[Forum ameli pour les assurés] Dernières réponses

Eligibility for IVF coverage

Christelle — Mon, 16 Mar 2026 12:40:22 GMT

Hello Pixie,

First of all, it is the date on which you effectively start your self-employed activity that enables you to register to French healthcare system.

I advise you read this topic entitled : "How to be covered if I am self-employed".

Once your rights are open by your local caisse primaire d'assurance maladie (CPAM), if your are about to begin a "procréation médicalement assistée (PMA)" pathway, your gynecologist will need to complete the application form for 100% coverage for infertility treatment.

He/She will then send this application form (demande d'entente préalable) to the medical service of your CPAM for approval.

If approval is granted, your CPAM will send you a letter confirming 100% coverage under the long term disease (affection de longue durée - ALD).

Acts for "assistance médicale à la procréation (AMP)" are 100% covered by Assurance Maladie up to:

6 inseminations to achieve a pregnancy
4 fécondations in vitro (FIV) attempts to achieve a pregnancy

Concerning egg retrieval, it is possible in France up to the age of 43 and embryo transfer may be done:

up to the woman's 45th birthday, whether she is unmarried or part of a couple, who will not carry the child.
up to the 60th birthday of the partner who will not be carrying the child.

You can find further information in this article from Service Public entitled : "Assisted Human Reproduction (ART)""

For any other information I suggest you contact a gynecologist who will be able to advise you upon your personal situation.

Have a nice day

Social Security number application

Géraldine — Mon, 05 Jan 2026 07:57:55 GMT

Hello Jinsu,

We do not have access to your file or your wife on this forum to fulfill with securtity policy of your personal information.

Therfore, I invite you to contact your caisse primaire d'assurance maladie (CPAM) to reach a counselor and know more about your application.

Have a nice day.

Congé payé pma

Marion — Fri, 12 Sep 2025 10:29:03 GMT

Bonjour Cynthia33mu,

Les modalités de congés accordés dans le cadre d'un parcours de procréation médicale assistée (PMA) sont régies par le code du Travail et les conventions collectives.

Ces dispositions, tout comme celles liés à l'éventuel retour sur vos congés payés, ne concernent pas l'Assurance Maladie, je ne suis donc pas en mesure de vous renseigner davantage.

Je vous conseille de vous rapprocher de votre employeur et si besoin , vous pouvez consulter le site des Directions Régionales de l’économie, de l’emploi, du travail et des solidarités (DREETS).

Dans l'attente, cette page du site du Service Public peut vous être utile : Une salariée a-t-elle droit à des absences liées à sa grossesse ?

Je vous souhaite une bonne journée.

Your maternity leave

Valérie — Mon, 18 Aug 2025 12:53:00 GMT

How to benefit from maternity leave ?

You are working as an employee:

In order to claim your daily allowance for maternity leave, you need to:

- have been registered with the Assurance Maladie as an employee for at least 6 months prior to the expected date of childbirth;
- have worked at least 150 hours as an employee during the three calendar months or 90 days preceding the maternity leave, from the date of the start of pregnancy or the start of antenatal leave (or from the actual date of childbirth if this occurs before the date of the start of antenatal leave), or from the date of cessation of activity OR have paid contributions on a salary at least equal to 1015 times the value of the hourly minimum wage (“SMIC”) during the six calendar months preceding the beginning of the pregnancy or the beginning of the antenatal maternity leave (or from the actual date of childbirth if this occurs before the beginning of the antenatal maternity leave) or from the date of cessation of activity.

Please note that your employer must send an “attestation de salaire” to your CPAM, with the mention of the last working day. This “attestation” will also allow CPAM to calculate the amount of your maternity leave based on your most recent salaries.

You are self-employed:

If you are self-employed, you have to completely stop working for at least 8 weeks (including 6 weeks after delivery). If you are eligible, you may receive a lump-sum called “allocation forfaitaire de repos maternel”, the first half before the delivery, and the second one after. You may also be eligible for a daily allowance, as detailed below.
You need to declare your work stoppage to your CPAM using the forms attached in the booklet for pregnant self-employed workers available on ameli.fr. This booklet will also provide you with useful information regarding maternity and paternity.
If you are in any other situation, please get in touch with your CPAM for a personalised analysis of your situation.

How much is my maternity leave going to be ?

You are working as an employee:

To get a quick estimate of your daily benefits, use the simulator available on ameli.fr.
After the first payment done by your CPAM, your daily benefits will be paid every 14 days, for each day of your maternity leave (including Saturdays, Sundays, and bank holidays). Keep all of your daily benefits statements alongside your pay slips.

You are self-employed:

To know the amount of daily benefits you can claim, you can read an article on the ameli.fr website named “Les prestations maternité des travailleuses indépendantes et des conjointes collaboratrices”.

To sum up, if you are eligible, you may receive a lump-sum called “allocation forfaitaire de repos maternel”, as well as daily benefits.

The “allocation forfaitaire de repos maternel” is paid in two instalments:

- half of the amount at the beginning of the maternity leave;
- half of the amount at the end of the mandatory leave (8 weeks).

Duration of your maternity leave

According to your situation:

- You are expecting one child and you do not already have children/and you already have one child: 16 weeks, including 6 before delivery and 10 after;
- you are expecting one child and you already have two or more (children already in your care or born viable) : 26 weeks, including 8 before delivery and 18 after delivery ; or 10 before and 16 after with no medical justification;
- you are expecting twins: 34 weeks, including 12 before delivery. The prenatal period can be extended to a maximum of 16 weeks, with postnatal rest reduced by the same amount;
- you are expecting triplets or more : 46 weeks, including 24 before delivery and 22 after.

To know more about the duration of your maternity leave, you can read an article on the ameli.fr website named “Durée du congé maternité”.

Have a nice day.

Your pregnancy

Valérie — Mon, 18 Aug 2025 12:33:40 GMT

Declaring your pregnancy

To benefit from a specific cover as soon as possible, you will have your first check-up with your doctor or midwife, who will declare your pregnancy online. You will subsequently be exempted from paying your medical expenses upfront (also called “tiers payant”).
If the declaration online is not possible, the doctor will give you a three-part pregnancy declaration form entitled "First antenatal medical examination". Fill in your details and send the pink section to your CPAM and the two blue sections to your Caisse d'Allocations Familiales (Caf).

Please note that:

- You must declare your pregnancy before the end of the 3rd month of pregnancy to benefit from maternity insurance cover as soon as possible.
- Remember to update your Vitale card as soon as possible.

Useful documents:

As soon as your CPAM receives your declaration of pregnancy, you will be provided with:

-    The guide "Ma maternité - Je prépare l'arrivée de mon enfant (PDF)" (My maternity - Preparing for the arrival of my child) provides simple, practical answers to all the questions you may have about healthcare cover, medical follow-up, health advice, daily allowances, maternity leave, paternity leave, etc.;

-    A personalised calendar of your medical check-ups
It shows you month by month the dates of your main pregnancy check-ups, the periods when you are entitled to 100% reimbursement and the dates of your maternity leave;

-    A checklist “Préparer votre prochaine consultation (PDF)” (Preparing for your next consultation checklist) to help you prepare for your next visit to your doctor or midwife.

Your coverage during pregnancy from the start of your pregnancy to the end of the fifth month

During the first five months, ultrasounds are covered at a rate of 70%. Other pregnancy-related compulsory examinations are covered at a rate of 100% (excepted for additional fees that can be applied by health professionals).

Your coverage during pregnancy from the sixth month of pregnancy and up until 12 days after the delivery

The medical monitoring of your pregnancy by your doctor or midwife continues throughout the final months of your maternity leave, to ensure you have a safe pregnancy until your baby arrives.

All reimbursable health expenses are covered at a rate of 100%, within the limit of the basis of reimbursement applied by CPAM. During this period, you will also be exempt from paying upfront medical fees usually applicable to medical consultations, pharmaceuticals, paramedical services and healthcare transport, as well as hospital fees and “forfait journalier”. For visits to the emergency room, you are not required to pay the emergency patient flat fee.

Please note that your CPAM offers you a personalised service on your ameli account : if you have opened an account on ameli.fr, remember to activate the "You are expecting a child" service available in your "Prevention" area”. This service allows you to receive practical information on the progress and monitoring of your pregnancy on a monthly basis.

Opening your ameli.fr account is easy: just log in to your ameli account and follow the instructions.

For more information regarding the declaration of your newborn baby and their registration on this forum.

Have a nice day.