Many English speaking people in France wonder how the French health system works and whether registering a business in France will entitle them to health cover and carte vitale. This article explains how the French health system works and what type of cover entrepreneurs will get.
Health cover for employees and business owners in France
Employees in France pay some social charges contributions on their salary to URSSAF which will go towards their pension, health cover, sickness indemnities and family allowances. Employees are also issued with a French social security number and get a health cover via a body called Caisse Primaire d'Allocation Maladie (CPAM).
This body also known a organisme santé will issue their carte vitale (used for all medical appointments or at the chemist) and will reimbursed their health expenses. With the French system you will indeed pay your doctor and tablets expenses upfront, but will be reimbursed 70% via your health cover.
For the self employed or small business owners in France, your social charges will be paid to URSSAF or RSI, but your health cover will be managed by an organisme santé such as RAM, Harmonie Mutuelle or PreviFrance.
If you are new to France, Urssaf or RSI will create your French social security number for you as part of your business registration, then pass your details onto your organisme santé . This body will in time issue an attestation letter to confirm that you are covered attestation de couverture santé, then your carte vitale. This process can be lengthy, with a two months delay in many situations. You will however be covered from your first day in business.
Health cover and top up insurance for business owners in France
As a French business owner, your health expenses will be covered up to 70%. This means that as for an employee, it is worth taking a top up insurance called assurance santé complémentaire for the remaining 30%. Some expenses such as spectacles or teeth (orhtodontists, crowns, bridges) are not reimbursed at good rates, so it worth having a top up insurance contract.
Sickness indemnities for business owners in France
Sickness indemnities are not systematic for all types of business owners. For instance profession liberales do not receive sickness indemnities and they may sign specific contracts with bodies such as Harmonie Mutuelle to start contributing.
Artisans and commerçants need to have worked for a full year and have reached a certain level of business income, in order to benefit from sickness indemnities after three days of work (when hospitalised) or seven days of work (due to an accident or sickness).
This rule is due to change on 1 January 2018. This delay called délai de carence will be taken down to three days for both hospitalisation and accident/sickness.