What is France’s PUMa healthcare system and am I eligible?

What is France's PUMa healthcare system and am I eligible?
Accessing medical treatment in France could be about to get a lot more complicated. Photo: AFP
After Brexit many British residents in France may need to register for the PUMa healthcare system - but what is it?

Unlike the NHS, which is free at the point of delivery, in France healthcare costs – whether it's a doctor's appointment or a prescription or medical procedure – are paid for up front by the patient. 

READ ALSO 'A massive betrayal' – UK's no-deal Brexit healthcare pledge for pensioners in the UK sparks fury

After a medical consultation in France you will need to pay the doctor, then swipe your card to get the costs refunded. Photo: AFP

The patient is then refunded some or all of the cost, but who refunds it and how it happens depends on your individual circumstances and the scheme you belong to.

If you are working in France you are entitled to have most of your healthcare costs refunded by the state – you can find out more about that here, but it operates on the simple principle that you pay taxes or social charges in France, therefore you are entitled to state healthcare.

But if you are not working the picture is a little more complicated. 

Since January 1st 2016, France has had Protection Universelle Maladie (universal sickness cover) commonly abbreviated to PUMa.

PUMa is based on residency – so as long as you have been legally resident in France for three months you are entitled to register for it.

British pensioners in France are eligible for the S1 scheme whereby the UK covers their health costs. The S1 also offers cover to people on certain types of disability benefits, some posted workers and students.

But people who have not reached UK pension age and are also not working fall into something of a grey areas, and that area is covered by PUMa.

To get yourself registered with PUMa you can download the form here and begin the process of applying. Documentation is likely to vary according to your situation, but you will definitely need to supply a passport, birth certificate and proof of a stable residence in France – for example a rental contract, house deeds and utility bills.

Be warned – the process is not a speedy one. It varies from place to place but many people wait six months or longer for their application to be processed – although if you need healthcare in the meantime you can ask your doctor to supply a feuille de soins (type of receipt) and get the costs reimbursed once you are in the system.

Another drawback is that although it entitles you to free or greatly reduced medical treatment other charges do apply.

Once you are in this system you will have to start paying the social charge that French pensioners do. This adds up to around 9-10 percent of pension income, and anyone with other capital income of more €20,262 a year – for example from investments or rental income from the UK – faces other charges.

One final note – this is only open to people who are permanent residents in France.





Member comments

Become a Member to leave a comment.Or login here.