Complementary solidarity health (CSS) – Increase in the ceilings to benefit from it – News

People with limited income can benefit from a specific individual complementary health insurance, called complementary health solidarity (CSS). For this, their resources must not exceed certain ceilings, depending on their family situation. They have just been upgraded.

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Complementary health insurance (CSS) comes in addition to reimbursements from health insurance, up to the moderating ticket. It replaced the CMU-C on the one hand and the ACS on the other. Depending on your resources and the number of people in your household, you can access it either completely free of charge (ceiling A), or for a modest financial contribution (ceiling B). No less than 7 million people currently have access to it: 5.5 million without participation and 1.5 million with participation (source: Cnam, December 31, 2021).

The new scope of resources taken into account

All your resources, taxable or non-taxable, collected during the 12 months preceding your application for CSS are taken into account. This is the case for your salaries, retirement pensions, unemployment benefits, family allowances, alimony received or other forms of income such as fees, interest from financial investments or rents from a property rented out… If you are the owner of your accommodation, if you are accommodated free of charge or if you receive housing assistance, a lump sum is added to your resources. This varies from 12 to 16.5% of the amount of the active solidarity income (RSA) depending on your family situation: for example, it is €69.06 for a single person (living in mainland France or in the overseas departments) and €138.12 for a couple.

On the other hand, certain resources are not taken into account when calculating the right to CSS: for example, the education allowance for disabled children and its supplements, the childcare allowance for young children, the activity or the back-to-school allowance. Finally, if you receive the RSA, you and each member of your household are de facto entitled to complementary health insurance. In any case, the request for CSS must be made through the Cerfa form no. 12504*09 and addressed to the CPAM on which you depend.

An unchanged financial participation

If your annual resources are between €12,424 and €9,203 (decree of March 24, 2022) i.e. between €1,035.33 and €767 per month, access to CSS is conditional on the payment of a flat-rate contribution , the amount of which, unchanged since 2019, depends on the age of each person in your household. This ranges from €8/month for anyone under 29 to a maximum of €30/month for anyone aged 70 or over.