Social Security

• General principles  

Everyone working in France must contribute to the French National Health Service and everyone (French or not, working or unemployed, child or retired, legal or illegal immigrant) is entitled to benefit from it with no exception. In fact, if you don't qualify for the social insurance scheme (Assurance Maladie), you can obtain health coverage through the universal health coverage scheme (Couverture Maladie Universelle: CMU). The system is threefold: Health, Family and Retirement, each of them has different structures and financing (each of them is financially autonomous). The Social Security structure is managed on a parity basis: each regional organization (Caisse) is managed by a board composed 50/50 of representatives of labour unions on one side, employers associations on the other side, with the State playing the role of a referee. The financial contribution of the patient is limited and most of the funding is public. 

• The health insurance

The health insurance (Assurance Maladie) is based on the concept of providing a large amount of help for any medical need, and total help when it is serious: on the basis of a standard cost, you get 70% of the cost paid for medical care (doctors appointments and visits, dental care, medicine etc..) when corresponding to a real medical need; to 40% for less needed and of course 0% for others. Serious illnesses, are covered 100%.

Standard cost for a general practitioner is € 21 but sometimes, they can charge more. Each doctor has the right to fix the amount of its own fees.

• The family allowances

The family allowances (Allocations Familiales) is a financial help to all families (whatever their income) plus various services such as day-care or vacation centres (according to income). For example, a family can receive around € 100 per month for each child (from two children) until the child is 20.    

• The pension scheme (Assurance Vieillesse)

This national system provides a minimal pension (about 50 to 55 % of the income) to any person who has worked 40 years. The system is based on the concept of "repartition", instead of "capitalization". Each year, it distributes what has been collected among the working population: it is, therefore, sensitive to demography and employment (less people, less money) but disconnected from the financial market. In France, the general rule is that you must retire at age 65 and you can retire from age 60, as long as you have worked 40 years. However in some professions, people can retire as early as 55 (public transport) or even 50 (bus or train drivers, miners...) and many early retirement public programs have been established. Women gain two years per child.

• Supplementary insurances

Of course a company can offer to its staff any system in addition to these national systems of health insurance and retirement pension.

• Access to the Social Security for foreigners

Foreign nationals can benefit from the social insurance scheme. However you must fulfil certain conditions and the procedures to register for the social insurance vary slightly depending on your personal situation, among other things your nationality. If you are a EEA citizen, you can get health insurance:       - with your European Health Insurance Card (EHIC) if you travel or study in France. See the "Entering the country" section.       - by registering for the social insurance scheme on the same conditions as French people if you are working. How to register? The employer is normally responsible for enrolling all employees, however you should make sure that your employer has done so. If not, the place to enrol is at your Local Sickness Insurance Office (CPAM). You should do this within 8 days of the date you started to work. If you are working in France for the first time, you will receive an identification number. This is a permanent number which you will keep for the rest of your life. It contains 13 digits. If you have already been given a number, even if it was many years ago, there is no need to ask for a new one. Once you have enrolled and received your social insurance number, you will get a computerised medical card called "Carte Vitale". The card serves as proof that you qualify for benefits under the social insurance scheme. The Vitale card is green and contains a computer chip. It is valid for three years. You need it in hospitals, clinics or medical centres to prove that you qualify for benefits and to obtain refunds. You also need to show the card at the doctor's and for other types of treatment (pharmacy, physiotherapist, dentist, speech therapist...).   If you're not from the EEA, you can enrol in the French social insurance scheme as long as you are a legal resident.       - As a student, you will need to provide your temporary residence permit stamped "student" and you will enrol in one of the two social insurance schemes for students (Sécurité Sociale étudiante; see links below).       - As a worker, you will need to provide your residence permit (a temporary permit stamped "salaried employee" or a long-term residence permit). Depending upon which country you come from, you will also have to produce proof of identity (passport, special document for border residents, etc.). If you don't qualify for the social insurance scheme, you can obtain health coverage through the universal health coverage scheme (CMU). As of 1 January 2000, anyone living in France as a stable, regular resident is legally entitled to social insurance coverage for health costs. You are eligible for Universal health coverage if      - you are living or intend to live for more than three months in France      - you live in France on a regular basis (for foreign nationals)       - your income is less than the amount shown below  

 To get the CMU, contact your Local Sickness Insurance Office (CPAM) who will give you an application form to apply for universal health coverage (CMU) (see link below).Source: CIDJ