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Maintaining Health Cover


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I am trying to weigh up our options of maintaining our healthcare cover having lived in France for less than 5 years. We have lived in France for 3 years 4 months, and have obtained our healthcare via my wife’s E121 due to ill health, not being of retirement age. As there is the possibility that her E121 could be withdrawn anytime in the imminent future I need to try and ensure we stay within CPAM. As private health cover is not possible, due to her many pre existing conditions, I know the other option is to obtain employment or start up a business.

Having spoken to an accountant I am a little confused with the information that I received and I would appreciate any comments you may have regarding the information that was relayed to me by the accountant.

I was told that entry into CMUB would not be granted after 5 years of residency if you have not paid into the into the system for 5 years via employment. You cannot combine say for example 3 years of health cover via an E form, and 2 years via an AE business, does anybody know if this is the case. I thought it was just a matter of remaining legal for 5 years either with an E form, private health cover or employment, to be granted entry into CMUB after 5 years if you wished to remain an ‘inactive’.

Also if you are paying into CMUB the 8% social charge is based on a minimum of €32,000 a year, I am pretty sure people I have never seen that written anywhere, and I think this would have had its own thread on these boards by now if it was the case.

Hope you are still with me, also I was informed you have to wait 12 months for a social security number to be granted if registered as an AE before access to CPAM is granted, again I have not read that anywhere, and I thought your number was issued when you register your AE business.

Sorry for all the above questions but as it is such a serious and worrying matter I need to try and get things sorted clearly within my own mind as to how we can maintain our health cover. I know in theory entry into CMUB before the completion of 5 years residency should be allowed after the recent EU ruling, but nobody anywhere I have read seems to have had any success on that front, although if the need arises I guess that will have to be our first port of call and hope our local CPAM office will grant us entry.

Another question that has puzzled me is when does the 5 year residency period start from, is it when you register yourself with the French tax authorities, as we did the day after we arrived in France, or from when you first registered with CPAM?

I really would appreciate any feedback anybody has on all the above points I have raised, and apologize for such a long thread.

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Back in the day, this was one issue which the health minister would not resolve (two of the other founders of FHI, both former forum members, had IB E121s and had a similar worry to yours).  However, I am of the opinion that the "accident de Vie" rules would be a good route for you.  You are so very nearly there and even if your IB is withdrawn in the future, it sounds as if you may have a bit more of a grace period from that (you can appeal, plus your wife needs to go before a medical panel here and this all takes time)

Of course you are entitled to get into CMU -B after 5 years.  It's European law.  Your "I have been told" person is talking... (well, they're round, and they bounce.)  5 years (legal living)from the date you took up residence (provable "by any means") is all it takes.  I'll find the reference for you later.

The 8% of income is not a social charge it's a cotisation.  That's what the 8% figure is about.  As being "a la charge" of the French system, you will pay o.5% (I think that's right) of your pensions and more on "unearned" income like shares/rentals etc on top.  Sunday and others are better at those things than I.  I do all this, and this is what I pay and have paid for 7 years. 

The info' about the so-called "new rules" is patchy but one thing which they have clarified are the Accident de Vie regs.  I'd say you have a good case.

I'll look into all this a bit more though and find some more documentation for you, but I've just got home after an op'.

 

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cooperlola said: 'The 8% of income is not a social charge it's a cotisation'

 

Strange you should say that Coops. I was on the phone to the CNAV the other day, the cheeky sow telephone call. I mentioned 'cotisations'  and she was off hand and put me right and said  'les charges sociales'. I don't care what they call it, I just know that payment has to be made.

So what do you make of that then? Has anyone ever called it that to you? I cannot remember it being said before.

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[quote user="Grecian"]I am trying to weigh up our options of maintaining our healthcare cover having lived in France for less than 5 years. We have lived in France for 3 years 4 months, and have obtained our healthcare via my wife’s E121 due to ill health, not being of retirement age. As there is the possibility that her E121 could be withdrawn anytime in the imminent future I need to try and ensure we stay within CPAM. As private health cover is not possible, due to her many pre existing conditions, I know the other option is to obtain employment or start up a business.

Having spoken to an accountant I am a little confused with the information that I received and I would appreciate any comments you may have regarding the information that was relayed to me by the accountant.

I was told that entry into CMUB would not be granted after 5 years of residency if you have not paid into the into the system for 5 years via employment. You cannot combine say for example 3 years of health cover via an E form, and 2 years via an AE business, does anybody know if this is the cas
e. I thought it was just a matter of remaining legal for 5 years either with an E form, private health cover or employment, to be granted entry into CMUB after 5 years if you wished to remain an ‘inactive’.

Also if you are paying into CMUB the 8% social charge is based on a minimum of €32,000 a year, I am pretty sure people I have never seen that written anywhere, and I think this would have had its own thread on these boards by now if it was the case.

Hope you are still with me, also I was informed you have to wait 12 months for a social security number to be granted if registered as an AE before access to CPAM is granted, again I have not read that anywhere, and I thought your number was issued when you register your AE business.

Sorry for all the above questions but as it is such a serious and worrying matter I need to try and get things sorted clearly within my own mind as to how we can maintain our health cover. I know in theory entry into CMUB before the completion of 5 years residency should be allowed after the recent EU ruling, but nobody anywhere I have read seems to have had any success on that front, although if the need arises I guess that will have to be our first port of call and hope our local CPAM office will grant us entry.

Another question that has puzzled me is when does the 5 year residency period start from, is it when you register yourself with the French tax authorities, as we did the day after we arrived in France, or from when you first registered with CPAM?

I really would appreciate any feedback anybody has on all the above points I have raised, and apologize for such a long thread.[/quote]

I am sure that entry into the CMU does not depend on having worked.  If you had you would probably be in the standard system anyway.

Equally, once you start an AE business you get into the system even if you have paid in very  little

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True, you have to pay it, regardless, Idun.  However, from Grecian's point of view, I thought it was important that he appreciated the difference in this particular case as perhaps it's why he feels this has never been addressed on here.  Anyway, HERE IT IS

  • "Payante si votre revenu fiscal de référence est supérieur à 9 029 €.
    Vous devrez alors payer chaque trimestre à l'URSSAF une cotisation dont le montant s'élève à 8 % du montant de votre revenu fiscal dépassant le plafond. Cette cotisation est due à compter du 1er jour du trimestre civil suivant la date de votre affiliation à la CMU de base.
    Exemple : pour un revenu fiscal de 10 509 €, le montant dépassant le plafond fixé est de 1 480 €. La cotisation est donc égale à 8 % de 1 480 €, soit 118,40 € annuels."

    The 8% is referred to as a cotis.  Who am I to argue?

    On this forum at least, I'm used to seeing "social charges" as the blanket term for the TAX (paid for annually - usually a week or two ago) we pay on unearned incomes etc. which is not payable for those whose healthcare bill is picked up by the UK.

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    [quote user="idun"]Yes, I'm used to seeing 'cotisation' too and so this rude functionnaire surprised me with her 'charges sociale'.[/quote]Both rude and ignorant, perhaps?[Www]  In my limited experience, the two so often go hand in hand!  Perhaps one is being used to cover the other up?[:)]
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    [quote user="cooperlola"]

    Of course you are entitled to get into CMU -B after 5 years.  It's European law. 

    [/quote]

    Better than that, it's French law....[;-)]

    For Grecian's wife to be able to invoke the 'accident de vie' provision over the loss of her IB E121, she'd likely have to show that the withdrawal of the benefit was an unforseen event.  In other words, she didn't expect to 'get better' and thereby lose it.  If the only remaining option open to her is to purchase private health cover, then having pre existing conditions which preclude this option would also count in her favour.

    But as you say, appeals against an IB withdrawal can take a while......

     

     

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    For what it's worth, here's the EU version, anyway:

    http://ec.europa.eu/youreurope/citizens/residence/worker-pensioner/rights-conditions/index_en.htm

    My point really, SD, is that the FG was forced to acknowledge this because of the European legislation.  The five year rule ended up in the French rules because they had no choice, in spite of trying all they could to ignore European law and exclude it.

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    Thank you all for your swift replies.

    I really did think I had been given false information regarding the 5-year rule and having to have worked the 5 years to qualify for entry into CMU-B. Also regarding the qualifying period for health cover if starting an AE business.

    Coops and SD in respect to my wife's IB E121 at the moment she has only just sent back her completed form, so I know things can take a while to materialize, and there is the option of an appeal, although I do not know what will happen to her E121 whilst she appeals any negative decision. Whilst I can see and know she is not fit to work, and there is no prospect of any of her problems ever getting better, unfortunately now the system is now heavily stacked against genuine sick and disabled people, and I feel I must try and have a ‘plan B’ so to speak if the situation arises. I will certainly try the Accident de Vie line if I am faced with the situation.

    If anybody is really interested the current government is transferring everybody who is on IB to a new benefit named ESA, via a much harsher and practically impossible test to pass to be placed in the top group, where the recipient will be left alone, and things will carry on for that person as they are now. If you are placed in the bottom group you will be means tested, and if you have been stupid enough to have saved more than £16,000 you will be deemed fit for work and your benefit will stop after 12 months. If on the other hand you have blown the lot, and have no savings and are placed in the bottom group you will be deemed unfit for work, and your benefit will continue indefinitely. What a crazy system, but there you go that’s why I need a ‘Plan B’.

    Hope you are going on OK Coops God knows you have had enough dumped on you, a bit like my wife really although differing circumstances for her.

    Once again thank you for all your replies.

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    [quote user="Grecian"]. . . . Also if you are paying into CMUB the 8% social charge is based on a minimum of €32,000 a year, I am pretty sure people I have never seen that written anywhere, and I think this would have had its own thread on these boards by now if it was the case. .[/quote]

    I suspect this is a bad interpretation of one part of the affiliation rules on the AMELI website:

    "En l'absence d'éléments permettant de procéder au calcul de votre cotisation, vous pourrez être taxé d'office par votre caisse d'Assurance Maladie sur la base d'une assiette fixée à 5 fois le plafond annuel de la sécurité sociale (35 352 € au 1er janvier 2011)."

    I notice that AMELI calls it a cotisation [:)]

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    [quote user="Grecian"]. If anybody is really interested the current government is transferring everybody who is on IB to a new benefit named ESA, via a much harsher and practically impossible test to pass to be placed in the top group, where the recipient will be left alone, and things will carry on for that person as they are now. If you are placed in the bottom group you will be means tested, and if you have been stupid enough to have saved more than £16,000 you will be deemed fit for work and your benefit will stop after 12 months. If on the other hand you have blown the lot, and have no savings and are placed in the bottom group you will be deemed unfit for work, and your benefit will continue indefinitely. What a crazy system, but there you go that’s why I need a ‘Plan B’. .[/quote]Your wife's panel though, will be here, afaik, not in the UK, thus they may well consider her disability to be sufficient when the UK would not.  Hopefully there are enough avenues of appeal to take time to get you to five years - in the meantime, whilst an appeal is in progress, I am pretty sure that your benefits cannot be withdrawn in the meantime but I'd need to find chapter and verse on that one for you (I'm pretty sure it's somewhere on the Amelie website.)
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