# Health Insurance For Long Stay Visa -France-



## InternationalGuy

I am about to apply for the VLS (visiteur) next week. The requirement is to acquire a one year health insurance for expats. The Visa checklist doesn't make clear if an annual prepayment of the policy is required. I am hoping to select the monthly payment plan and cancel it once I am eligible for the French Health system after 90 days.

I am looking at Cigna. They allow me to increase the deductible and out of pocket amounts, which substantially lowers both monthly and annual premiums. Would selecting $10,000 trigger VFSglobal ( visa processors) to reject my health insurance certificate. The guidelines state " 

*Assurance médicale de voyage*
*Assurance médicale couvrant toute la durée du séjour. L’assurance devra être valable pour toute la durée de validité du visa (maximum 1 an)."*


which doesn't tell me much. 

Thank you!


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## EuroTrash

I am not sure how easy it is to cancel a policy after a few months. Normally even if you pay monthly, it is still a one year contract and you can't cancel before the end of the first year.
But I believe there are policies that you can convert to normal "top up" policies once your affiliation to CPAM has gone through, ie it will reimburse expenses that are not covered by the State.
I imagine Cigna can tell you what is / is not acceptable for visa purposes.


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## Bevdeforges

As I mentioned in your other thread, there are many more companies out there than just Cigna, and in fact Cigna is not terribly well known outside the US, even if they call themselves a "global" health care service. You may want to check the details on the AARO health insurance plan Plan Summary simply because the group plan has been designed with American expats in mind. You do have to be an AARO member to enroll, but the outline of the plan that is available should give you some ideas about what type of plan you need to have for visa purposes.

You should check with the VFS people, but I believe they may require a paid up one-year plan for the visa application unless you already are enrolled with Cigna (or whatever insurer you decide to go with). And in any event, it can take some time to get your paperwork together to enroll with CPAM after you meet the 3 months residency requirement - and at that point, it can take "a few" months for your application to get processed.


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## Nunthewiser

There are a number of French insurance brokers and firms that probably can beat Cignas pricing and will be more comfortable to French authorities. Check out Mamassur, Mondassur, ACS, Fab. I am sure others will pop up as you google these. Most of these will warrant that their policy will fly for a visa.


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## BackinFrance

InternationalGuy said:


> I am about to apply for the VLS (visiteur) next week. The requirement is to acquire a one year health insurance for expats. The Visa checklist doesn't make clear if an annual prepayment of the policy is required. I am hoping to select the monthly payment plan and cancel it once I am eligible for the French Health system after 90 days.
> 
> I am looking at Cigna. They allow me to increase the deductible and out of pocket amounts, which substantially lowers both monthly and annual premiums. Would selecting $10,000 trigger VFSglobal ( visa processors) to reject my health insurance certificate. The guidelines state "
> 
> *Assurance médicale de voyage*
> *Assurance médicale couvrant toute la durée du séjour. L’assurance devra être valable pour toute la durée de validité du visa (maximum 1 an)."*
> 
> 
> which doesn't tell me much.
> 
> Thank you!


Are you planning on staying in France for no more than a year? I ask because of the reference to travel insurance, and cover for the entire stay, which suggests to me that you have checked the box for a visa that requires you to return home at the end of the year with no ability to apply in France to stay beyond that time.


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## Bevdeforges

InternationalGuy said:


> I am hoping to select the monthly payment plan and cancel it once I am eligible for the French Health system after 90 days.


It's this statement that leads me to believe that the OP is intending on staying past their first year. If you plan on renewing the visa/titre de séjour and have not checked the box indicating that you plan on staying for *1 year +* then you'll wind up having to buy a full year policy in order to apply for a new visa for the second year.


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## InternationalGuy

BackinFrance said:


> Are you planning on staying in France for no more than a year? I ask because of the reference to travel insurance, and cover for the entire stay, which suggests to me that you have checked the box for a visa that requires you to return home at the end of the year with no ability to apply in France to stay beyond that time.


I am planning to immigrate to France, there is a difference between Travel Insurance and Health Insurance which is required for long stay visas holders leading to la carte sejour. I am referring to the latter.


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## InternationalGuy

Bevdeforges said:


> It's this statement that leads me to believe that the OP is intending on staying past their first year. If you plan on renewing the visa/titre de séjour and have not checked the box indicating that you plan on staying for *1 year +* then you'll wind up having to buy a full year policy in order to apply for a new visa for the second year.


I am intending to renew my carte sejour, what box are you referring to? the one on the Health Insurance or the long term visa. Either way, I selected 12 months+ . I am not getting the point of the second year visa given that I will be in France either way. Did you mean the second/renewed carte de sejour?



Bevdeforges said:


> As I mentioned in your other thread, there are many more companies out there than just Cigna, and in fact Cigna is not terribly well known outside the US, even if they call themselves a "global" health care service. You may want to check the details on the AARO health insurance plan Plan Summary simply because the group plan has been designed with American expats in mind. You do have to be an AARO member to enroll, but the outline of the plan that is available should give you some ideas about what type of plan you need to have for visa purposes.
> 
> You should check with the VFS people, but I believe they may require a paid up one-year plan for the visa application unless you already are enrolled with Cigna (or whatever insurer you decide to go with). And in any event, it can take some time to get your paperwork together to enroll with CPAM after you meet the 3 months residency requirement - and at that point, it can take "a few" months for your application to get processed.


Thank you for your input, but I haven't seen any other threads regarding Health Insurances. I applied with GeoBlue, but I will definitely look into AARO. I had called VFS and they were unable to give me a clear answer, I will retry on 06/15. In general, do we have to demonstrate Health Insurance coverage while applying/waiting for CPAM processing. It appears that VFS/Consulates and possibly the border police ( PAF) would be the only admins that would actually need to confirm a paid up one-year plan and prefectures do not deal with coverage certificates. is that correct?
I appreciate you!


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## BackinFrance

It seems that you have applied for the correct visa. VFS does preliminary checking of your application and forwards it to the French Consulate for final approval. Your visa will be in your passport and that is what border control will check. When you apply for CPAM cover they usually check that you have the appropriate health cover and that you are legally in France. CPAM will be interested in your visa and your health insurance policy.


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## GraceS

InternationalGuy said:


> I am about to apply for the VLS (visiteur) next week. The requirement is to acquire a one year health insurance for expats. The Visa checklist doesn't make clear if an annual prepayment of the policy is required. I am hoping to select the monthly payment plan and cancel it once I am eligible for the French Health system after 90 days.
> 
> I am looking at Cigna. They allow me to increase the deductible and out of pocket amounts, which substantially lowers both monthly and annual premiums. Would selecting $10,000 trigger VFSglobal ( visa processors) to reject my health insurance certificate.


Not sure if the requirements have changed recently, but when I applied in November for this same visa, the health insurance had to have:
1. A deductible of 0
2. Repatriation coverage
3. At least 30,000 euro of coverage

Here is a link to a recent thread with more details about requirements, insurance companies, and premium refund/conversion to a mutuelle after CPAM approval. 

(1) Americans want to retire in France | Expat Forum For People Moving Overseas And Living Abroad


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## Peter_E

This is a monthly or annual policy for visa applications. They also paid promptly after I required surgery.





Health Insurance for Foreign Residents in France EFE(np) - ACS


Comprehensive health insurance for foreigners living in France from 3 to 12 months. Three different options to suit your needs and budget. Click here.




www.acs-ami.com


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## Bevdeforges

InternationalGuy said:


> I am intending to renew my carte sejour, what box are you referring to? the one on the Health Insurance or the long term visa. Either way, I selected 12 months+ . I am not getting the point of the second year visa given that I will be in France either way. Did you mean the second/renewed carte de sejour?


The terms "visa" and "titre de séjour" are often used interchangeably in common parlance. You are correct in that the visa is the document you need in order to enter France, while the titre (or carte) de séjour is the residence permit. If you get a VLS-TS that is simply a visa (in your passport) that serves as your titre de séjour during your first year in France. When you go for renewal, you'll receive the actual "carte" de séjour in the form of a laminated i.d. card showing your status and other documentation.

BackinFrance has given you a very good explanation of the process involved in obtaining a visa, and then validating the visa to serve as a residence permit, plus applying to CPAM after establishing at least 3 months of residence. In states where it is available, we've heard very good things about the GeoBlue cover - though it can be tricky to get a certificate that works for the visa application out of them. Just don't cancel the private insurance until you have confirmation of your CPAM cover. It can take a while to come through (especially given the delays and backlogs we seem to have at the moment in almost all administrative functions).


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## bhamham

One component missing with these 'health insurance' threads/recommendations is how well the insurance agency handles claims. I get that most folks never have to file one. And, if it works to get you through the visa process then 'it's great and you should buy it like I did.'

I'm in the middle of a claim with a well known agency often mentioned here and the tactics they're using to delay an outcome are really interesting. The first response following a month of silence was to dispute the dates saying I wasn't covered at the time of the event. I arranged the policy when I was in the US and even though they're a French company they wrote the policy using the US numbered dating format, which interpreting by the FR/EU format showed that I wasn't covered. I pointed their error out to them a week ago that I was covered and they said they'd get back to me and asked for a copy my plane ticket into the Schengen zone and a copy of my visa, so it's back to the waiting game. I can't wait for the next episode - I doubt it will be a check!


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## BackinFrance

FR/US date formatting can certainly give rise to problems.


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## jweihl

There are definitely Schengen compliant health insurance policies you can sign up for for 1 year that allow you to either cancel, or to convert them to a mutuelle once you've gotten into Assurance Maladie. You might want to check with Exclusive Healthcare and ask them about it. They do speak english and have products that will fit your needs.


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## Peter_E

bhamham said:


> One component missing with these 'health insurance' threads/recommendations is how well the insurance agency handles claims. I get that most folks never have to file one. And, if it works to get you through the visa process then 'it's great and you should buy it like I did.'
> 
> I'm in the middle of a claim with a well known agency often mentioned here and the tactics they're using to delay an outcome are really interesting. The first response following a month of silence was to dispute the dates saying I wasn't covered at the time of the event. I arranged the policy when I was in the US and even though they're a French company they wrote the policy using the US numbered dating format, which interpreting by the FR/EU format showed that I wasn't covered. I pointed their error out to them a week ago that I was covered and they said they'd get back to me and asked for a copy my plane ticket into the Schengen zone and a copy of my visa, so it's back to the waiting game. I can't wait for the next episode - I doubt it will be a check!


When I took the ACS policy, which is very inexpensive, I was concerned about the claims procedure and the length of time it would take to reimburse and how they would try and avoid the claims. I partially amputated my finger and had to have surgery. They dealt with the claim promply, explaining all the reasons for rejection some of the payment, for example they didn't pay 20 euros for the pajamas you are given to wear into surgery, but they covered everything else according to policy. My biggest complaint I guess is the pre-existing conditions which you have to declare. I have had previous elbow surgery and they initially excluded my arm from all subsequent claims, but I argued with them saying that it was unreasonable, and they finally reduced it to just the elbow. I found their subjective assessment frustrating, but otherwise everything else has been acceptable. You have 2 years to finalise the full claim, and the hospital bills only arrive 6 months after the event, so if cashflow is an issue, then that is something to consider. However hospital/doctors fees are very cheap compared to say private UK healthcare. A surgeon charges 35 euros for an appointment, x-rays are less that 30 euros etc


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## Peter_E

However, there many other insurance providers, but generally more expensive. Here is an online site that gives you quotes for visa insurance policies 


SFN - Medical


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## J&R

We got our health insurance through Insuby. Our policy includes repatriation and the minimum 30,000 euro coverage requirement. However, I just noticed that we have a $100 deductible. Is that going to be a problem for the VISA? Has anyone applied for the VISA with an insurance policy having a deductible?

Thank you.


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## nrlaurin

J&R said:


> We got our health insurance through Insuby. Our policy includes repatriation and the minimum 30,000 euro coverage requirement. However, I just noticed that we have a $100 deductible. Is that going to be a problem for the VISA? Has anyone applied for the VISA with an insurance policy having a deductible?
> 
> Thank you.


Yes please, the no-deductible issue is news to me also, can anyone please elaborate?


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## J&R

nrlaurin said:


> Yes please, the no-deductible issue is news to me also, can anyone please elaborate?


One more thing that I would like to add to my previous post. Our policy is way above the minimum requirement and we also paid it in full. I hope it is not an issue during our interview.


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## InternationalGuy

I just applied, the VFS representative looked at the dates of coverage on the insurance statement, I also added a copy of the GEOBlue insurance card and a little brochure ( 9 pages) that I printed from the insurance website. VFS has not mentioned anything about the payment or deductible amounts. My brochure does say no deductible applicable for preventive and medical appointments, however surgeries and such require $2.500 deductible. While sitting in the waiting room, I have heard them inquiring about deductibles for what I believe was short visa stays, and I also believe it was for Portugal not France. I actually thought that specific representative was kind of rude and condescending to that Asian family who was applying for a visa. The french Long Stay Visa reps had the checklist which is broad in nature, and kept telling me that the more docs I supplied the better would be. Crossing fingers! Good luck to all


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## Bevdeforges

I have seen that "no deductible" clause cited on several sources, yet at the same time, people with "expat policies" with relatively nominal deductibles have no problem getting their applications approved. The old policy used to be that your private policy had to be "roughly" equivalent to the national insurance cover (and the French national cover only reimburses for about 70% of the official rates for medical services and other costs). Sometimes you just have to play the game and take your chances. Good luck to all of you going for visas for France. We actually haven't had hardly any folks come back here to say that they were flat out turned down since VFS came into the picture, so perhaps they are actually making the process somewhat more efficient.


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## GraceS

I'm the person who, upthread, mentioned the "zero deductible" requirement.

I got this info from two main sources:

1. A VFS representative, October 2021​​2. Friends who had gotten their visas shortly before the change-over to VFS a few years ago. They were able to ask this health insurance question directly to the French Embassy, and the reply was that the health insurance had to cover "any possible costs"--which was interpreted by their organization to mean the policy required a zero deductible.​
Were these answers correct? Is this all still true? I don't know. I do know that the French visa wizard will still tell you today that you have to have "a health insurance certificate issued by the insurance company (covering any possible costs for medical repatriation, and emergency and/or hospital treatment, for a minimum amount of €30,000, valid in France for the whole stay.)" 

Bonne chance!


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## InternationalGuy

It's definitely a tricky topic. As I mentioned my $2,500 deductible would only be applicable for "the more serious stuff" but there is no maximum amount to be paid aka $unlimited. The $250K global travel benefits ( emergency transport, repatriation, accidental death), visits, immunizations, basic prescription drug benefits and X-rays in conjunction with visits are all covered at 100%, but there is a $10 copay for adult office visits.

Based on what Bev said, the benchmark of %70 should be met, but I have no idea how the $2,500 deductible would be interpreted by the embassy. The monthly rate I paid is more than $700 due to preexisting conditions, choosing the $1,000 or the $0 deductible would have obviously increased it. I apologize if this was too much info, but yes it's out of my hands, the ball is in their court now.


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## nrlaurin

InternationalGuy said:


> It's definitely a tricky topic. As I mentioned my $2,500 deductible would only be applicable for "the more serious stuff" but there is no maximum amount to be paid aka $unlimited. The $250K global travel benefits ( emergency transport, repatriation, accidental death), visits, immunizations, basic prescription drug benefits and X-rays in conjunction with visits are all covered at 100%, but there is a $10 copay for adult office visits.
> 
> Based on what Bev said, the benchmark of %70 should be met, but I have no idea how the $2,500 deductible would be interpreted by the embassy. The monthly rate I paid is more than $700 due to preexisting conditions, choosing the $1,000 or the $0 deductible would have obviously increased it. I apologize if this was too much info, but yes it's out of my hands, the ball is in their court now.


Very interested to see the outcome, please keep us posted!


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## bradders2175

When we moved here, I asked our broker for help in deciding what mutuelle insurance we might require as the reimbursement of 100,200 or 300% was confusing. He told us to view it like we would car insurance for which the minimum requirement would be third party. He said our minimum should be hospital cover as likely or not, we might be able to afford a one or two day stay, but it gets expensive. We took his advice and took out family hospital cover, saving us between €1-120 per month on an enhanced cover, that would reimburse us for GP and dental visits etc.
You need to look at what your long term health requirements might be. Many things are free. Critical care etc. 
You need to realise that the more you pay, the more you will be reimbursed. As an example, I got a devis from the dentist for some work. There were three figures on there. €3800, €666 and €427. I took it to our insurer and asked if I had cover, would it all be reimbursed. She replied it wouldn't. The €3800 was to pay the dentist. The €666 was the figure the Government priced the work at and the €427 was the amount I would get back on my Carte Vitale. If I had insurance cover, I would be reimbursed the difference between amounts two and three.
It's not for everyone, but sixteen years here of not paying for a mutuelle that we didn't really need, has saved us a lot of money. We rarely visit the doctor, so to pay for insurance to return €12-4, isn't worth it. Opticians are expensive here, so we renew spectacles for minimum cost when in the UK. During that time, my wife and I have had four hospital visits for minor surgery. All paid for by the hospital cover.


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## TomMM

I just purchased health insurance for my visa application. Initially I looked at GeoBlue but the zero deductible plan for me was about $1k per month. I met a new US expat in Paris who suggested April whose plan was about €500 per month. A better price but still a little pricey for my situation. Last week I found a comment here about ACS and after confirming the coverage I purchased their ‘F’ option for just under €1200 per year but their product might not be for everyone. Claims have to be submitted by mail. No restrictions on the doctors I can see but they only reimburse 100% of the French SS amounts. Coverage limit is €40000 and good through out the EU. For me this plan was perfect. I have no health issues and can accept any financial responsibilities while waiting for reimbursement. They have a cheaper plan but it has a lower reimbursement rate.


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## InternationalGuy

nrlaurin said:


> Very interested to see the outcome, please keep us posted!


I am here to report Visa was approved and there was no mention regarding the deductible.


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## InternationalGuy

bradders2175 said:


> When we moved here, I asked our broker for help in deciding what mutuelle insurance we might require as the reimbursement of 100,200 or 300% was confusing. He told us to view it like we would car insurance for which the minimum requirement would be third party. He said our minimum should be hospital cover as likely or not, we might be able to afford a one or two day stay, but it gets expensive. We took his advice and took out family hospital cover, saving us between €1-120 per month on an enhanced cover, that would reimburse us for GP and dental visits etc.
> You need to look at what your long term health requirements might be. Many things are free. Critical care etc.
> You need to realise that the more you pay, the more you will be reimbursed. As an example, I got a devis from the dentist for some work. There were three figures on there. €3800, €666 and €427. I took it to our insurer and asked if I had cover, would it all be reimbursed. She replied it wouldn't. The €3800 was to pay the dentist. The €666 was the figure the Government priced the work at and the €427 was the amount I would get back on my Carte Vitale. If I had insurance cover, I would be reimbursed the difference between amounts two and three.
> It's not for everyone, but sixteen years here of not paying for a mutuelle that we didn't really need, has saved us a lot of money. We rarely visit the doctor, so to pay for insurance to return €12-4, isn't worth it. Opticians are expensive here, so we renew spectacles for minimum cost when in the UK. During that time, my wife and I have had four hospital visits for minor surgery. All paid for by the hospital cover.


Thank you for the practical examples you shared. Have you also enrolled in the CPAM Assurance Maladie or just kept the enhanced private insurance cover. I thought it was required however the online application for VLS-TS renewals asks specifically for "private health insurance proof" submission. Is it possible that paying the CPAM insurance taxes and contributing to it is elective for Carte de Sejour Visiteurs.


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## Bevdeforges

According to this note from AARO, paying into CPAM is not elective for French residents, though there is no formal advice on how and when you must enroll in the system if you are on a non-work visa. Special Note for Residents in France

Mutuelle cover is not mandatory (at least as far as I know) but it definitely makes life a whole lot simpler, given that CPAM usually passes along all "claims" directly to your mutuelle if you have registered this information with them.


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## InternationalGuy

Bevdeforges said:


> According to this note from AARO, paying into CPAM is not elective for French residents, though there is no formal advice on how and when you must enroll in the system if you are on a non-work visa. Special Note for Residents in France
> 
> Mutuelle cover is not mandatory (at least as far as I know) but it definitely makes life a whole lot simpler, given that CPAM usually passes along all "claims" directly to your mutuelle if you have registered this information with them.


The Special Note states that the Fisc shares its data with the Urssaf, therefore once a non-working resident files a Fisc declaration an Urssaf bill is initiated. I am planing to file yearly taxes, as you advised on other threads, and to declare my US social security benefits. Hopefully, AARO is correct concerning the exoneration from the CSM for the benefits.

I am also wondering how would a US or french bank account (checking with a large balance) be treated by the Fisc if it does not generate any income or interest. Do the French require the declaration of such an account to the Fisc and subsequently to Urssaf. The table for CSM calculation does not list non interest/income bearing accounts as a criterion.


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## Bevdeforges

InternationalGuy said:


> Hopefully, AARO is correct concerning the exoneration from the CSM for the benefits.


Can only tell you that I've been declaring my US SS benefits for 5 years or more now and have not been assessed the CSM in all that time.


InternationalGuy said:


> I am also wondering how would a US or french bank account (checking with a large balance) be treated by the Fisc if it does not generate any income or interest. Do the French require the declaration of such an account to the Fisc and subsequently to Urssaf. The table for CSM calculation does not list non interest/income bearing accounts as a criterion.


Basically, the banks still function like when they were nationalized. The banks report all your French bank accounts to the Banque de France and they share whatever information they do with the Fisc. They do need to have a record of those who have those tax-free accounts, since each person is only allowed one account per person (think, Livret A or Development Durable) no matter how many banks they deal with. And if you have interest bearing savings accounts, the bank takes your income tax and a "social prelevement" - total of 30% of all interest paid.


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## InternationalGuy

Bevdeforges said:


> Can only tell you that I've been declaring my US SS benefits for 5 years or more now and have not been assessed the CSM in all that time.
> 
> Basically, the banks still function like when they were nationalized. The banks report all your French bank accounts to the Banque de France and they share whatever information they do with the Fisc. They do need to have a record of those who have those tax-free accounts, since each person is only allowed one account per person (think, Livret A or Development Durable) no matter how many banks they deal with. And if you have interest bearing savings accounts, the bank takes your income tax and a "social prelevement" - total of 30% of all interest paid.


So theoretically if a non-working Visiteur wants to reside in France and bases the financials on a comfortable "US checking balance account" (saved from prior employment) with no other current sources of income, neither the income tax nor the "social prelevement" applies. However, as you reminded us several times the French prefer seeing a continuous source of income and may deny the VLS application at the Consulate.


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## Bevdeforges

What the banks require (or expect) for opening an account is an entirely different matter than what the consulate and/or visa processing office require for a visa application.


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## phillyangevin

J&R said:


> We got our health insurance through Insuby. Our policy includes repatriation and the minimum 30,000 euro coverage requirement. However, I just noticed that we have a $100 deductible. Is that going to be a problem for the VISA? Has anyone applied for the VISA with an insurance policy having a deductible?
> 
> Thank you.


I had that exact same insurance when I applied last January. I had no problems getting the Visa. If it makes any difference I went to the NYC office to have my application approved.


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## Bevdeforges

There was a time when the health insurance requirement for a visa made some reference to having to have coverage that is "roughly equivalent to the national health cover" - but that explanation fell out of favor (probably because no one really understands the national cover until you get here and have lived in the system for a while). Then came the statement (still published on some sites and in some literature) about "0 deductible" - which isn't really practical (considering that the national system here doesn't reimburse 100% of health care costs for most people anyhow). 

The main thing is to make sure the cap on how much the insurance will cover is "adequate" (sometimes there is a figure cited, like "at least $30,000" or something like that) and that you aren't dealing with one of those "large deductible" policies, where the insurer doesn't pay until you're already threatened with bankruptcy.


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