Go Back  British Expats > Living & Moving Abroad > Europe > France
Reload this Page >

Healthcare conundrum

Healthcare conundrum

Reply

Old May 16th 2018, 3:42 pm
  #1  
Just Joined
Thread Starter
 
Joined: May 2018
Posts: 4
C.K. Dexter Haven is an unknown quantity at this point
Default Healthcare conundrum

Hello everyone.

I have a healthcare conundrum.

We moved to France from the UK in 2010. My partner immediately became an auto-entrepreneur, and set about earning an income whilst I began the somewhat necessary renovation of our chosen hovel, at the same time slipping nicely into the role of house-husband. My partner's income has been sufficient to meet our needs ever since; I have no income of my own from any source.

We were not married or otherwise officially partnered when we move here. My partner duly got her carte vitale through her auto-entrepreneur status, and I got mine via her as an 'ayant droit'.

Now, two things.

First, I believe that the status of 'ayant droit' is no longer granted. Should this have had any impact on my right to a carte vitale under our current circumstances? In practice, it doesn't seem to have had any repercussions so far.

Second, I now intend to become an auto-entrepreneur in my own right. Would this mean that I would be issued a new carte vitale in place of the old one?

I can foresee unintended consequences here. I am unlikely to turn over a great deal in my first few years, if ever (maybe a few thousand euros p.a. to start with). I would have to register as an artisan (my line would be in arts & crafts, but not fine art), at which point I believe my income would then be counted as 50% of my turnover. This is clearly unlikely to be a huge amount, and I have heard mention that if ones income is less than a certain amount, one might be expected to pay additionally to PUMA.

This is where my understanding fails me. Have I begun to grasp this correctly? I'm not sure if my current position is even regular, and if it is, I'm not sure if I'm about to disadvantage myself by changing my status.

Third (of two). We got Pacs'ed a year ago, if that has any relevance at all.

If anyone can help me clarify this, I will be eternally grateful!
C.K. Dexter Haven is offline  
Reply With Quote
Old May 16th 2018, 4:48 pm
  #2  
BE Forum Addict
 
Joined: Jan 2012
Location: Dépt 61
Posts: 3,488
EuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond repute
Default Re: Healthcare conundrum

You seem to have understood it correctly
As you say, the ayant droit status is being phased out and every adult is now covered individually. Since 2016 no adult joining the health system has been given this statut, and those who already held it have been allowed to continue until the cut off date which I've forgotten what is, maybe 2020 or maybe sooner, I'm sure you'll find it if you google, probably on the ameli website.
As you also say, in some circumstances an additional payment is due. Basically the intention of PUMA is to spread the burden fairly so that everyone pays in according to their means. Where a person / household has paid cotisations on a very low amount of earned income but also has a sigificant amount of unearned income on which no cotisations have been paid, this obviously means that what they've paid in is out of kilter with their ability to pay, so to bring it into line, there is an extra calculation levied on the unearned income. If the person or household has no unearned income then no payment will be due. Again you'll find full details of how it's calculated on the ameli website, it's a two tier calculation and is quite complex.
.
In your circumstances, from what you've said; I would think the chief thing is to ensure that you're ticking the boxes to show that you are correctly exercising freedom of movement, in preparation for Brexit. Hopefully the authorities will be sympathetic, and as long as a person's / household's tax forms show a reasonable income since they've been here, or for the previous 5 years, there shouldn't be any problem. Although if a person / household literally only turns over a few thousand € a year and that is all they have to live on, I'm not sure if that would be sufficient for a carte de séjour. If an activity is seen as a hobby business rather than a genuine income then the person could be classed as inactif rather than self employed, and as such would have to meet the self-sufficiency criteria for inactifs, But how it will all be administered in practice when and if the time for applying for cartes de séjour arrives, is anyone's guess.

Hope this helps, I'm not really sure what you're worrying about.
EuroTrash is offline  
Reply With Quote
Old May 16th 2018, 5:18 pm
  #3  
Born again atheist
 
Novocastrian's Avatar
 
Joined: Jul 2005
Location: Europe (to be specified).
Posts: 29,680
Novocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond reputeNovocastrian has a reputation beyond repute
Default Re: Healthcare conundrum

Originally Posted by EuroTrash View Post
If an activity is seen as a hobby business rather than a genuine income then the person could be classed as inactif rather than self employed, and as such would have to meet the self-sufficiency criteria for inactifs, But how it will all be administered in practice when and if the time for applying for cartes de séjour arrives, is anyone's guess.

Hope this helps, I'm not really sure what you're worrying about.
Another excellent and helpful post ET. The bolded bit interests me (although my circumstances are very different from the OP's).

Can you give me a link to the self-sufficiency criteria please?
Novocastrian is offline  
Reply With Quote
Old May 16th 2018, 5:26 pm
  #4  
Just Joined
Thread Starter
 
Joined: May 2018
Posts: 4
C.K. Dexter Haven is an unknown quantity at this point
Default Re: Healthcare conundrum

Originally Posted by EuroTrash View Post
Hope this helps, I'm not really sure what you're worrying about.
Oh, I worry about everything! We try hard to keep all 'i's dotted and 't's crossed. We are extremely happy here, and would hate to upset the apple-cart simply because I/we didn't understand what was expected of us.

We have no unearned income. But my partner (what do you call a pacs'ed person - a pacsee?) does earn well, and her income I'm sure would be seen as plenty sufficient for the two of us to live perfectly happily without recourse to state funds. So I hope what you're saying is that even if my putative activity is seen more as a 'hobby business', our joint income should put us in a position where no-one will have a problem? As a pacs'ed couple, we now enter a joint tax return, although up until this year we had put in individual returns (with me simply stating a big, fat zero as my income).

Certainly one reason for going ahead with my auto-entrepreneur registration now is to make sure that I can still take advantage of my (more or less) automatic right to work whilst the UK is still a member. Who knows what the procedure will be after Berxit. The only problem I could foresee with that was the possibility of upsetting my current rights to my carte vitale, were that to be dependent on my (possibly minimal) individual income rather than our joint income.

You have been very helpful; thanks very much indeed!
C.K. Dexter Haven is offline  
Reply With Quote
Old May 16th 2018, 7:42 pm
  #5  
BE Forum Addict
 
Joined: Jan 2012
Location: Dépt 61
Posts: 3,488
EuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond repute
Default Re: Healthcare conundrum

Originally Posted by Novocastrian View Post
Another excellent and helpful post ET. The bolded bit interests me (although my circumstances are very different from the OP's).

Can you give me a link to the self-sufficiency criteria please?
Hi Novo, it's all part of the EU directive and the definition of a "worker" in the context of freedom of movement a much discussed point, a quick google brought up https://eumovement.wordpress.com/201...o-is-a-worker/
I did look into it in some detail with relation to self employed in France a few years back and found some quite interesting stuff, haven't got time to reply in detail right now but will come back later, however the above might answer your questions?
EuroTrash is offline  
Reply With Quote
Old May 16th 2018, 10:01 pm
  #6  
BE Forum Addict
 
Joined: Jan 2012
Location: Dépt 61
Posts: 3,488
EuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond repute
Default Re: Healthcare conundrum

Originally Posted by Novocastrian View Post
Can you give me a link to the self-sufficiency criteria please?
Oops I went off on the wrong tangent didn't I, sorry!
Self sufficiency criteria for EU inactifs are quite straightforward - https://www.service-public.fr/partic...sdroits/F12017, then under ressources suffisantes choose the appropriate age band and it gives you a figure. The threshold is pretty low, I really don't think you need to worry about it!
EuroTrash is offline  
Reply With Quote
Old May 17th 2018, 6:57 am
  #7  
Forum Regular
 
Joined: Mar 2009
Location: Bouche du Rhone (13)
Posts: 221
south_bound is just really nicesouth_bound is just really nicesouth_bound is just really nicesouth_bound is just really nicesouth_bound is just really nicesouth_bound is just really nicesouth_bound is just really nicesouth_bound is just really nice
Default Re: Healthcare conundrum

Originally Posted by EuroTrash View Post
Oops I went off on the wrong tangent didn't I, sorry!
Self sufficiency criteria for EU inactifs are quite straightforward - https://www.service-public.fr/partic...sdroits/F12017, then under ressources suffisantes choose the appropriate age band and it gives you a figure. The threshold is pretty low, I really don't think you need to worry about it!
Depends what you mean by a low threshold - for a couple with no children it is nearly 826€ pm (10k € pa) which for many micro-entrepreneurs is a good year.

My wife just set up an an ME this year after many years as inactif and ayant-droit. Yes she had to change caisse maladie and get a new carte vitale, and work her way through the maze of redeclaring her doctor and linking everything back to my Mutuelle (which I have supplied through my employer). What struck us was that for the simplest possible means of setting up a small business, this generated a huge amount of admin (as all things do in France) and at one point we were getting at least 2 or 3 letters a week from some government department or other. She has yet to declare her first income statement but not yet had a month which meets the minimums stated above so its a good job I also have an income. Similar paper trail for my son when he turned 19 and started post secondary education...new ciasse, new CV, letters about mutuelles...all to keep the same conditions for medical treatment as before.
south_bound is offline  
Reply With Quote
Old May 17th 2018, 8:55 am
  #8  
Just Joined
Thread Starter
 
Joined: May 2018
Posts: 4
C.K. Dexter Haven is an unknown quantity at this point
Default Re: Healthcare conundrum

Originally Posted by south_bound View Post
My wife just set up an an ME this year after many years as inactif and ayant-droit. Yes she had to change caisse maladie and get a new carte vitale
This is where I thought unintended consequences might occur, in moving from one status to another. Namely, if my turnover and subsequent reckoned income was very low - and hence my cotisations were also low - whether I would be required to top up those cotisations to a minimum level, once no longer protected as an ayant-droit. If that were to turn out to be the case, it might make changing my status in this way less attractive, although of course the ayant-droit status is going anyway.

There are all sorts of semi-explanations going around about PUMA requiring extra as a healthcare levy if you don't earn more than €3800-something a year (that being actual income, not turnover, so for an artisan possible equaling €7600+ turnover p.a.). Some of these explanations are contradictory. However, it does seem that if you are married or Pacs'ed to someone with a healthy income, this levy is not required. I'm not sufficiently confident in my understanding of the new system to be absolutely sure of where I stand.

It does seem remarkably difficult to find a definitive answer to this that respects all circumstances. What I don't need is a large (or even a small) bill turning up in the post, through a lack of understanding on my part.
C.K. Dexter Haven is offline  
Reply With Quote
Old May 17th 2018, 4:15 pm
  #9  
BE Forum Addict
 
Joined: Jan 2012
Location: Dépt 61
Posts: 3,488
EuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond repute
Default Re: Healthcare conundrum

Originally Posted by south_bound View Post
Depends what you mean by a low threshold - for a couple with no children it is nearly 826€ pm (10k € pa) which for many micro-entrepreneurs is a good year.
Erm, well, I wouldn't be calling 10k a good year, in fact I'd be worrying.
But the point is that this threshold is nothing to do with MEs, it's the figure that's considered necessary for inactifs to be self supporting and not in danger of needing bailing out by the state. I would think it is pretty much the minimum income a couple would need to be self supporting in the long term, no?
EuroTrash is offline  
Reply With Quote
Old May 17th 2018, 11:13 pm
  #10  
BE Forum Addict
 
Joined: Jan 2012
Location: Dépt 61
Posts: 3,488
EuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond repute
Default Re: Healthcare conundrum

Originally Posted by C.K. Dexter Haven View Post
It does seem remarkably difficult to find a definitive answer to this that respects all circumstances. What I don't need is a large (or even a small) bill turning up in the post, through a lack of understanding on my part.
You really are determined to worry, aren't you!
You say your wife is earning a decent income and paying sufficient cotisations for the two of you, therefore there will be nothing extra to pay. You have also that you have no unearned income, hence even if she wasn't paying sufficient cotisations, if there's no other income then there's nothing to charge CS on. It wouldn't affect your healthcare directly, although it might affect your right to a carte de séjour.
If you want to work, start a business. If you don't want to work, don't start a business. Don't confuse a business with healthcare, they are two different things. Everyone who lives in France in a stable and regular manner is entitled to healthcare. Please forget about the ayant droit status disappearing, it won't affect you; the reason the status is being withdrawn is that it has become irrelevant, no adult needs to piggyback on a spouse any more because everyone who lives here has their own individual entitlement, it's as simple as that.

A final comment, and please don't take offence, but I don't understand why you seem so horrified at the idea of potentially having to contribute a little towards your healthcare? Your posts rather give the impression that you've had a free ride so far and you're terrified of doing anything that might conceivably result in you having to pay a cent if you can avoid it, and this does beg the question, why would you not be prepared to pay your fair whack like most of us do? It's a moot point because as said it sounds like your household is already paying its fair whack through your wife. But I think you've got yourself so hung up on the details that you're missing the point of PUMA. By and large it's a good system, it's not some kind of trap lying in wait for the unwary. The point is to try and ensure that everyone has access to healthcare, and also to ensure that everyone pays in what they can afford, so that enough money is collected so that hopefully the black hole in the French health service budget doesn't get any bigger. Probably most importantly, it's plugged the loophole that used to exist where you could have a couple with an unearned income of say 50k a year, one of them sets up an auto entreprise and declares a couple of thousand euros a year, thus paying a few hundred in cotisations and nothing at all on the 50k unearned income. And that is a loophole that needed to be plugged.
EuroTrash is offline  
Reply With Quote
Old May 18th 2018, 9:08 am
  #11  
Just Joined
Thread Starter
 
Joined: May 2018
Posts: 4
C.K. Dexter Haven is an unknown quantity at this point
Default Re: Healthcare conundrum

Originally Posted by EuroTrash View Post
You really are determined to worry, aren't you!
It's what those of us who suffer occasional bouts of irrational anxiety do, I'm afraid to say.

Originally Posted by EuroTrash View Post
A final comment, and please don't take offence, but I don't understand why you seem so horrified at the idea of potentially having to contribute a little towards your healthcare?
I won't take offence, although it's a struggle not too. But I'm not horrified at the idea at all - that's a complete misunderstanding/mischaracterisation on your part. I'm only too happy to pay my way, and always have been.

My question here was a genuine one, in trying to work out what my position is, and how it might change if I changed my status. I asked because I didn't understand - that's what we do, isn't it? You know everything about PUMA, etc., and the way it all works, I don't. We each have different skills and knowledge sets. You share yours. I say 'thanks', and sorry for being so stupid! I then look forward to sharing my skills and understanding when I can.

But it is really rather unfair of you to suggest that I'm free-loading, or looking to do so in the future. I've spent most of my life using my skills for the greater social good; in reality (and in the UK) that translates into low-paid, low status jobs. My choice, and a good one, but not the choice of someone determined not to give back. I don't think I've ever been accused of that until now, but there's a first time for everything, I suppose.

Thanks for your responses, they've been most helpful. But I probably won't ask again.

Last edited by C.K. Dexter Haven; May 18th 2018 at 9:18 am.
C.K. Dexter Haven is offline  
Reply With Quote
Old May 18th 2018, 4:14 pm
  #12  
BE Forum Addict
 
Joined: Jan 2012
Location: Dépt 61
Posts: 3,488
EuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond reputeEuroTrash has a reputation beyond repute
Default Re: Healthcare conundrum

Oh 'eck, I obviously made my point wrong because you did take offence.
Like I said,"I think you've got yourself so hung up on the details that you're missing the point of PUMA" - that was my point I was trying to make. I wasn't accusing you of freeloading, I was trying to get across that I think you are being too mistrustful of the system. Making lifestyle decisions based on how you think your PUMA entitlement will be affected, seems so sad to me. My point is, just do what you want to do, and have faith that whatever you do, you won't be sent a bill that will cause you hardship because the system doesn't do that to people.If you don't have a lot of money you won't be expected to contribute a lot. You don't need to consciously choose the most advantageous status.
EuroTrash is offline  
Reply With Quote

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Contact Us Archive Advertising Cookie Policy Privacy Statement Terms of Service