As part of the fight against exclusion, State medical aid (AME) provides access to care for people in an irregular situation during a stay in France. The AME is not applicable to Mayotte.

What medical care is concerned?

The AME gives the right to 100% coverage of medical and hospital care within the limits of social security rates, without advance payment:

• Medical and dental care;
• Medicines reimbursed at 100%, 65% or 30%;
• Analysis costs;
• Hospitalization and surgical intervention costs;
• Costs related to certain vaccinations as well as those related to certain screenings;
• Costs related to contraception, voluntary termination of pregnancy, etc.

 All health professionals have an obligation to welcome AME beneficiaries.

What medical care is excluded?

Note that the following medical costs are not covered for adults but remain 100% covered for minors:

• Technical acts, examinations, drugs and products necessary for the realization of medically assisted procreation;
• Medicines with low actual benefit reimbursed at 15%;
• Spa treatments.

Any foreign national in an irregular situation in France – except Mayotte – can benefit from the AME.

The conditions to be fulfilled are as follows:

• Reside in a stable manner, that is to say uninterrupted for more than 3 months, in France – mainland and overseas departments, except Mayotte;
• Do not exceed a certain resource ceiling: this ceiling is identical to that of the Solidarity health supplement (see “How to apply for AME”).

People detained, held or awaiting escort at the border to an administrative detention center (CRA) may be admitted to the AME for treatment if their state of health so requires.

When released after detention, a person can benefit from the AME as soon as he meets the conditions mentioned at the beginning of the paragraph.

To make a request for State medical assistance (AME), the “Request for State medical assistance (AME)” form must be completed and sent, along with supporting documents, to the insurance fund. disease of the place of residence.

The request form is accessible:

• Online on the Health Insurance website Ameli.fr: Request for State medical aid (AME) (PDF);
• Or from a primary health insurance fund (CPAM).

To complete the AME application form, you need to provide three main documents.

Proof of identity

The identity and that of the dependents must be supported by one of the following documents:

• Passport (s) indicating the date of entry into France: all passport pages must be photocopied;
• National identity card (s);
• Extract (s) of birth certificate or family record book: except if the names, first names, date and place of birth can be verified directly, these documents must be translated beforehand by a person sworn in by the French courts or by the consul, in France, of the country having established the birth certificate or the family record book;
• Copy (s) of an old residence permit;
• Any other document attesting to the identity or that of the dependents: driving license, professional card (s) from the country of origin, student card (s), name document from the Ministry of Foreign Affairs, etc.

Proof of stability

Residency in France uninterrupted for more than 3 months must be justified by presenting one of the following documents:

• The visa or the stamp appearing on the passport bearing the date of entry into France of more than 3 months;
• A copy of the rental contract, a rent receipt or a hotel bill dating back more than 3 months;
• An electricity, gas, water or landline bill dating back more than 3 months;
• A notice of taxation or non-taxation of income tax, property tax or housing tax;
• In the event of free accommodation by a natural person: a rent receipt or an electricity, gas, water or landline telephone bill drawn up in the name of the accommodation and dating more than 3 months;
• In the event of accommodation in an accommodation or social reintegration center: an accommodation certificate drawn up by the center and dating more than 3 months;
• In the event of a homeless situation: a domiciliation certificate drawn up free of charge by an approved body – for example, from a municipal social action center or an approved association – and dated more than 3 months;
• Or any other document proving that this condition is met, such as a document from a private health or social organization dating back more than 3 months: notification of refusal of asylum application, date of school enrollment children, etc.

Proof of resource limit

To benefit from the AME, the resources must not exceed a maximum annual ceiling, identical to that of the Solidarity health supplement and defined according to the number of people making up the household and the place of residence.

In mainland France, the maximum annual resource ceilings to benefit from the AME have been as follows since April 1, 2019:

• For one person: € 8;
• For two people: € 13;
• For three people: € 16;
• For four people: € 18;
• For more than four people: + € 3 per additional person.

In the overseas departments (except Mayotte where the AME is not applicable), the maximum annual resource ceilings to benefit from the AME are as follows since April 1, 2019:

• For one person: € 9;
• For two people: € 14;
• For three people: € 17;
• For four people: € 20;
• For more than four people: + € 3 per additional person.

All the resources received during the 12 months preceding the request must be declared, whether they are taxable or not, whether they were received in France and / or in a foreign country, for each member of your household.

The resources to take into account are:

• Salaries (after deduction of CSG and CRDS) and non-salary income from the previous fiscal year;
• Allowances (family, unemployment, etc.);
• Pensions received (retirement, annuity, alimony);
• And other resources: rental of real estate, income from savings and securities, etc.
• Note that alimony paid must be indicated: they will be deducted from resources.
• In addition, in the absence of being able to present supporting documents for resources, a declaration on honor can be attached to the application form.

Authorized bodies can be contacted in order to obtain assistance for the constitution and / or transmission of the AME application file:

• The municipal social action centers (CCAS);
• Health and social services;
• Approved associations;
• Health establishments.
• With your agreement, these organizations must send the file to the Health Insurance within 8 days.

Dependents can also benefit from the AME and must be indicated when applying using the form:

• Spouse, cohabiting partner or partner linked by a PACS;
• Dependent children under 16 or up to 20 if they are studying.

Note that family members residing abroad visiting France are not entitled to AME as dependents. On the other hand, they can request AME on a humanitarian basis in case of necessity or via an international healthcare system, if an agreement exists between their country of origin and France.

The CPAM informs the applicant of its decision at the latest 2 months after the filing of the application. A non-response at the end of this period means that the request is refused.

Please note, the finance law for 2020 provides for a period of 3 months to benefit from the AME but pending publication of the decree specifying this measure, the 2-month period remains valid.

When the request is accepted, a summons invites you to come and collect the AME admission card which must then be presented to health professionals during consultations.

The AME is granted for a period of one year from the date of filing of the application.

The right to the AME cannot be closed before the end of the sixth month following the expiration date of the titles or documents justifying that the applicant is entitled to it. This time limit does not apply in one of the following situations:

• Report a new situation of non-residence in France;
• No longer fall under French social security legislation;
• Having made a false declaration;
• Being subject to an administrative expulsion order that has become final – in this situation, the deadline is then shortened to 2 months instead of 6.

The refusal to award the AME can be contested: a free appeal can then be made to the CPAM within 2 months of receipt of the decision.

The departmental commission for social assistance (CDAS), whose contact details are indicated on the refusal decision, can also be contacted within 2 months of the date of the decision.

Renewal is not automatic. A new request must be made in the same way as for the initial request 2 months before the due date mentioned on the admission card to the AME.