CSS: Conditions and Procedures

What Is Complementary Solidarity Health Insurance?

Complementary Solidarity Health Insurance (CSS) is a state aid that allows people with modest incomes to benefit from free health insurance or for less than one euro per day. It replaced CMU-C and ACS in November 2019. Visit our insurance section for more information on health coverage options in France.

Two Levels Based on Income

Free CSS: For households with income below a first threshold. No contribution is required.

CSS with contribution: For households with income between the first and second thresholds. A modest financial contribution is required (less than one euro per day per person).

Income Conditions

Income Thresholds

Thresholds depend on household composition and location (mainland France or overseas). They're revised annually. For reference, for a single person in mainland France, the free CSS threshold is approximately 10,000 euros annual income, and the CSS with contribution threshold is approximately 13,500 euros.

Income Considered

The assessment covers the last 12 months. Counted are employment income, unemployment benefits, pensions, capital income, and certain family benefits.

Excluded Income

Not counted are basic family benefits, back-to-school allowance, housing assistance, and means-tested student grants.

CSS Coverage

Comprehensive Protection

CSS offers a high level of protection, the best possible reimbursement for routine care, 100% Health coverage in optical, audiology, and dental, and full third-party payment (no out-of-pocket advance). For detailed information on complementary health coverage, see our complete health insurance guide.

What It Covers

Medical consultations without extra fees, medications, tests, hospitalization, 100% Health optical (glasses every 2 years), 100% Health dental prostheses and hearing aids.

What It Doesn't Cover

Extra fees (except emergencies), non-standard care, private hospital rooms (except medical necessity).

How to Qualify?

Run a Simulation

Visit ameli.fr or msa.fr to simulate your eligibility. You'll immediately know if you qualify and at which level.

Compile Your File

The file includes the application form (cerfa), proof of income for the last 12 months, and proof of situation (identity, residence).

Where to Submit

To your health insurance fund (CPAM for the general scheme), online via ameli.fr, or at a reception point.

Processing Time

The decision is made within 2 months. If approved, your rights start from the decision date or the 1st of the month if you had previous CSS.

Duration and Renewal

Attribution Period

CSS is granted for one year. Near the expiration date, you receive a letter inviting you to renew your application.

Renewal

Renewal isn't automatic. You must resubmit a file with updated documentation. Your income will be reassessed.

In Case of Situation Change

If your income increases during the year (return to work, inheritance), you must report it. You may lose CSS eligibility or switch to the contribution version.

Transitions

You Had CMU-C

If you benefited from CMU-C before November 2019, you automatically switched to free CSS.

You Had ACS

Former ACS beneficiaries could apply for CSS with contribution, which offers better coverage than former ACS contracts.

Conclusion

Complementary Solidarity Health Insurance is an essential scheme for enabling people with modest incomes to access care without out-of-pocket costs. If you think you're eligible, run an online simulation to check your rights.

The information provided in this article is for informational purposes only. Income thresholds are revised annually. Visit ameli.fr for current amounts.