- If you're receiving a pension — including a private pension drawn well before State Pension age — you're very unlikely to be caught by this. Pension income already attracts social charges (CSG/CRDS) once declared in France, part of which covers healthcare contributions
- This mainly applies to a smaller group: people living in France with no pension or earned income at all yet, mainly off investment, rental, or dividend income
- It's officially the Cotisation Subsidiaire Maladie (CSM), nicknamed "taxe PUMa" — a healthcare contribution, not an income tax, billed separately by URSSAF
- Income ceilings 2026: you're only liable if your activity/pension income is under €9,612 AND your investment/rental income is over €24,030 — both conditions have to be true at once
If you're already drawing a private pension well before State Pension age, this is unlikely to apply to you. This article is aimed at a smaller, specific group: people living in France with no pension or earned income at all yet, living mainly off investment income, rental property, or dividends.
What this actually is
The official name is the Cotisation Subsidiaire Maladie (CSM), though it's commonly nicknamed "taxe PUMa," after the universal healthcare system (Protection Universelle Maladie) it helps fund. Despite the nickname, it's officially a social security contribution, not a tax — which matters for a few practical reasons: it's billed separately by URSSAF rather than appearing on your income tax notice, and it's deductible against your taxable income.
The logic behind it: everyone legally resident in France gets access to healthcare through PUMa, regardless of whether they're working. Most people pay into that system automatically through payroll deductions or pension contributions. The CSM exists to capture the people who benefit from the healthcare system without earning a sufficient level of income — typically because they're living off capital rather than earned income, with little or no pension.
Why pensioners are mostly not affected
This is worth understanding properly, because "pensioners are exempt" isn't quite the full story — and the real reason matters if you're trying to work out where you stand.
The CSM exists to make sure people who use the healthcare system (PUMa) contribute toward funding it, one way or another. Most people do this automatically: through payroll deductions if they work, or through social charges (CSG/CRDS) deducted from pension income if they're retired. Pension income is subject to social charges (CSG/CRDS) once you're a French tax resident (unless exempted by an S1).
Investment or rental income social charges, by contrast, are a different type of social charge and don't count as contributions into the healthcare system for CSM purposes.
A UK-specific nuance worth flagging: many UK retirees draw a private pension well before reaching State Pension age and S1 eligibility — often from age 60, sometimes earlier. During that gap, there's no S1 exemption from social charges (CSG/CRDS) — the pension is taxed and charged the same way a French private pension would be. This means the pension income is doing the same job as a French pension would, contributing through the standard social charges (CSG/CRDS) route.
One caveat: there isn't an official URSSAF statement that explicitly confirms a foreign private pension is treated identically to a French one for this specific exemption. The legal text (Article L380-2 of the Code de la Sécurité Sociale) refers simply to receiving "a retirement or invalidity pension," without specifying nationality, and the CSM calculation runs off the income categories on your French tax return rather than which country the money came from. The reasoning holds up logically, but it's an inference from how the mechanism works, not a directly confirmed rule for foreign pensions specifically. If your situation is borderline — for instance, a lump-sum pension withdrawal rather than a regular income stream — it's worth checking directly with URSSAF or a tax advisor.
Where you are also exempt regardless: if you or your spouse/PACS partner has professional income above the threshold, the whole household is exempt — even if the other partner has no income of their own at all.
Who this actually catches
Given the reasoning above, the people genuinely exposed are specifically those with no pension or earned income at all:
- Early retirees with no pension income of any kind yet — no UK State Pension, no private pension drawn, no French pension — living off savings, investments, or rental income alone
- Anyone who's deferred claiming any pension entirely — including deliberately, as a strategy. If you've read our article on deferring your French pension to protect your S1, it's worth knowing this is the trade-off on the other side of that decision: deferring every pension claim can help your S1 position eventually, but if you have zero pension income during the deferral period and you're living off investments, you may fall into CSM territory in the meantime. Drawing a private pension during that gap, even a small one, changes this picture
- A surviving spouse with no pension of their own, living off a late partner's investments or property
- Anyone who's sold a business and is living off the proceeds before any pension — French, UK, or otherwise — kicks in
The actual thresholds for 2026
The calculation runs on two separate thresholds, both based on the social security ceiling (PASS), which is €48,060 for 2026:
Activity/replacement income threshold: €9,612 (20% of the PASS). If your activity income, or your pension/unemployment/sickness benefit income, is below this, the first condition for liability is met.
Investment/wealth income threshold: €24,030 (50% of the PASS). This covers dividends, rental income, interest, and capital gains. You are only liable above this threshold.
Both conditions have to be true at the same time — low or no activity/pension income, and investment income above the threshold — to create liability.
How much it actually costs
The rate is 6.5%, applied only to the portion of your investment income above €24,030, capped at a maximum assessable base of €384,480 (8 times the PASS). The rate isn't fixed at 6.5% for everyone though — it tapers down as your activity income gets closer to the €9,612 threshold, reaching zero once you cross it. So a small amount of earned income can meaningfully reduce, or entirely eliminate, the contribution.
As a rough illustration: someone with no activity income at all and €60,000 of investment income would have €35,970 in the taxable band (€60,000 − €24,030), giving a contribution of roughly €2,338 at the full 6.5% rate. The same person with even a modest amount of earned income approaching €9,612 would see that figure drop sharply, potentially to a few hundred euros or nothing at all.
How and when it's billed
This isn't assessed alongside your income tax. URSSAF calculates it based on the income you declared on your tax return for the previous year, and sends a separate contribution notice, typically in November. You then have a set window to pay — generally around 30 days — with options to spread payment over several instalments if you ask.
Frequently Asked Questions
I already receive a UK private pension at 60, well before my S1 eligibility — do I need to worry about this?
Not if your pension income is above the €9,612 threshold. Once you're a French tax resident, your pension income attracts CSG/CRDS the same way a French pension would. The reasoning holds up well, though there isn't an explicit URSSAF statement confirming foreign pensions are treated identically for this specific exemption, so if your situation is unusual — a one-off lump sum rather than regular income, for instance — it's worth double-checking with URSSAF or a tax advisor.
My spouse has no income but I'm still working — are we both liable?
No. If either you or your spouse/PACS partner has activity income above the threshold (€9,612 for 2026), the whole household is exempt, even if the other partner has no income of their own.
Is this the same as paying social charges on investment income?
No, though they're related concepts. Social charges (CSG/CRDS) apply to investment income itself as part of your annual tax return. The CSM is a separate contribution assessed afterward by URSSAF specifically to fund healthcare access, based on the combination of low activity income and high investment income. See our guide to social charges in France for the full picture on CSG/CRDS.
If I've deferred my French pension to protect my S1, could this affect me?
Potentially, yes — if you have no other pension income during the deferral period and you're living mainly off investments or rental income. It's worth weighing this alongside the S1 benefits when deciding whether and how long to defer. See our article on deferring your French pension to protect your S1.
What if I think I've been wrongly billed?
It's possible to contest a contribution notice with URSSAF if you believe you meet an exemption — for example, if you do receive a qualifying pension or your activity income clears the threshold. Practice on this can vary between regional offices, so it's worth raising directly with URSSAF if your situation doesn't match what you've been billed.