Health Insurance
Statutory health insurance coverage
Subscription to a health insurance scheme is compulsory. Social protection in the area of health is essentially the role of the Assurance maladie, the health insurance branch of the social security system (which also includes a family benefits branch and an old-age pensions branch), operated by the “social partners” under the supervision of the state. The entire population thus has health insurance coverage, generally on a work-related basis (as a beneficiary) or as a dependant of a beneficiary.
In France, health insurance is administered by several different schemes. The principal scheme is the general social security scheme (Régime général) which provides coverage for salaried workers in commerce and industry, and their dependants (about 80% of the population in all).
The scheme operates through three different tiers:
- the National Health Insurance Fund for Salaried Workers (CNAMTS),
- 16 regional health insurance funds (CRAM),
-
128 local health insurance funds (CPAM) in mainland France and 4
general social security funds (CGSS) in the overseas departments.
The agricultural scheme (MSA) covers farmers and agricultural employees and their dependants (about 9% of the population).
The social security scheme for the self-employed (RSI) comprises the different funds managing health insurance coverage for non-agricultural self-employed people: entrepreneurs, artisans, tradespeople, self-employed professionals, etc. (about 6% of the population).
Other smaller schemes, also operating on a work-related basis, cater for certain specific categories of the population (miners, railway workers, seamen, etc.).
Health insurance is funded by contributions based on professional earnings and a tax levied on all income (including investment income) known as the CSG (contribution sociale généralisée).
For the payroll contributions component, the burden is shared by employees and employers.
To qualify for cover an individual must generally have worked at least 120 hours during the previous month, or 600 hours in the previous six-month period. Different rules apply for self-employed people.
