A Guide to the S1 Form in France
This comprehensive guide will cover the S1 form – an important document for many seeking to establish their lives in France – outlining its purpose, eligibility, application process, and significant advantages, particularly for those arriving from the UK.
- The S1 Form: Your French Healthcare System Gateway
- Pension and Investment Income: The Financial Benefits of the S1 Form
- The S1 Form in a Post-Brexit World for UK Nationals
- UK Citizens in France and EU Healthcare Rights Post-Brexit
- Retiring to France After Brexit: S1 Eligibility Still Available
- When You Might Not Need an S1 Form
- The S1 Application Process |Access Healthcare Services:
- Important Considerations and What to Expect in French Healthcare
- Understand the purpose and eligibility requirements of the S1 form in France.
- Learn how the S1 form grants access to France's healthcare system and its benefits for pensioners and dependents.
- Discover the financial advantages of the S1 form, including exemptions from social charges on pension and investment income.
- Gain insight into the step-by-step process for applying for and registering the S1 form in France.
- Explore how the S1 form impacts UK nationals post-Brexit and the healthcare rights available to them in France.
The S1 Form: Your French Healthcare System Gateway
The S1 form, formerly known as the E121, serves as a certificate of entitlement to state healthcare in another European Union (EU) country, or in the case of the UK, under specific post-Brexit agreements. Essentially, it's an agreement that your home country will cover your social security contributions, thereby granting you access to France’s robust state healthcare system, known as Assurance Maladie.
This vital document is typically issued by the social security authority of the country where your state pension is held. For UK nationals, the NHS Business Services Authority is the issuing body. The S1 form is particularly relevant for:
- Individuals in receipt of a state pension from their home country (e.g., the UK).
- Those posted to France by a home-country employer.
- Dependents of someone who qualifies for an S1.
Pension and Investment Income: The Financial Benefits of the S1 Form
While the primary benefit of the S1 form is access to healthcare, its advantages in France extend significantly into financial planning. One of the most compelling reasons for S1 holders to obtain this document is the exemption from French social charges (prélèvements sociaux) on their pension income. These charges can be substantial, historically up to 9.1%. This exemption can lead to considerable savings, allowing you to retain more of your retirement income.
Furthermore, for S1 holders in France, there's a significant reduction (9.7%) in social charges levied on investment income such as bank interest and dividends, rental income, and also on capital gains made on the sale of property or investments. This makes the S1 form an invaluable tool for optimising your investments in France, ensuring your wealth is preserved and grows efficiently.
It is important to understand, however, that while the S1 exempts you from French social security contributions and related social charges on pension income, it does not mean healthcare in France is entirely free. The French health system typically covers a percentage of basic health charges, which can range from 35% at the bottom end to 100% for major illnesses. Therefore, we always recommend taking out voluntary "top-up" health insurance (known as a mutuelle) to cover the remaining costs and any residual expenses not picked up by either the social security system or most voluntary health insurance plans.
Definition: What are French Social Charges?
Prélèvements sociaux are a series of social security taxes or contributions that individuals pay on their income, including wages, pensions, investment income, and capital gains. These charges are designed to fund various social programs, such as healthcare, pensions, and family benefits, and are an essential part of the French social security system.
The S1 Form in a Post-Brexit World for UK Nationals
Brexit introduced significant changes for UK citizens wishing to retire to France, particularly concerning the right to freedom of movement. However, the good news for many is that the S1 form remains accessible.
UK Citizens in France and EU Healthcare Rights Post-Brexit
If you were a UK citizen living in France (or another EU country) before December 31st, 2020, your healthcare rights are protected under the UK-EU Withdrawal Agreement. This means:
- If you already have an S1 form, the UK will continue to cover your healthcare costs while you remain resident in France.
- If you were living in France before the deadline but hadn’t yet obtained an S1, your rights are still protected, as long as you were eligible for an S1 before Brexit.
A key benefit under the Withdrawal Agreement is that you retain access to NHS services in the UK. This is not the case for S1 holders who moved after Brexit. You can use the NHS by showing your special UK EHIC or S1 documentation.
Retiring to France After Brexit: S1 Eligibility Still Available
If you moved to France after December 31st, 2020, you’re not covered by the Withdrawal Agreement. However, you may still be eligible for an S1 form if you're receiving a UK State Pension.
The UK continues to issue S1 forms to pension-age retirees moving to France, and this policy remains unchanged since Brexit.
Top Tip
Apply early! If you're a UK national planning to move to France, you can apply for the S1 up to 90 days before your move. It's advisable to apply as early as possible to ensure timely processing, especially if you require it for visa or residency applications. If you're moving with dependents, ensure they are also included in your S1 application. Their coverage will be contingent on your S1 registration
When You Might Not Need an S1 Form
Living and Working in France Before Retirement: S1 Eligibility
If you live and work in France before reaching retirement age, you're unlikely to qualify for an S1 form. This is because you'll be part of the French healthcare system, paying social security contributions in France. When you retire, you'll receive a French pension, and your healthcare will continue to be covered by the French system.
However, there's an important exception:
If you've spent most of your working life in the UK and later move to France before retiring, you may become eligible for an S1 once you start receiving your UK State Pension.
The S1 Application Process |Access Healthcare Services:
A Step-by-Step Guide
The process of obtaining and registering your S1 form involves distinct steps in both your home country and France.
Step 1: Requesting the S1 Form from Your Home Country
The first step is to apply for the S1 form from the country responsible for your state pension. For UK nationals, this can be done once you start receiving your UK State Pension.
For UK Nationals:
Contact NHS Overseas Healthcare Services (part of the NHS Business Services Authority)38383838.
You can reach them by telephone at +44 (0)191 218 1999 (Monday-Friday 8 am-6 pm GMT) or by email at ohsregistrations@nhs.net or s1applications@nhsbsa.nhs.uk.
You will need to provide your National Insurance number and proof of your pension or benefit entitlement.
The S1 certificate will then be posted to your French address.
If you are already receiving your UK State Pension and planning to relocate, it’s recommended that you apply for your S1 form at least 28 days before your move. The NHS has stated that the S1 application should be submitted 90 days before departure from France. However, it's worth noting that it might not always be possible to receive your S1 prior to your visa application being submitted, which may necessitate private health insurance for the visa process. It's advisable to enquire with the Overseas Healthcare Services about their processing times.
For individuals who have worked in multiple EU countries, the country in which you have worked for the longest period will generally be responsible for your healthcare during retirement, and this is the country from which you should request an S1.
Step 2: Registering the S1 with Your Local CPAM Office in France
Once you have your S1 form, you must send it to your nearest CPAM (Caisse Primaire d’Assurance Maladie) office in France for registration. This process is essential to confirm your S1 registration and activate your entitlement to healthcare under the French system.
Complete the Demande d’ouverture des droits à l’assurance maladie form.
Gather the necessary documents, which typically include:
Your valid passport.
Proof of address in France (e.g., a utility bill or rental contract).
Your S1 form.
Your birth certificate and any other civil status documents, with certified translations if required.
Submit these documents by post (preferably lettre recommandée, avec accusé de réception - recorded delivery with confirmation of receipt) or in person to your local CPAM office. Keeping a good quality copy is essential as duplicates can be difficult to obtain.
Processing times can vary, but it usually takes a minimum of one month for your application to be reviewed. In most cases, you’ll receive a temporary social security number within three months, which allows you to access French healthcare services while your full registration is being finalised.
Step 3: Applying for Your Carte Vitale
After your S1 is processed and you receive your French social security number (which is your unique ID for the French system) , the next step is to apply for your Carte Vitale, France’s national health insurance card. This card is essential for facilitating healthcare reimbursements.
Documents and Steps for Carte Vitale Application:
A passport photo (in digital format).
Your social security number.
A copy of your passport and proof of residence.
Expect a processing time of around 4 to 8 weeks after your social security number has been issued.
Important Considerations and What to Expect in French Healthcare
The Médecin Traitant (Primary Care Doctor)
Once registered with the French healthcare system, it is highly recommended to register with a médecin traitant (primary care doctor). This ensures better reimbursements for your medical expenses and improved coordination of your care.
Healthcare Costs and Top-Up Health Insurance Cover (Mutuelle)
As mentioned, while the S1 provides access to state healthcare, it does not cover 100% of all medical costs. The French system operates on a reimbursement basis, meaning you pay for your treatment upfront, and a portion is then reimbursed. The amount reimbursed varies depending on the treatment and whether you have a médecin traitant. To cover the remaining costs and potentially access private facilities or services not fully covered by the state, obtaining a mutuelle (supplementary health insurance) is highly advisable.
Healthcare in the UK for S1 Holders Resident in France
For S1 holders who moved to France after December 31st, 2020, you are generally no longer entitled to use NHS services in the UK. The UK’s NHS is a residency-based service, and therefore, once you move to France, you give up your rights to healthcare in the UK. However, you can still apply for a French European Health Insurance Card (EHIC), granting you access to emergency and "necessary" care whilst visiting the UK.
Dependent Spouses and Incapacity Benefits
A "dependant" spouse of someone reaching State retirement age is also granted cover under an S1. This typically includes all those in a married relationship or in a civil partnership. Thus, even though your spouse may have an independent source of income, they would be admitted as a dependent. The decision as to who is dependent is not made by the French authorities, but by your country of origin. If the S1 holder dies before their dependent younger spouse reaches retirement age, the surviving partner will continue to retain health cover through the S1 for 12 months.
For individuals in receipt of long-term incapacity benefits from their home EEA country, such as the UK's Employment and Support Allowance (ESA), they may also be entitled to an S1 form, provided they meet certain criteria and undergo periodic assessments by a French doctor. Those suffering from a long-term or major illness (classified as an Affection de Longue Durée – ALD) may find that 100% of the costs of the treatment of this illness are covered by the French social security system.
How An S1 Can Bring Both Health Cover And Income Tax Benefits
The S1 form is undeniably a cornerstone for many seeking to establish a fulfilling life in France, particularly for retirees and those with specific benefit entitlements. At The Wealth Genesis, we emphasise that a smooth transition involves meticulous planning across all aspects of your financial and personal well-being. By understanding the S1 form's purpose, navigating the application process, and being aware of its significant financial benefits, you can unlock access to one of the world's most reputable healthcare systems and optimise your financial position in France.
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