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Change from CPAM to RAM


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I've made a similar posting in another section but have had no response so I thought I'd try here; it may be more appropriate.

Husband has registered and has had expected demand from RAM, new carte vitale etc. We're in the middle of paying the CPAM cotisations for the current year.  Do we end up paying twice, does one lot get refunded - what happens to my cover? His RAM attestation only mentions himself as beneficiary.  I have nowt to do with his business.

Also, the Avis d'appel de Cotisation says: cotisation exigible le 01/04/07,  € xxx à regler avant le 01/05/07.  He's hoping this means he has until 1st May to pay as he hasn't paid it yet on the advice of the accountant who was supposed to speak to them & confirm the position. Daily phone calls to her (constantly out of the office) have produced no answer yet.  As much use as a chocolate teapot.


I know there are lots of lovely knowledgeable & helpful folk out there.....



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I changed from CPAM to RAM and had to inform CPAM that I was no longer with them but with RAM, I then had my husband and son added to this RAM listing.  Interestingly on moving recently I have been contacted by CPAM after submitting my address change on the centrl website and they said I was still listed with them, so had to tell them again.

You need to take some advice and I know from experience how much of a nightmare getting hold of an accountant can be, you should make sure you deregister with CPAM though, as soon as poss to avoid any double billing, you should also ensure RAM add you to their listing, I sent a copy of my attestations under CPAM to RAM to confirm that my husband and son should be listed as well as myself.  It's got nothing to do with involvement in the business (my husband is not involved in my business) it's about my dependents and who should also benefit from my cotisations.

Good luck with it,


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Please can someone help.  We have been registered with CPAM at St Lo and since arrival here.  That is fine complimentary assurance as well with Groupama payed our tax last year and monthly payments on account this year.

Someone I met last week said that he was not registered with CPAM.  Please forgive my ignorance but surely everyone must be registered with the system?  If not what please is RAM for this has totally thrown me into a whirl.

Is RAM for those of you who are self employed? and who run businesses?

I was confused before now totally confused.



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There are in fact quite a few health caisses, though CPAM is probably the largest. It is also covers many Brits as it is covers employees and more importantly those with no professional activity.

For the record RAM covers  l’assurance santé obligatoire des professionnels indépendants.




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Hello Bastet,

Your RAM payments will be effective from the day the business was registered. (Yes L, although the CPAM is the principal sickness organisation in France there are others that cover specific sectors, eg; the self-employed and agricultural workers.). It is important therefore to send a copy of your business registration to the CPAM so that you are removed from their books. You are also now covered by RAM as a dependant but clearly you need to get this regularised. If you have a "top up" insurance you need to review this. Some providers give premium reductions to the self-employed and also for the self-employed the premiums can be offset against income tax if the contracts comply with "loi Madelin" - most do.



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Thanks everyone.  The RAM cotisations therefore "take priority" over CPAM, that's helpful.  So much for what the accountant implied.  So presumably, as the  CPAM cotisations we're currently paying were calculated on income from 2005, we will carry on paying these as well as RAM.  

OK, I have to send a copy of the old CPAM attestation to RAM.  If my husband sends back his CPAM carte vitale as requested, will mine still be active until I get a new one when they get around to adding me officially as a dependent?  It's all very confusing.....

Finally, what is the "loi Madelin" please?  

Thanks again.            

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When I changed from being affiliated to CPAM to another caisse on becoming registered self employed it all happened automatically. But that was a few years ago now. As a 'migrant worker' I didn't have a carte vitale, though could pay then claim for refunds, so that simplified it.

As far as your cards are concerned, when your affliation is transferred from CPAM, both of your old cartes vitales will become invalid. They should be returned, if you try to use them they will be rejected by the system. You will receive new cards from your new caisse, which will probably have the same SS numbers as your old ones, but will be issued under a different organisation. You should get two, if you have applied for cards for both you and your dependent spouse.

Until your cards arrive, just pay the doctor, pharmacist etc and get a feuille de soins (the form, usually brown but sometimes green, which is your official receipt). Send these to your caisse and you will get refunded, just the same as with the card. All the card does is simplify and speed up the process.

As Owen indicated, the loi Madelin means that if you have a top up insurance that qualifies under the law, the premiums can count as an allowable business expense. Your new caisse will no doubt try to sell you its own top ups, and may put pressure on you by making it difficult for you to use your old one, but there is no reason why you cannot keep it if you are happy with it.

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