What is an S1 Form? How to Get One?

Moving to France as a UK or EU national involves navigating various administrative processes, one of the most important being healthcare coverage. The S1 Form plays a crucial role in ensuring that you can access healthcare in France while remaining covered by your home country’s social security system.

This guide explains what the S1 Form is, who is eligible, how it works, and how it interacts with your visa application process.

What is an S1 Form?

The S1 Form (previously known as the E121) is a certificate issued by the social security institution of your home country (e.g., the UK’s NHS Business Services Authority). It confirms that you are entitled to state-provided healthcare in France, with the costs reimbursed by your home country. This form is particularly important for UK and EU nationals moving to France who wish to access the French healthcare system without relying solely on private insurance.

The S1 Form ensures that you can receive medical treatment in France under the same conditions as French residents, including access to doctors, hospitals, and prescriptions. However, it is important to note that the S1 Form does not replace a visa or residence permit. Instead, it serves as supporting documentation for your long-stay visa application, particularly if you are applying as a visitor (non-working resident).

S1 Form vs. EHIC Card: What’s the Difference?

The S1 Form and the European Health Insurance Card (EHIC) are often confused, yet they serve entirely distinct purposes. The EHIC Card is designed for short-term travellers within the EU, EEA, or Switzerland, providing temporary access to necessary healthcare during visits such as holidays or business trips. 

In contrast, the S1 Form is intended for individuals who are moving to or already residing in another country, such as UK retirees living in France, and ensures long-term access to state-provided healthcare under the same conditions as residents.

While the EHIC Card covers emergency and necessary medical treatment for temporary stays, the S1 Form grants ongoing healthcare coverage for those establishing residency abroad. So, if you are planning to move to France, the S1 Form is the appropriate choice, whereas the EHIC Card is suitable only for short-term visits.

Who is Eligible for an S1 Form?

You may be eligible for an S1 Form if you fall into one of the following categories:

• Pensioners: Individuals receiving a UK State Pension or a pension from another EU/EEA country or Switzerland.
• Exportable Benefit Recipients: Those receiving certain exportable benefits, such as contribution-based Employment Support Allowance (ESA).
• Frontier Workers: Individuals who live in one country but work in another (e.g., living in France but working in Switzerland).
• Posted Workers: Employees temporarily posted to France by a UK or EU company but still paying social security contributions in their home country.
• Dependents: Spouses, civil partners, or children of someone who qualifies for an S1 Form.

What Does the S1 Form Cover?

The S1 Form provides access to state-provided healthcare in France, including:

• Local State Care: You can access France’s public healthcare system, including doctors, hospitals, and prescriptions.
• Local Rates: You will receive treatment under the same rules and co-payments as French residents. For example, if French residents pay a fee for prescriptions or doctor visits, you will also be required to pay the same fee.
• Home Country Access: If you hold a UK-issued S1 Form, you can return to the UK temporarily and still access free NHS treatment during your visits.

How Does the S1 Form Work for British Expats Post-Brexit?

Following Brexit, the UK-EU Trade and Cooperation Agreement (TCA) ensures that the S1 Form continues to function for eligible British expats. However, there have been some changes to the application process and eligibility criteria:

What Stayed the Same?

• Full Healthcare Rights: If you qualify, you still receive state-provided healthcare in France, with costs covered by the UK.
• UK NHS Access: You can return to the UK temporarily and use the NHS for free.
• Dependent Coverage: Your spouse, civil partner, or children can still be covered under your S1 Form, subject to approval by the French authorities.

What Changed Post-Brexit?

• Proof for Residency Visas: British citizens no longer have freedom of movement within the EU. As a result, you must apply for a long-stay visa (e.g., VLS-TS) to live in France. 
  The good news is that your S1 Form can serve as proof of healthcare coverage during your visa and residency applications, meaning you may not need to purchase expensive private health insurance.
• Dual-Pension Restrictions: If you receive a UK State Pension and a state pension from your new EU host country (e.g., France), you cannot get a UK-issued S1 Form. In this case, the host country (France) becomes solely responsible for your medical costs.
• Benefit Restrictions: The S1 Form is now strictly limited to those receiving a UK State Pension, frontier workers, posted workers, and specific exportable benefits, such as contribution-based Employment Support Allowance. Other benefits, such as ordinary disability or unemployment benefits, no longer qualify.

How to Apply for an S1 Form

The application process for an S1 Form has been modernised to make it easier for expats moving to France:

1. Apply Online:
   If you receive a UK State Pension, you can apply for the S1 Form entirely online up to 90 days before your move via the NHS Business Services Authority (NHSBSA)
2. Receive Your Certificate:
   Eligible applicants receive a digital copy of their S1 certificate via email instantly, followed by a physical copy in the mail.
3. Register Locally in France:
   Once you arrive in France, you must register your S1 Form with CPAM (Caisse Primaire d’Assurance Maladie) via the Ameli portal, the online platform for healthcare administration. 

After registration, you’ll receive your French social security number and, later, your Carte Vitale, a green plastic card that simplifies reimbursement for medical expenses.

The Carte Vitale is your key to seamless access to healthcare in France, while Ameli is the online system for managing your account and claims.

The Relationship Between the S1 Form and Your Visa Application

The S1 Form is not a visa or residence permit, but it is a critical supporting document for your long-stay visa application, particularly if you are applying as a visitor (non-working resident). Here’s how it interacts with your visa:

S1 Commencement Date

This is the date when your healthcare coverage in France becomes active. It does not determine the start date of your visa. However, your visa’s validity period should ideally overlap with the S1’s active dates to ensure you have continuous healthcare coverage during your stay.

Visa Start Date

The start date of your one-year long-stay visa can be before or after the S1 commencement date, but you must ensure that:

• Your visa covers the period during which you intend to reside in France.
• You have healthcare coverage (via the S1 Form) for the entire duration of your stay.

If there is a gap between your arrival in France and the S1 commencement date, you will need private health insurance to cover this period. This is often a requirement for your visa application anyway.

Timing the Visa Application

If you’ve previously applied for 6-month visas and are now transitioning to a one-year visa, here’s what you should consider:

• Visa Application Timing:

You can apply for your one-year visa up to 3 months before your intended travel date. There is no strict requirement for the visa start date to match the S1 commencement date. However, it’s logical to align them to avoid gaps in healthcare coverage.

Steps to Apply for a One-Year Visa

Here’s a step-by-step plan to coordinate your S1 Form and visa application:

1. Book your TLS Appointment:
Schedule your appointment at the TLScontact visa centre as soon as possible. Demand can be high, so booking early is advisable. Check the time difference if you’re unsure about the time in France. 

2. Prepare your Visa Application:
Gather all necessary documents for a long-stay visitor visa (VLS-TS). This typically includes:

• A valid passport.
• Proof of accommodation in France (e.g., property ownership documents).
• Proof of sufficient financial resources (e.g., bank statements, pension income).
• A handwritten attestation stating you will not work in France.
• Your S1 Form (to prove healthcare coverage).
• Travel insurance covering the period until your S1 becomes active (if applicable).

3. Submit your Application:
At your TLS appointment, submit your visa application along with all supporting documents, including the S1 Form. Clearly explain your intention to reside in France for one year and your healthcare coverage plan.

4. Visa Start Date:
When completing your visa application, you can request a start date that aligns with your travel plans. If you want your visa to start on or after the S1 commencement date, specify this in your application. The consulate will ultimately decide the exact start date based on your supporting documents and travel itinerary.

Additional Considerations

Health Insurance Gaps

If there is a gap between your arrival in France and the S1 commencement date, ensure you have private health insurance to cover this period. This is often a visa requirement anyway.

Property Ownership

If you own a property in France, include proof of ownership (e.g., a property deed) with your visa application. This strengthens your case by demonstrating your ties to France.

Previous Visas

Mention your history of successfully obtaining 6-month visas in your application. This demonstrates your compliance with French immigration rules and may support your case for a one-year visa.

How the French Healthcare System Works with an S1 Form

In France, the healthcare system generally operates on a reimbursement basis. The state (social security) covers a percentage of the costs, and you or your top-up insurance (mutuelle) covers the rest. Here’s what you need to know:

Liability for the Difference

Even with an S1 Form, you will typically be liable for the ‘co-payment’ or ‘ticket modérateur’, the difference not covered by social security. In France, the securité sociale system usually refunds around 70% of set medical fees. Without a mutuelle (top-up insurance), you are personally responsible for the remaining balance.

Reimbursement Delays

Obtaining a French social security number can take several months. During this gap, you must pay for medical services upfront and collect paper receipts (feuilles de soins, or ‘brown forms’). You can only claim your 70% refund once your Social Security number is issued.

Importance of Private Insurance

Because of potential coverage gaps and long administrative wait times, it is strongly advised to maintain temporary private health insurance during the application process. Private insurance provides:

• Comprehensive protection for areas not fully covered by social security or the S1 Form.
• Accident and emergency cover, including specialist plans designed to bridge the gap until you are fully integrated into the French system and can switch to a mutuelle (top-up insurance).

Real-Life Scenario: Aligning Your S1 Form and Visa

Question:
“My S1 Form has a commencement date of 01/01/26. Does my one-year French visa application need to start after this date? I’m a UK resident living in France, and the only property I own is our house in France. I’ve been applying for 6-month visas for the past 5 years, but was told to apply for a one-year visa. I now have an S1 Form, and am confused about aligning the S1 start date with my visa application.”

Answer:
Your visa start date does not need to match the S1 commencement date exactly, but you must ensure you have healthcare coverage for your entire stay. Here’s what you can do:

• If you plan to arrive in France before 01/09/26, your visa can start earlier, but you will need private health insurance LINK to cover the period until your S1 Form becomes active.
• If you plan to arrive on or after 01/09/26, your visa start date can match the S1 commencement date, ensuring seamless healthcare coverage from the outset.

When applying for your visa, include your S1 Form as proof of healthcare coverage and specify your intended travel dates. The consulate will review your application and determine the visa start date based on your documents.

Where to Find Further Information

For official guidance, refer to the French Visa Application Guidelines. For Brits, visit the UK Government website for Guidance on S1 Forms and Healthcare advice for UK nationals living in France.

To help you integrate into your new life, here’s a list of everyday French words and expressions that you may not yet know, “y’as pas de quoi!”  And read our blog packed with tips and advice for foreigners planning to live in France.