Universal health protection
Any person who works or resides in France on a stable and regular basis has the right to have their health costs covered personally and continuously throughout their life: this is the principle of universal health protection.
Universal health protection
Any person who works orresides in France on a stable and regular basis has the right to have their health costs covered personally and continuously throughout their life: this is the principle of universal health protection.
Since January 1, 2016, with the universal health protection (PUMa), any person who works or resides in France on a stable and regular basis has the right to coverage of health costs.
As a result, the conditions for granting rights are simplified:
- employees (and similar) no longer have to demonstrate a minimum activity, only the exercise of a professional activity is taken into account;
- the self-employed (artisans, traders, liberal professions, micro-entrepreneurs...) are also entitled to have their health costs covered from the start of their professional activity.
As for people without professional activity, they benefit from coverage of their health costs solely through their stable and regular residence in France.
Universal health protection thus completes the logic initiated by basic universal health coverage (CMU) in 1999, which aimed to open rights to health insurance to people residing in France on a stable and regular basis, and who were not covered by any compulsory health coverage.
Universal health protection, which came into force on January 1, 2016, is based on several fundamentals.
In practice, to the extent that you work or reside in France on a stable and regular basis, universal health protection (PUMa) guarantees you right to cover your health costs by simplifying your procedures. You will no longer be asked to provide supporting documents, sometimes every year, to assert your health insurance rights.
Universal health protection also allows you to stay in your health insurance plan, including in the event of loss of activity or change in personal situation. Possible periods of termination of your rights are thus avoided.
Universal health protection provides that all adults without professional activity are entitled to coverage of their health costs on a personal basis, as long as they reside in France on a stable and regular basis. They no longer need to be attached to an eligible insured person. Thus, for those aged 18 and over, the notion of beneficiary disappears. Only minors continue to have the status of beneficiary.
In practice, any adult is insured individually from the age of majority (or from the age of 16 at their request). She can choose to receive her reimbursements in her own bank account, receive her own reimbursement statement and have her own ameli account, which guarantees better confidentiality of information on the health costs covered.
Changes in personal situation therefore no longer have an impact on the rights of policyholders without professional activity, which guarantees greater autonomy. Indeed, in the event of marriage, separation or widowhood, the insured continues to have their own rights, independently of their spouse or ex-spouse.
If you are the adult beneficiary of an insured person
If you yourself are the adult beneficiary of an insured person, you continue to benefit from coverage of your health costs without any change.
If you wish, you can request your affiliation as an insured person based on residence criteria from your health insurance fund.
To do this, complete form S1110 Application for entitlement to health insurance (PDF) and send it, accompanied by the requested supporting documents, to your health insurance fund.
To make your request for rights, you must complete the cerfa Form S1106 and send it to the Health Insurance organization of your place of residence, accompanied by the supporting documents requested depending on each person's situation.
You must spontaneously declare your departure abroad. Nothing could be simpler, complete the form Declaration of transfer of residence outside France (PDF) and return it to your primary health insurance fund.
Furthermore, Health Insurance carries out automated exchanges of information with certain administrations in order to detect undeclared departure situations.
As part of these checks, any beneficiary of Health Insurance, with the exception of minors, may receive a letter requesting supporting documents for regularity of stay and/or stability of residence.
A deadline of 30 days is set to provide the requested documents, in order to update your administrative file. In the absence of a response from you, your primary health insurance fund will be required to close your rights to cover health costs and to claim any sums paid from you since the date on which the conditions are no longer united.
Health Insurance regularly sends letters to random checks with all PUMa beneficiaries, whether they are of foreign or French nationality. The control concerns the place of residence since you have to be able to justify 6 months of residence in France out of 12 last months. Indeed policyholders can sometimes forget to report a change in situation professional or personal.
That's why you can receive a request for supporting documents even if you have been in the same situation for several years, retired for example.
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