New healthcare fee in France: more retirees set to face charge
New wording brings extra people into scope of fee originally aimed especially at American retirees
Obligation to pay will bear in mind international conventions and European regulations
Iryna Rahalskaya / Shutterstock
A new healthcare fee aimed at some foreign people in France who obtain French healthcare without paying French social charges has been voted through parliament.
Originally described as being especially aimed at American retirees on ‘visitor’ visas by its instigator, MP François Gernigon (Horizons, Maine-et-Loire), the final legal wording creating the fee that was passed in the 2026 social security budget changes the focus.
It says the fee will be payable by people settled in France who do not work and who also do not pay the main CSG or CRDS social charges as a result of a treaty (such as double tax conventions).
It implies that it will be payable periodically, saying that if a person does not pay it during a certain defined period, their local state health insurance body (Cpam) will check their situation then notify that their rights will be suspended if they do not pay the fee.
The law also states that the obligation to pay will “bear in mind international conventions and European regulations”, likely meaning that, as expected, holders of British or EU S1 forms (whose healthcare in France is paid for by their country of origin) would be exempt, and possibly others, for example if it is found that a French person moving to the country benefits from free healthcare there.
The new fee would not apply to people who already pay the existing ‘Puma tax’, who must have substantial income from sources such as investments or renting out property to be eligible to pay this.
Full details will remain to be clarified by ministerial decree, however, among those likely to be affected are those originally targeted, ie. American retirees on one-year (renewable) ‘visitor’ visas/residency cards who do not pay social charges on their US pensions as they are tax/charges exempt under the US-France DTC.
However, the new wording may even extend the scope to include some people with 10-year cartes de résident.
It may also include people such as UK government pensioners who do not pay social charges on their government pensions due to the UK-France DTC, especially if they are not (yet) also UK state pensioners and thus eligible for an S1 form.
