As in many countries, the French social security system, also known as la sécu, can seem a bit daunting at first. But once you break it down into bite-size bits it soon starts to make sense.
To begin with, the key thing to know is that the social security system is divided into four categories that apply to each person’s working status:
The Régime Générale covers up to 80% of all French citizens and is itself divided into four groups: Family Income Support; Retirement and Health Insurance; Collection of Contributions; and Accidents at Work.
When you first start working for a French company, they are obliged to provide you with your own social security number. This gives you eligibility to get reimbursed for medical expenses, which is stated under the régime obligatoire. Afterwards, you will receive your carte vitale, which must be presented each time you visit the doctor. This card allows them to view your administrative status only and is intended to simplify the reimbursement process. French people tend to top up their régime obligatoire with private insurance ‘mutuelle‘.
Rules for employees
If you are an employee, your contributions are automatically deducted from each month’s salary. It is also highly likely that the private insurance, or ‘mutuelle‘ contribution, will be deducted simultaneously.
Salaried employees receive reimbursements for medical treatments from the CPAM (Caisses Primaires d’Assurance Maladie) under the umbrella of the public administrative body, the CNAMTS (Caisse Nationale de l’Assurance Maladie des Travailleurs Salariés).
For family income, support is paid by the CAF (caisses d’allocations familiales).
Rules for the self-employed
If you are self-employed, you are expected to register directly with the URSSAF (Unions de Recouvrement des Cotisations de Sécurité Sociale et d’Allocations Familiales) in order to start paying into the system. These self-employed contributions go directly to one of the 31 CMR (Caisses d’Assurance Maladie Régionales), which are the regional funds that come under the CNAMPI (Caisse Nationale d’Assurance Maladie des Professions Indépendentes).
For the various caisses that handle the retirement and invalidity benefits for the self-employed – also in the case of independent professions such as private doctors or architects – these funds fall under the CNAVPL (Caisse Nationale d’Assurance Vieillesse des Professions Libérales).
URSSAF: www.urssaf.fr (this site has a helpful chart showing how the social security system is organised)
CANMTS: www.cnamts.fr (an informative site that also has information in English)