Healthcare Reimbursement in Jersey: Who Reimburses What Depending on Your Situation

According to CLEISS (the French centre for European and international social security liaison), coordination between France and Jersey rests on the general Franco-British social security convention of 10 July 1956, extended to Jersey by an exchange of letters of 29 May 1979 and an administrative arrangement of 12 May 1980, in force since 14 May 1980. It concerns employed workers of French or Jersey nationality and covers all branches, except unemployment. The rules therefore change according to status: employed worker, retiree, self-employed, student, mere visitor. The notions of bilateral social security convention, reimbursement base and out-of-pocket cost help compare offers.

Jersey is not in the NHS: GPs are private surgeries and free hospital care depends on length of residence (see the guide to the Jersey healthcare system). The Government of Jersey specifies that only a British card (GHIC) opens rights under the UK-Jersey arrangement and that a European card gives no entitlement on that basis; CLEISS mentions no European card for Jersey. Proof of nationality (passport or ID card) serves as supporting evidence for French citizens' access to urgent care.

The employee on a local contract is affiliated to Jersey social security by their employer (6% contribution from the employee and 6.5% from the employer according to gov.je). They receive a social security number on registration, then a health card after six months of residence and contributions; non-emergency hospital care is free after six months of continuous residence, while GP consultations remain paid with a public subsidy of £50.28. In case of illness, the daily allowance is paid for 2 to 364 days, subject to contribution conditions, according to a scale revised every year (CLEISS). See the glossary entry on the local contract.

The seconded employee can be kept on the French scheme by their employer, under conditions. According to CLEISS, care in Jersey is covered with no additional contribution: cover is requested from the Jersey fund for the place of residence with a copy of form SE 132-J 01 (secondment certificate), and reimbursement can be obtained from the affiliation fund with form S 3125c and paid invoices. The cost may exceed French rates: supplementary health cover should be checked. A sick note is reported to the affiliation fund within 48 hours. Dependants who accompany the employee follow the same procedure; those who stayed in France continue to deal with the affiliation fund; family benefits cannot be exported. The maximum duration is not specified on the CLEISS page: to be confirmed before departure. See seconded or expatriate and the glossary entry on the seconded employee.

The expatriate employee falls under Jersey legislation as soon as they work there. They ask their French fund for a certificate of their insurance periods (there is no specific convention form) and hand it to the Jersey fund. Their family who stayed in France can benefit from health insurance on the basis of their activity in Jersey, with form SE 132 J 03 / FJ3 given to the CPAM, and receive French family allowances with form SE 132 J 05 / FJ5 given to the Jersey fund.

The self-employed person is covered on the same terms as the employee, according to CLEISS, if they are over 18, have lived in Jersey for more than six months and hold no employed job. The health card and hospital eligibility follow the same residence rules as for the employee. For the first months, or as a complement, the CFE or digital nomad insurance bridges the wait.

The student over 18 in full-time study has had free consultations with the GP, nurse, allied health professional and health assistant since October 2024, including by telephone and video (automatic registration for pupils of the island's institutions, request by email for others); blood tests, home visits and out-of-hours consultations remain paid. For non-emergency hospitalisation, the eligibility policy applies according to length of residence. Before 30, the CFE offers its youth offer; see also student insurance abroad.

The retiree falls under neither form S1 nor an automatic scheme. According to CLEISS, the 1956 convention contains no provision allowing reimbursement of care received in Jersey on the basis of a French pension, and no certificate of entitlement to care is issued before departure. Care is covered by the Jersey fund on the basis of residence; it should be contacted to find out the extent of cover. For temporary stays in France, the pensioner and their minor children are covered provided they hold an old-age or survivor's pension from a French basic scheme, can show at least 15 years of insurance in France and do not pursue a professional activity; a hospital stay of more than a month requires prior recognition by the CPAM. The spouse is not covered and takes out health and hospital insurance before coming. Retirees of the general scheme are handled by the Cnarefe (CPAM of Seine-et-Marne), which also receives requests from CFE members. If tax residence is no longer in France, neither CSG, CRDS nor Casa are due; a health insurance contribution may be withheld from the pension (about 3.2% on the basic pension, 4.2% on the supplementary pension, 7.1% for a self-employed person, according to CLEISS).

The spouse and children obtain, under Jersey's eligibility policy, the same eligibility as the eligible person if they live with them on the island, are registered, have a residence status and intend to stay; children under 18, or under 25 in full-time study, benefit. Holders of a temporary permit cannot be accompanied by dependants. See expatriate family insurance and the page retiring in Jersey.

The CFE is a voluntary social protection body. On its website, it offers health insurance for expatriates, with contributions that depend on age and the plan chosen, for the main offer (30 and over), the youth offer (under 30) and the retiree offer; the final cost depends on age, family situation and country of residence, and is calculated with its simulator. Abroad, reimbursement applies at rates or flat amounts specific to the country of care; the gap with the price billed in Jersey remains at the member's expense. The guide to CFE reimbursements details the mechanism, and the waiting period is checked in the CFE documents.

International health insurance on a first-euro basis reimburses actual costs within its ceilings, after any deductible, waiting period and exclusions. It covers the period before hospital eligibility in Jersey, as well as evacuation and repatriation, which the eligibility policy bills to patients who are not fully eligible. Contracts are compared on annual ceiling, coverage zone, evacuation and handling of medical history; see also the assistance contract.

The tourist of French nationality admitted to hospital in an emergency contacts the local fund for their place of stay and receives benefits in kind like a Jersey insured person, on presentation of their passport or ID card (CLEISS); for other nationalities, there is no cover on the spot, with possible reimbursement on return to France on paid invoices. During the stay, no daily allowances from the French scheme are paid. According to the Government of Jersey, visitors from countries bound by a reciprocal health arrangement, including France, are entitled to urgent care for a limited period, generally three months; everything the arrangement does not provide for remains at their expense. A long-stay travel insurance usefully complements the arrangement.

On return to France, service-public.fr states that a CFE contributor can, under conditions, benefit from CFE scheme benefits for three months after returning. Otherwise, an employee is affiliated to the Assurance Maladie (the French national health insurance) from the first hour worked (form S1106 and supporting documents to the CPAM); in the absence of employment, three consecutive months of residence in France are required before universal health coverage. A retiree depends on the existence of a convention and on the possibility of applying for universal health coverage with the S1106. See return to France and the guide on reducing the waiting period.

• Consultation: paid private surgery in Jersey, with a public subsidy of £50.28 for a health card holder; reimbursement of the seconded employee on the French scale; country scale for the CFE; actual costs for a first-euro contract.
• Hospitalisation: emergency care and ambulance free for residents; hospital free for a fully eligible patient, billed otherwise; French scheme for the seconded employee, who presents the SE 132-J 01; CFE on its scale; international contract with direct settlement.
• Medicines: GP prescriptions free with a health card, full price without a card; hospital prescriptions collected from the hospital pharmacy, with a possible contribution; reimbursement according to the scale for the CFE or the contract.
• Dental: private sector; free for children under 11 and partly covered for certain age and income categories (CLEISS); the rest is at the patient's expense, the CFE's according to its scale or the contract's.
• Optical: mainly falls under international contracts, with ceilings per period; the Pension Plus scheme helps people aged 65 and over on low incomes (dental, optical, chiropody).
• Maternity: under the eligibility policy, maternity, birth and postnatal care are free for fully eligible patients; CLEISS indicates a maternity allowance paid for a maximum of 32 weeks and a birth grant per child, subject to contribution conditions and a scale revised every year; the CFE requires conception after joining.

The reimbursement guide and the page expat health insurance provide benchmarks; Expavy helps compare these options against your situation.