Can You Use an S1 Form to Cover French Healthcare?

ARTHER CUTLER of Navigate France responds:

There are a number of considerations to take into account when looking at this option, and some are not immediately evident.

Firstly let’s look at what the S1 certificate is. There is a cross-country agreement between France, other EU countries, and some other countries outside the EU (the UK being one). When a person is entitled to an S1, medical costs arising in France can be covered by the issuing country – essentially this means that although medical care is provided in France, another country pays the cost.

However, the S1 only provides the same level of cover as you would receive as a French citizen, which is generally not 100% of the actual cost of medical care. On average, the French healthcare system covers around 70% (but it varies between around 35% and 100%), leaving the patient to pay the balance from their own resources, or via a top-up insurance policy, called a ‘mutuelle’. Some specific major illnesses and treatments qualify for 100% reimbursement.

A UK individual of retirement age is entitled to apply for an S1 certificate from the NHS, and potentially so are individuals with long-term incapacities (note, it is the country of origin that defines this, not France). If one partner of a married couple (or civil partnership) qualifies, but the other does not because they are not yet of retirement age, then the younger spouse automatically qualifies for an S1 certificate by ‘piggy-backing’ from the older spouse’s entitlement.

Entitlement rules applying in other EU countries vary.

The next question is how soon after moving to France does the S1 provide cover, and the answer is not immediately!

It can take months because the S1 has to be registered by the local CPAM office (French healthcare authority), and that is usually not possible within the first three months of arrival. Even after that, it can take several more months to become registered.

To ensure you have health cover for this period, you will need private health insurance and if you also wish to be covered for 100% of actual costs, potentially a top-up policy as well.

Once fully registered, the S1 will provide health cover in France indefinitely. The holder will also still be entitled to full medical care in the country of issue.

In terms of a long-term visa application, an S1 certificate is accepted by the French authorities even though it does not provide immediate cover. However, it is important to take out appropriate private health insurance, because without that, you will have no cover for a considerable time!

Private health insurance policies vary in terms of cover, premiums and whether pre-existing medical conditions are taken into account. Seek alternative quotes and compare cover and cost before deciding.

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