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Claiming free or cheaper top-up French health insurance to get easier

Households claiming certain other benefits will be presumed to have entitlement to ‘Complémentaire santé solidaire’ - we list the four linked benefits

Most people use mutuelle or complémentaire santé top-up insurance in France but CSS helps those who cannot afford it Pic: PeopleImages.com - Yuri A / Shutterstock

New legislation should make it easier for low-income households on certain benefits to claim free or discounted top-up health insurance from 2024.

Complémentaire santé solidaire (CSS) helps to cover medical costs exceeding the basic state reimbursement threshold.

Most people use mutuelle or complémentaire santé top-up insurance for this but CSS helps those who cannot afford it. 

Beneficiaries must still register with a government-approved complémentaire santé, but the state will pay for the company to cover your costs. 

For those whose incomes are not sufficiently low, a financial contribution (less than the cost of an ordinary mutuelle) is required.

Read more: The CSS, France’s free or low cost top-up health insurance

Presumption of entitlement to CSS

Figures released last year showed CSS take-up to be just 44% of those entitled to it. 

To address this, the Social Security Financing Bill for 2024 proposes a simplified allocation of the CSS to most recipients of the:

  • allocation aux adultes handicapés (AAH)

  • allocation supplémentaire d’invalidité (ASI)

  • allocation de solidarité spécifique (ASS)

  • allocation du contrat d’engagement jeune (ACEJ)

“Subject to meeting certain criteria, these groups will henceforth benefit from a presumption of entitlement to CSS with a financial contribution,” the bill states. 

Read more: Why did UK and EU retirees in France get back CSS health top-up?

Implementation over next two years

Individuals will automatically be sent a letter proposing that they are covered by the scheme. 

They will then have to send back the “documents required for payment of the contributions”.

The reform, due for approval by the end of the year, will be implemented gradually, starting with ASI recipients in 2024. 

Those receiving AAH will follow in 2025, and ASS and ACEJ in 2026. 

People on RSA income support are already automatically attributed CSS.

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