking for money.

L’addition finally arrives

After letting both 2016 and 2017 pass without collecting social security contributions for public health coverage, URSSAF is now on a mission to catch up and fill the hole in the coffers. While French public healthcare coverage is one of the least costly in the world, it’s not free in most circumstances. The system is supported by the millions of salaried workers and independent professionals who pay social charges to finance the healthcare regime. And before 2016, inactive residents who qualify for coverage because they’ve resided legally on French soil for more than three months also paid social charges to URSSAF.

Since the creation of PUMa (Protection Universelle Maladie), which introduces the right to public healthcare coverage based on legal residency alone, our clients have been anxiously awaiting their first bill.

What to do with the URSSAF bill

The bill for 2016 coverage is due today (January 19th), unless you have taken one of the following actions:

  1. Contact URSSAF by phone 0810 594 267 or e-mail (depending on your region):
  2. Contest the bill to URSSAF. If you feel that the contribution amount does not take into full consideration your situation, you can send URSSAF documentation to support your claim. You can contest the bill 30 days before the due date, which delays the due date another 30 days and incurs no late fees.
  3. Contest the bill to CRA. You can also follow the same type of procedure with CRA (Commission de Recours Amiable), and eventually with the TASS (Tribunal des Affaires de Sécurité Sociale) to contest the bill. Late fees may or may not be incurred.

Note that If the contributions are not paid within 30 days, a 5% late fee may be added, then an additional 0.4% per month thereafter.

How to pay for French healthcare coverage

Send your payment, in the form of bank or personal check (French Euro account), to the URSSAF address indicated on the letter you received.

Otherwise, you can choose to pay in three installments via automatic bank transfer. The first within thirty days of the notice and the last two no longer than 90 days after the first. Contact your local URSSAF to obtain their bank account details and instructions on how to properly label your payments so they are accurately attributed to your account. Keep in mind that your bank will likely require at least one business day to add URSSAF as a recipient (bénéficiaire) for bank transfers.

If you shouldn’t have to pay

If you have never applied for French public healthcare coverage and have received a bill anyway, this is most likely due to the fact that French tax authorities provided URSSAF with details on every individual susceptible of having PUMa coverage. However, since many expats living in France are still insured through private health insurance policies, and technically PUMa is not mandatory, these calls for payment should be contested.

Renestance can provide you personal assistance with this matter. Whether you need help determining whether you’ve been charged the correct amount or contesting the URSSAF bill, contact us for a free estimate.

For more detail on URSSAF billing and PUMa, many thanks to the fine professionals at AARO for their extremely detailed article on this subject, found here: https://www.aaro.org/2017/advocacy/social-security/642-puma-protection-universelle-maladie

Jennifer Rowell-Gastard

Jennifer was Renestance's Activity & Excursions Coordinator between 2015 and 2020, a bilingual American from Vermont who's been loving her life in France since 1998. She was passionate about sharing her knowledge and allowing you to discover all of the scenic, cultural and culinary wealth of the Languedoc-Roussillon region.

All articles by: Jennifer Rowell-Gastard

7 Comments

  1. geraldine

    geraldine

     on 2018-02-27 at 19:15

    I have been living in France for 6 months and 2 months ago I applied to join assurance maladie. They have just sent me my social security number and a list of additional documents they need. They have asked for my husbands proof of income but I thought the cotisations would be based on my income only because I am only asking for my son and myself to join. My husband is already covered by the Swiss system because he works there. Can you please confirm if 1. my cotisations will be based on my income only or also on my husbands even if he is already paying into the Swiss system? 2. How are children charged for – my son is under 2 years and I am wondering what % I will have to pay for him?

  2. Jennifer
    Jennifer on 2018-02-28 at 12:04

    Hi Geraldine,
    Thanks for your question.
    The good news is that no matter what, your minor child is automatically a beneficiary under your coverage, as long as you fill out the S3705 Cerfa form “Demande de rattachement des enfants mineurs à l’un ou aux deux parents assurés”.
    However, your question concerning your coverage under PUMa and the fact that your husband is already a beneficiary of the LAMal system in Switzerland is a bit more complicated to answer, as it completely depends on several different factors that are specific to your personal situation. If you would like us to explore this issue with you further, please let us know and we can set up an initial consultation. Many thanks!

  3. Ron Groves

    Ron Groves

     on 2019-01-08 at 19:33

    We are an American retired couple moving to France shortly with a Long-Term (12 mos) Visitor Visa. Our only income will be Social Security and Pensions which are not taxable in France. If we join assurance maladie and later file our French tax returns – no taxes owed – should we still expect to eventually receive a URSSAF bill? Will we still owe even though we pay no income taxes to France?

    • Sally Sprinkle

      Sally Sprinkle

       on 2019-06-28 at 14:25

      I would love to know what the response to Ron Groves question above was as I am in the same situation.

      • Dennelle Taylor Nizoux
        Dennelle Taylor Nizoux on 2019-06-28 at 16:56

        Hi Sally, thanks for drawing our attention to Ron’s comment, which had fallen through the cracks. Hope my response to him answers your question as well.

    • Dennelle Taylor Nizoux
      Dennelle Taylor Nizoux on 2019-06-28 at 16:54

      Hi Ron, thanks for your question. For now, URSSAF does not take retirement or pension into account when calculating the CSM. We don’t draw a lot of attention to this fact, because there are many legal cases in progress intended to change the CSM…and I think you’d agree that it would be nice if this particular aspect did not change! 😉

  4. Charles Smith

    Charles Smith

     on 2022-06-15 at 00:21

    My wife and I will be retiring in a couple of years and our plans are to reside in France on a long-stay visa. Our source of income will be a pension supplemented by savings and occasional withdrawals from retirement accounts (ROTH, 401ks, etc.) Two questions: Is there an age limit for PUMA & Mutuelle coverages? (We’ll be 65 & 66 yrs old.)
    And – What premium costs would we expect and how will they be determined.

    And will there be any exclusions for pre-existing conditions?

    We get conflicting and confusing information regarding age limitations, costs, etc. using google searchs.

    Thanks in advance.

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