This page outlines what will happen to our health care in France under the Withdrawal Agreement. The provisions here will kick in at the end of the transition period, currently set for 31 December 2020.

IMPORTANT: Last September, the UK government announced that reciprocal (S1) health cover would only continue for 6 months after Brexit. This would have applied only in the case where the UK left the EU without a Withdrawal Agreement - a ‘no deal’ exit - and it does NOT apply now as the Withdrawal Agreement has come into effect. The rights covered by the Withdrawal Agreement will extend for your lifetimes, or until you stop meeting the conditions under the Withdrawal Agreement (for example, you move permanently out of your host country back to the UK). This is not affected by whether there is a 'deal' on trade and the future relationship (see here for more about that).

So if you're a current S1 holder, please don’t worry that your health cover is time limited - under the Withdrawal Agreement, it isn’t!

Health care under the Withdrawal Agreement

Now that the Withdrawal Agreement is in force, those of us already resident in France can breathe something of a sigh of relief. This is what will happen from the end of the transition period.

Workers, self-employed and those who’ve retired after working in France

• You’re already in the French health system, and France is your ‘competent state’, which means that it is responsible for funding your healthcare.
• You have, or can apply for, a CEAM - the European health card that covers emergency treatment in other EU countries. Under the Withdrawal Agreement this will also continue to cover you in the UK, although the administrative procedures for this are still unclear.
• Nothing will change for you under the Withdrawal Agreement. 
  
  

UK state pensioners and cross border workers who hold an S1 form

• Your S1 form means that the UK is your ‘competent state’ - responsible for funding your health care.
• You are affiliated to the French health system via CPAM and receive health care on the same basis as a French national, but the UK reimburses France for your health care costs. You have, or can apply for from the UK, an EHIC card that covers emergency treatment in other EU countries.
• Nothing will change for you under the Withdrawal Agreement. The Withdrawal Agreement continues the reciprocal health care / S1 scheme for British residents in the EU and EU nationals in the UK.
• Your S1 form will continue to be valid for as long as you’re resident in France, and the UK will continue to fund your health care costs.
• S1 holders will also continue to be eligible for a UK-issued European Health Insurance Card (EHIC-E) which will cover you for medically necessary treatment during a temporary visit to any EEA country or Switzerland.
• If you are a UK state pensioner who holds an S1 form registered in an EU/EEA country, you will remain entitled to receive full medical care in the UK (see here for more about this).
• If you’re living in France at the end of the transition period but you haven’t reached state pension age at that point, you may be eligible to receive an S1 form when you eventually qualify for your UK state pension. This will be the case if you haven’t worked in France OR you haven’t worked long enough in in France to qualify for a retirement pension here - in these situations the UK will become responsible for funding your health care and you will receive an S1 under the Withdrawal Agreement. 

Early retirees and others who are economically inactive and are currently covered by PUMa

• PUMa (la Protection Universelle Maladie) is France’s universal health care scheme, open to all those who’ve been legally resident for at least 3 months. Those who don’t fit into either of the 2 categories above will have applied to join the PUMa scheme. It’s contributory, though not onerously so (see here) and for most people not at all, and is administered by CPAM (La Caisse primaire d'assurance maladie).
• You have, or can apply for, a CEAM - the European health card that covers emergency treatment in other EU countries. Under the Withdrawal Agreement this will also continue to cover you in the UK, although the administrative procedures for this are still unclear.
• Nothing will change for you under the Withdrawal Agreement.
• You will continue to benefit from health care in the way you do now.
• If you later become entitled to a UK state pension on your retirement, the UK will become your competent state; you will then be covered by the provisions of the Withdrawal Agreement for reciprocal health cover and can request an S1 form.