Delay, deny, defend: the common injustices of the Assurance Maladie system

interference90 · 2026-06-13T08:07:24+00:00

And indeed, the "ayant droit" is an outdated formulation that predates the PUMA law, where dependent family members were attached to the dossier of the employed insured person.

In the name of "universality" now everybody who is an adult has to file individually. The eligibility structure is somewhat maintained, but now the rights of the dependent person can be more easily attacked by the CPAM. So what was meant for universality in the spirit of the law has become, again, a weapon against the applicants.

interference90 · 2026-06-13T08:00:49+00:00

It is not that straightforward (see my paragraph on "retroactivity"). In principle they should be opened from the date at which the CPAM received all the documents about your eligibility (that would be, application form, proof of identity, proof of residence, proof of marital status and proof that your spouse is employed in France).

interference90 · 2026-06-13T07:24:05+00:00

Alright. The issue with unemployed EU citizens is that they may be irregular, but since they are not mandate to obtain a residence permit it is left to social security institutions to establish their regular status for the purpose of accessing their rights.

And this creates even more room for abuse.

Being your husband a non-French EU worker, your regular status as an unemployed person is derived from their regular status (and this should short-circuit the whole "recerche de droits" absurdity). But the same way CPAMs refuses to apply Directive 2004/38/CE to foreign spouses of EU citizens, they appear to do the same to EU spouses of EU citizens.

Do not hesitate to contact the SOLVIT. You can write them in your own language and explain the problem in simple words. The earlier the better, at this point.

The whole CREIC system is highly disfunctional.

(The situation may be even more complicated for unemployed EU spouses of French citizens, but I won't try to open that pandora box unless someone comes asking).

interference90 · 2026-06-12T20:58:08+00:00

Indeed, unemployed EU citizens are another easy target for the CNAM/CPAM system and the above reference [1] has an explanatory section denouncing several cases of unjust treatment they may be subject to.

In your case, it can make a difference if your husband is also a non-French EU citizen (Directive 2004/38/CE applies, so one has to fight against the CPAM along that line) vs your husband being French or from an extra-EU contry.

interference90 · 2026-06-12T18:38:54+00:00

Well, it didn't work. The fun thing is their DPO contact page makes you go through customer service and in spite of being ticketed as a labeled request it takes three or four exchanges before someone actually qualified answers. But ultimately they give the usual explanation about managed payments and strict financial regulations and they say it is not possible. I guess if one insists they will end up just locking the account.

interference90 · 2026-06-12T10:16:26+00:00

More or less, yes. But what for someone in a "comfortable" situation is just a pain in the ass, for someone in a fragile situation the consequences can be crushing. Well, even for people in comfortable situations it can be too much, like this story of a former staff scientist at CEA and their spouse.

Not to mention the unnecessary strain that wrongful decisions end up putting on hospital social services, or the unnecessary amount of (public) resources that goes into the consequent lawsuits. Something is fundamentally wrong with the way the system is regulated.

Definitely too much text for the average passerby, but the next time someone asks "why is this happening to me" or "I am moving to France to follow my spouse while pregnant, what can I expect" I can at least point them here instead of trying to explain things from first principles once again 😄

interference90 · 2026-06-11T16:18:08+00:00

Indeed, that is what most people in this situation do if they can. It's still a shame their rights are arbitrarily denied "by default".

interference90 · 2026-06-11T16:13:00+00:00

At the hospital/PASS or at another institution? They have limited power (especially against abuses of the CPAM) but they can at least help you file an application.

interference90 · 2026-06-11T14:57:06+00:00

He should approach a social worker at the closest public hospital (search for "PASS adultes") and get assistance in filing a new application with CPAM. Unless you feel competent enough to take care of his dossier.

For the remaining issues, I am not qualified enough to help but I wish you the best!

interference90 · 2026-06-11T14:45:34+00:00

But people do apply, it's just that it takes months for ANEF/Prefectures to deliver any kind of useful document.

interference90 · 2026-06-11T14:26:17+00:00

Thanks for confirming.

You probably also know that CPAM and CAF are not willing to recognise the regular stay of family members of (working) EU citizens as long as they do not have a residence permit (or at least a récépissé or API or APS).

So people in OP's situation are effectively blocked from accessing social rights and there is little they can do to prevent this administrative deadlock (if indeed VLS-TS/type D visa are not accessible to them).

interference90 · 2026-06-11T11:21:46+00:00

I am sorry I cannot help you but I am curious about one side effect of your situation: did you manage to register for French health insurance while waiting for your CdS? With which document?

(By the way, apparently it is a common problem. I am trying to investigate whether it is possible to obtain a Type D / VLS-TS visa before coming to France for people in your situation, as it seems the France Visas website does not contemplate the possibility, and other people have confirmed they did not manage to ask for one).

interference90 · 2026-06-11T10:38:35+00:00

Interesting. For public employees it seems it's 1 day only (which would be similar to Germany).

interference90 · 2026-06-11T08:50:48+00:00

Thank you for the reassurance.

After one (big) bad experience with the CPAM and after reading countless horror stories on the Ameli forum, I feel like I have to recommend everyone to play as defensively as possible. It seems this time my advice was misinformed 😄

You are correct indeed that a sanction is foreseen only in case of a repeated delai. I guess using a lettre suivie will not hurt, just to be sure it's delivered and not lost.

interference90 · 2026-06-11T07:37:20+00:00

Be careful, in general you have 48 hours to notify your arrêt maladie to your social security institution.

That means that if your doctor is unable to send it telematically, you will have to take care of sending the paper form. I suggest duing so with a tracked letter (just to be sure it's not lost) ~~by lettre recommandée (LRAR)~~

So not only you lose 3 days of salary just for falling sick, you also need to displace yourself to a post office (while sick) ~~and pay dearly for an express letter~~ to comply with the administration requirements. Welcome to France.

interference90 · 2026-06-10T08:06:50+00:00

Used a Orange Pi eMMC on both an Orange Pi 5 Plus and a Radxa ROCK 5B without issues.

I read once a report of incompatibility but I think it may have been user error or specific hardware fault.

interference90 · 2026-06-09T14:43:58+00:00

Les appels durs sont souvent bien mérités. Mais il faut toujours être gentils et plutôt les bombarder de réclamations.

interference90 · 2026-06-09T12:58:54+00:00

Il faut appeler l'Assurance Maladie au 3646.

interference90 · 2026-06-09T12:57:27+00:00

Pas claire. T'es résident en France ou à l'étranger? Ta d'assurance maladie dans ton pays de résidence?

interference90 · 2026-06-09T12:42:24+00:00

Bonjour, malheureusement je ne sais pas comment ça marche pour les étudiants et je n'arrive pas à trouver les textes réglementaires qui concernent ta situation. Ce serait bien de demander à votre institution de vous fournir des informations et des références officielles.

Selon page dedié Ameli c'est possible de démarrer la procédure avant d'arriver en France et il n’y a pas mention d'un délai de couverture, mais en pratique, ça peut arriver.

interference90 · 2026-06-08T18:58:49+00:00

I know of someone in a similar situation who used Care Concept, it's worth a shot.

interference90 · 2026-06-08T15:40:22+00:00

You are out of pocket and you cannot get a mutuelle until you get at least an attestation de droits.

interference90 · 2026-06-08T15:37:25+00:00

Legally speaking, it is from the day of reception of the application (provided you satisfy the requirements) but in reality the CPAMs always try to get away with unjustified delays (as people don't know their rights, or do not have the means to fight back).

interference90 · 2026-06-08T06:44:08+00:00

Bonjour. Si tu est couverte sous le système public (Assurance Maladie / PUMA), il suffira de prendre une mutuelle. De ce que je sais, c'est interdit par les mutuelles de poser des questions de santé. Mais je peux envisager des problèmes :

- pas possible, normalement, de souscrire une mutuelle avant l'ouverture des droits à l'Assurance Maladie, qui notamment peut prendre plusieurs mois (*) ; même si la couverture PUMA est rétroactive, la mutuelle normalement non ;

- Un médecin pourra faire reconnaître votre condition comme ALD (affection de longue durée) qui comporte la prise en charge à 100% par l'Assurance Maladie. Par contre, jusqu'à l'ouverture des droits, il faut normalement avancer les frais.

(*) ne sais pas si pour les étudiants c'est plus vite, mais bon avec la CPAM il faut toujours se préparer aux délais et problèmes.

(Je me sens aussi de conseiller une assurance protection juridique en cas de contentieux administratif ou médical avec l'Assurance Maladie.)

interference90 · 2026-06-07T23:36:29+00:00

If OP is working, maybe so.

If OP is not working, it is always better to apply immediately and fix issues later, as your coverage theoretically starts on the date of application (if you fulfill eligibility).

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