In addition to the basic entitlements under France’s state health care system that come with French social security membership, most people choose to pay for additional insurance to cover costs not covered by the state. Select.
this is Mutuel again complementary sante Offered by either a non-profit organization or an insurance company.
But France has a ‘free top up’ system to help those with little money.
current scheme, Complémentaire santé solidaire (CSS) has been around since late 2019, replacing the two previous programs.
these are Couverture Maladi Universe Complementaire (CMU-C) and Aide pour une complémentaire santé (ACS). Both CMU-C and ACS assisted medical expenses above basic state reimbursement thresholds that are typically recovered in Carte Vitale.
The CSS program aims to improve two old aid regimes by extending the existing aid system to more low-income people.
Read more: Explained by: French medical terms you should know
Where is CSS applied?
As with previous programs, CSS also applies to doctor’s visits, prescription pharmacies, blood laboratories, etc., and hospital admissions.
CSS beneficiaries are exempt from paying fees to doctors, dentists, and paramedics (nurses, physical therapists, etc.).
Pharmacies, medicines and medical equipment (canes, wheelchairs, bandages, prosthetics, etc.) are also covered, and most eyeglasses, dentures and hearing aids are now available free of charge to beneficiaries.
How does the CSS system work?
Under the new CSS system, eligible recipients will still be required to register for government approval. complementary santeand the government pays the company to cover your expenses.
You don’t have to pay upfront, and your doctor won’t charge you for depassman.
Read more: How much does hospitalization cost in France?
Please note that not all health insurance companies are approved to administer CSS benefits. To find a list of government-approved insurance companies in your area that can underwrite your application, please refer to our searchable database available here.
Who is CSS for?
Eligibility for CSS is based on income level and membership in the French health system.
Unfortunately, France last year suspended CSS eligibility for people (mainly pensioners) whose medical costs are covered by another EU state or the UK under the S1 health certificate scheme. There has been speculation that scrutiny of post-Brexit rules may have played a role in force at this point, whereas in the past this has not been the case.
Groups that help foreigners in France have suggested the change could be argued to be discriminatory, suggesting that those involved would apply and be denied. should dispute thisHowever, so far we have heard there is no change in policy.
Otherwise, CSS is free for those who qualify and have the lowest income. For others whose income is not considered low enough, financial contributions will be required, but less than the full cost of obtaining regular insurance. Mutuel.
The income level and age of the applicant are taken into account when calculating this contribution.
Anyone with an RSA Income Assistance benefit automatically Complémentaire santé solidaire (CSS) Because it turns out that too few people are picking it up.
In addition, access for pensioners using the Aspa pension top-up will be “facilitated” and will automatically be sent paperwork authorizing them to sign up.
Beneficiaries of government CSS programs are required to pay a small contribution once their income reaches a certain level. In that case, premiums are calculated based on income and age.
Donations to CSS are guaranteed not to exceed a maximum of €1 per person per day.
Additional costs may not be covered by CSS if you choose to consult a doctor outside of normal business hours, if the doctor pays for the visit, or if the doctor determines that the consultation was unreasonable.
What is the maximum benefit income?
A household with an annual income of €9,571 or less receives CSS coverage free of charge, while a household with an annual income of €12,921 or less receives CSS coverage for a fee.
On the other hand, two-person households with an income of up to €14,357 are entitled to CSS coverage free of charge, and married couples with an income of up to €19,381 are eligible for paid coverage. For large families, the ceiling will rise accordingly.
These figures relate to members of your household, including spouses, civil partners, informal long-term partners, and dependents.
Eligibility is based on actual amounts received in the previous 12 months before the application was made, but excludes some forms of income such as certain social benefits (see below for details). (see form link in ).
Please tell me how to apply for CSS.
You can apply for your CSS online through your Ameli account below. Mes demarches Or directly at your local Cpam.
To apply for CSS, you must complete Cerfa form nº 12504*08 describing your household and family income.
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