Registering for the complementary state health insurance known as the “Complémentaire santé solidaire (CSS)

If you have few or no financial resources and are enrolled in the state health insurance system known as social security or “sécurité sociale”, you can apply for “Complémentaire santé solidaire (CSS)”. It covers any health expenses that are not fully reimbursed under social security.

Verified by Comede on 29/11/2023

How does it work?

The complementary state health insurance known as the “Complémentaire santé solidaire (CSS)” ensures that:

  • you will not have to pay doctors, dentists, pharmacists or hospitals upfront
  • you are exempt from any excess medical charges
  • you will not have to pay for most glasses, dental implants and hearing aids.

Depending on your resources, you can either benefit from the “CSS”:

  • completely free of charge
  • or by paying a contribution, based on the number of people in your family who you wish to be covered.

Note: the “CSS” has replaced the “Couverture maladie universelle complémentaire (CMU-C)” system.

Conditions

To be eligible, the main conditions are:

  • You must be registered in the state health insurance system called “Protection universelle maladie (Puma)”, also known as social security or “sécurité sociale”.
  • Your household’s resources must not exceed the fixed threshold.

How to apply

There are two ways to apply for the complementary state health insurance or “Complémentaire santé solidaire (CSS)”.

  • Log into your ameli.fr account and select “Mes démarches > Faire une demande de Complémentaire santé solidaire” and follow the instructions.

    Once the application has been registered, you will receive an e-mail confirmation in your Ameli account inbox.

  • Download and fill in the application form.

    Attach the requested documents to the form.

    You can submit it in person at the reception desk of the organisation that manages your state health insurance, known as the “caisse d’assurance maladie”, or send it by post. If you do not know your “caisse d’assurance maladie”, you can contact a “Caisse Primaire d’Assurance Maladie (CPAM)” near you to find out more. Contact details can be found on this site.

    If you post your application, send it by registered post or “lettre recommandée avec accusé de réception”, which is the only way to have proof of receipt. Keep the receipt as proof of postage.

After the application

After receiving your application, your “caisse d’assurance maladie” has two months to process your application and inform you of its decision.

It will inform you of its decision by post.

Depending on the response you receive, here’s what you can do:

  • If you are approved for “Complémentaire santé solidaire (CSS)” free of charge, you simply need to update your “carte vitale” at any pharmacy in order to benefit from it by asking them for a “mise à jour”. If you do not have a "carte vitale", you must present your certificate of rights or "attestation de droit" to healthcare professionals.
  • If you are approved for “Complémentaire santé solidaire (CSS)” with a financial contribution, you must first send off the membership form or “bulletin d’adhésion” that you received with the notification by post. You will then receive a document that confirms you have the “CSS” known as “attestation de droit”. You will then need to update your “carte vitale” at any pharmacy in order to benefit from it by asking them for a “mise à jour”. If you do not have a "carte vitale", you must present your certificate of rights or "attestation de droit" to healthcare professionals.
  • If your application is refused, you could take out a private health insurance policy called a “mutuelle”.
  • If you do not agree with the decision of the “caisse d’assurance maladie” and you believe you meet the criteria for the “CSS”, you can contest their decision. The process to contest the decision or “recours” will be detailed in the decision letter.

Find support

In France, there are many services that can support you, give you advice, and assist you with procedures and paperwork. Most of them are free of charge.

  • Comede” is an organisation that helps immigrants and refugees to have access to health care.

    • These services are free of charge.
    • They can assist you to access healthcare and help you with your paperwork, in particular via their telephone service.
    • Languages available: interpretation possible in all languages.
    • Contact: by phone.
  • The "PIMMS Médiation" are organisations that inform, guide or support in administrative procedures in many areas: access to public services, access to health care, applications for state financial assistance, tax declarations, declarations to “France Travail”, etc.

    • This service is free of charge.
    • Languages available: mainly French.
    • Contact: you can find a “PIMMS Médiation” near you in this directory.
  • Social workers or “travailleurs sociaux” and “assistants sociaux” are professionals who support people in their administrative procedures and help them find solutions according to the difficulties they are faced with.

    • These services are free of charge.
    • You can make an appointment to receive personalised advice according to your situation and help you with the next steps, for example: applications for state financial assistance, applications for social housing, registration with the French unemployment office “France Travail”, etc.
    • Available languages: mainly French.
    • Contact: you can request an appointment with a “travailleur social” with:

While the utmost care has gone into providing you with the most accurate and up to date information, this page is not intended to replace legal or professional advice. Laws and procedures change regularly so it is important to consult qualified professionals.

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