What is the Sécurité sociale?

Behind the carte Vitale lies one of the most concrete expressions of republican fraternity. Understanding the logic of the Sécurité sociale — everyone contributes according to their means and receives according to their needs — sheds light on a good part of the everyday life topic.

What it is for

Created in 1945, the Sécurité sociale protects against the major hazards of existence. The health branch reimburses care, medicines and hospital stays. The family branch pays family benefits and housing allowances, handed out by the caisses d'allocations familiales. The pension branch provides retirement pensions. To these are added cover for workplace accidents and occupational illnesses, and a branch devoted to the independence of elderly or disabled people. Together they form a safety net available to anyone who works or lawfully resides in France.

How it is funded

Funding rests mainly on social contributions levied on wages — one part paid by the employee, another by the employer — topped up by tax contributions. That is what explains the gap between gross pay and net pay on a payslip. The principle is solidarity: contributions are not placed in a personal account, they immediately fund the benefits of those who need them. Everyone contributes according to their means and receives according to their situation.

Carte Vitale and médecin traitant

The carte Vitale certifies your entitlements and automatically triggers reimbursement after a consultation or the purchase of medicines. Declaring a médecin traitant, your regular doctor, means being followed within a coordinated care pathway and obtaining a better rate of reimbursement. The Assurance maladie, however, reimburses only part of the cost: the rest may be covered by a complementary health insurance, or by the Complémentaire santé solidaire for people on modest incomes.

Opening your entitlements and keeping them alive

Affiliation is not automatic: you have to apply for it. Anyone who works or resides in France in a stable and lawful way can obtain a social security number, the thirteen-digit number that appears on the carte Vitale and identifies each insured person. The application is made to the health insurance fund of the département, with proof of identity, of residence and, where relevant, of employment. An online account then lets you follow your reimbursements, download your certificates and report a change of situation. Reporting a move, a birth or a return to work is what keeps your entitlements alive: it is the step people most often forget.

Worth remembering

• Created in 1945, it covers illness, family, retirement, workplace accidents and independence.
• Funded by contributions on wages and by tax, on a principle of solidarity.
• The carte Vitale proves your entitlements; the médecin traitant improves reimbursement.

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