Social protection and health in Saint-Pierre and Miquelon

Saint-Pierre and Miquelon is attached neither to the mainland Assurance Maladie nor to a fund of an overseas department: according to CLEISS, the archipelago has its own social security scheme, separate from the mainland French scheme and covering all risks. The Caisse de prévoyance sociale (CPS) manages it: sickness, old age, work accidents, family allowances, unemployment and wage guarantee, for employed and self-employed workers. The CPS presents itself as the body that collects contributions and pays benefits in the territory.

People affiliated to the CPS are those who meet one of these conditions: residing stably and regularly in the archipelago, carrying out a professional activity there as an employee or self-employed person, or being a child under 18 who is a dependant of their parents. Every adult is affiliated in their own right from the age of majority. Members of another scheme who present a coordination form on arrival are not affiliated to the CPS but receive the same entitlements to health insurance benefits in kind.

Care provision is centred on the Centre hospitalier François-Dunan, in Saint-Pierre. When appropriate care is not available on site, the medical evacuation (EVASAN) system makes it possible to be treated in Canada or mainland France: the doctor requests the evacuation from the CPS medical department, which seeks the opinion of a medical committee (medical adviser, hospital practitioners and prescribers) responsible for saying whether the care is possible in the archipelago, where it will be provided and whether a companion is needed.

• Entry and stay: the archipelago is part of France; a French citizen has no visa or residence permit to request. The sources consulted do not detail the identity documents to present depending on the route: ask the airline or carrier.
• Transit through Canada: the archipelago is reached in practice via Canada. According to the Government of Canada, a French citizen transiting through a Canadian airport needs an electronic travel authorisation (eTA), linked to the passport and valid for 5 years or until the passport expires. French residents of the archipelago are exempt for a direct trip to Canada. Since 5 June 2026, most visa-exempt nationals reaching Canada by boat from the archipelago must also obtain one.
• CPS affiliation: on arrival, register with the CPS (identity document, family record book if there are dependants, bank details slip (RIB), school certificate for each dependent child; a non-civil-servant employee provides a local payslip, a civil servant their transfer order). A person coming from mainland France or an overseas territory adds the certificate from their former fund (CPAM or CGSS) and their Carte Vitale.
• Supplementary insurance: the co-payment (ticket modérateur) and the hospital charge (forfait hospitalier) remain payable by the insured person; the CPS states that the hospital charge is not reimbursed by health insurance and can be covered by a mutual insurer or supplementary health insurance. According to ameli.fr, the Complémentaire santé solidaire does not apply in Saint-Pierre and Miquelon.
• Trips to Canada: the sources consulted do not detail the coverage of care received outside the archipelago during a private trip; this point is to be clarified with the CPS before departure, and an assistance policy can complement local cover.
• Student: the CPS provides an information sheet dedicated to students returning from abroad; affiliation depends on the place of study and the situation, to be confirmed before departure. For studies outside the archipelago, see also the student insurance page.
• Seconded employee : continuation on the French scheme is possible as long as the duration of the secondment does not exceed two years, leave included, on the basis of the certificate of coverage (form SE 975-01) requested from the CPS by the employer; an exceptional exemption is possible, after a favourable opinion from the competent French body.
• Retiree: a pensioner of a French scheme can register with the CPS with form SE 975-07 to receive benefits in kind, as can their dependants residing with them; a health insurance contribution is withheld from the pension if the retiree remains covered by a French scheme.

No individual penalty is mentioned in the sources consulted for lacking supplementary insurance. The risk mainly lies in the costs that remain payable by the insured person and in care received outside the archipelago outside the framework of medical evacuation.

As Saint-Pierre and Miquelon is part of the Republic, this is neither an international social security agreement nor an application of EU regulations: the archipelago is an overseas collectivity endowed by Organic Law no. 2007-223 of 21 February 2007 with its own institutions, and its social security scheme is local. Coordination with the schemes in force in mainland France, in the overseas departments, in Saint-Barthélemy and in Saint-Martin is organised by Decree no. 2011-512 of 10 May 2011, which applies with no nationality condition and can avoid waiting periods for sickness and maternity benefits.

• Temporary stay of an insured person from mainland France: form SE 975-03 requested from their fund before departure and presented to the CPS, which covers the immediately necessary care under local legislation; if care continues, the CPS contacts the fund for a new certificate. Planned care is not covered.
• Sick leave or planned care in Saint-Pierre and Miquelon: form SE 975-04 issued by the French fund and handed to the CPS, which provides the benefits in kind; daily allowances continue to be paid by the French fund.
• Employee working on site without being seconded: subject to the legislation of Saint-Pierre and Miquelon, for themselves and the family members residing in the archipelago. Before departure, form SE 975-02 (aggregation of insurance periods), requested from the mainland fund, avoids a waiting period on return to France.
• Family remaining in mainland France during a secondment: registration with the primary fund of the place of residence with form SE 975-06 issued by the fund of Saint-Pierre and Miquelon.
• Retiree: form SE 975-07 to register with the CPS with dependants residing with them; a retiree attached to a fund in mainland France or an overseas territory can also, according to the CPS, make use of coordination so as not to advance their costs. According to ameli.fr, Saint-Pierre and Miquelon is among the bilateral agreements providing for the coverage of retirees' care during stays in France.

1. Before departure: report your departure to French bodies (CPAM or CGSS, CAF, France Travail, pension funds) and check your health cover, as recommended by the CPS.
2. Depending on the situation, ask your fund for the suitable coordination form: SE 975-03 (temporary stay), SE 975-04 (sick leave or planned care), SE 975-02 (aggregation of insurance periods before settling).
3. Seconded employee: the employer requests the certificate of coverage (SE 975-01) from the CPS; the family remaining in mainland France registers with the primary fund of the place of residence with form SE 975-06.
4. Travel: if the route goes through a Canadian airport, obtain the electronic travel authorisation (eTA) online on the official Government of Canada website before buying tickets.
5. On arrival: register with the CPS with the registration form, identity document, family record book, a bank details slip (RIB), the children's school certificates, the certificate from the former fund and the Carte Vitale; an employee adds a local payslip (transfer order for a civil servant).
6. Family benefits: request the transfer of the CAF file to the last body that paid the benefits; the CPS requires permanent residence in the archipelago.
7. Retiree: register with the CPS with form SE 975-07 and inform your pension fund of your change of residence.
8. Take out, if needed, supplementary health insurance covering the co-payment and the hospital charge, and check with the CPS the coverage of care in case of travel to Canada.
9. If leaving the archipelago: inform the CPS using the departure form provided for that purpose.