# Health care - not working but not retirement age



## Garywest12

Hi all

Am trying to understand how best to get a *carte vitale* in France if I am not of retirement age and therefore as I understand it *not* eligible for an S1 from the UK? I am on a private pension as I stopped work early due to cancer, now thankfully in remission. 
My situation is slightly more complex - an issue that I have raised here before - in that I am staying in France with an Irish passport, which solved the residency issue, but I was born in Northern Ireland and throughout my life used the UK health system. So I have no health authority in another European country to refer to although I am an Irish (and British) citizen - I was never an Irish taxpayer and never used the Irish health system. My pension is a UK private pension. 
Without an S1 is it simply a matter of proving income (my monthly pension payments) and residence (rented Airbnb) here in France - or do I need something health related from the NHS? I understand you need to get the *social security number* in France first before getting a carte vitale but how do you do that if you are not employed here and also not eligible for an S1?
My husband is a British citizen and got his carte de sejour via my Irish passport, but now faces the same issue re the carte vitale. We have private health cover for the first five months of our time in France and are now approaching three months. 

Any thoughts as always welcome and gratefully received, kind regards, Gary


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## Bevdeforges

If you are not yet of retirement age, you would normally have had to show proof of private health cover (for both of you) as part of the carte de séjour process. If you can't get an S1 from the UK system (ask the question at least - just for your own peace of mind), then you enroll in the CPAM and your charges for the sécu health coverage are based on your declared revenue. 

You probably want to declare a "medecin traitant" (i.e. a primary doctor) and then ask them about possibly qualifying as someone with a serious or chronic condition - which means that the French health care system would cover you 100% percent for treatments related to your cancer. The French sécu system is a reimbursement system, where most reimbursement for treatment is at 70% or less of what you pay to the doctor or other practitioner. Once you are enrolled with CPAM, you then need to find a mutuelle (to cover the part of costs that the sécu doesn't pay) - and to register your mutuelle with CPAM so that reimbursements are handled quickly and easily.

But go ahead with the CPAM registration as soon as you hit the 3 month mark for residence. (Living in an AirBnB may complicate this a bit - but maybe not.) If you don't already have a sécu number, CPAM will assign you one when they approve your dossier. Getting the actual card may take a little longer, but once your sécu number is assigned, you can send in your feuilles de soin for reimbursement until you get the actual card.


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## Garywest12

Very detailed and helpful as always and much appreciated. A couple of questions that flow from what you said: do you have to have identified a doctor who will agree to be your primary doctor before the application and provide that name? I am aware of a significant problem with general practitioners in some areas of France and think this could be an issue. Last time I tried to get to get appointment with a local doctor it proved almost impossible. 
Are you saying you can apply without a social security number and they then assign a temporary one to you?
The Airbnb wasn’t issue with carte de séjour - so I am hoping it won’t be in this case but you never know. 
Kind regards and thanks again, Gary


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## Bevdeforges

Garywest12 said:


> do you have to have identified a doctor who will agree to be your primary doctor before the application and provide that name?


No, not at all. If you don't have a medecin traitant, that will affect the reimbursement rate from CPAM by a little bit. But when you find a doctor you want to use for medecin traitant, you need to get him or her to sign a form saying that they are willing to take you on. (It does NOT need to be a GP. If you have a specialist you see more regularly than you do a GP, they may agree to be your primary doctor. It's mainly a matter of record keeping - your medecin traitant keeps a copy of all your medical records and test results.) Just for the record, many doctors listed on Doctolib or any of the other online appointment booking services (Maiia, allodocteur, Keldoc, etc.) often state whether or not they are accepting new patients.


Garywest12 said:


> Are you saying you can apply without a social security number and they then assign a temporary one to you?


Yes. We have a number of forum members here who applied to CPAM and then received their sécu numbers later - and some got their permanent number without any temporary number. Like so many things here in France, the process varies from one departement to the next.

The AirBnB address may be less of an issue with CPAM than with your carte de séjour. The key thing tends to be whether you can receive mail at the address - and whether you can have mail forwarded to your new address when you move on. That's not really as critical with CPAM registration since so much is handled online now.


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## Nunthewiser

We are in a similar situation. Just arrived 2 days ago and staying, for now, in an Air BNB. We'll be looking for permanent apartments in a few days, but I was told by CPAM that AirBNB counts toward the 3 month residency requirement. If you look at the application form S-1106, it even suggests that hotel receipts count. I suggest you call the English speaking help line at CPAM and see if they think your situation qualifies.


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## BackinFrance

AirBnB is fine for CPAM applications, or at least it was during the last Covid crisis. You would need to explain that you cannot receive mail and they will hopefully propose a work around (which definitely exist).


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## Garywest12

Nunthewiser said:


> We are in a similar situation. Just arrived 2 days ago and staying, for now, in an Air BNB. We'll be looking for permanent apartments in a few days, but I was told by CPAM that AirBNB counts toward the 3 month residency requirement. If you look at the application form S-1106, it even suggests that hotel receipts count. I suggest you call the English speaking help line at CPAM and see if they think your situation qualifies.


Thank you, much appreciated. Good luck on your side, Gary


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## Garywest12

BackinFrance said:


> AirBnB is fine for CPAM applications, or at least it was during the last Covid crisis. You would need to explain that you cannot receive mail and they will hopefully propose a work around (which definitely exist).


Good to know, thank you, Gary


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## Crabtree

Once you have been here for 3 months you can apply to join CPAM.You should describe yourself as an "inactif" NOT Retraite.As you have a pension you will not be required to make a contribution to CPAM. You should also get a mutuelle but they do not take previous illnesses into account You should then get a medecin traitant explain about your cancer and they may well certify it to be a ALD ie the French state will pay for all your treatment for this problem and also diags etc.
As an aside you should note that private pensions are always fully taxable in France and you should arrange for the pension to be paid free of UK tax.


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## 1790260

Crabtree said:


> You should describe yourself as an "inactif" NOT Retraite


Yes, there is a distinction. By my understanding, you cannot (officially anyway) be early retired or any such description. I think to be retired you have to be in receipt of a pension.At least that is my understanding, and I'm happy to be corrected.

Edit: I did see an distinction drawn (by AXA I think it was, for motor vehicle insurance purposes) between inactif under 60 and inactif over 60.


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## Garywest12

Crabtree said:


> Once you have been here for 3 months you can apply to join CPAM.You should describe yourself as an "inactif" NOT Retraite.As you have a pension you will not be required to make a contribution to CPAM. You should also get a mutuelle but they do not take previous illnesses into account You should then get a medecin traitant explain about your cancer and they may well certify it to be a ALD ie the French state will pay for all your treatment for this problem and also diags etc.
> As an aside you should note that private pensions are always fully taxable in France and you should arrange for the pension to be paid free of UK tax.


All very helpful and important points, thank you, Gary


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