Retirement Homes in France – Who Pays?
17th July 2023
Residential care is not cheap, and children are often required to pay some of the costs.
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Retirement Homes in France – Who Pays?
17th July 2023
Residential care in France is not cheap, and children are often required to pay some of the costs.
Residential homes are called Etablissements d’Hébergement pour Personnes Agées Dépendantes (EHPAD), or maisons de retraite in normal lexicon.
The charges for residential care comprise three components – for accommodation, social care and medical treatment.
- Medical costs can be removed from the equation as they are paid via the health system.
- The accommodation charge includes full board, activities, supply of linen etc.
- Social care costs include assistance with toileting, dressing, and taking meals, use of incontinence products and dependence related additional laundry costs.
The monthly bill varies by establishment but would rarely be less than €2,500. In Paris and the Ile-de-France, and in top-end homes, it can easily be double that amount....or more.
Family Solidarity
Although social benefits can pay for both accommodation and social care, they are means tested, and only accessed after implementation of the family solidarity provisions of the civil code.
In the first instance the spouse or civil partner is expected to provide financial support.
If this assistance proves impossible or inadequate, the responsibility passes to the children. Article 205 of the civil code states: “Children owe maintenance to their father and mother or other ascendants who are in need.”
This is known as the l’obligation alimentaire.
It is an obligation that extends to grandchildren if the children are unable to help, although this depends on the regulations in place in the departmental council, who are responsible for control of the homes and social benefits.
A spouse also has the same legal duty towards their parents-in-law, but, again, department regulations may be more favourable.
There is no maintenance obligation between siblings or other family members.
Contribution Level
Each departmental council has its own rules for determining the contribution to be made, which is based on income.
As a consequence, the amounts paid by the children in a family will vary.
If one of the children does not pay, it has no bearing on the others, although the council may sue the defaulter to enforce payment (including by a bank seizure).
When a person enters a residential home and social assistance support is deemed necessary, the contact details of the children (and possibly the grandchildren) should be provided on the application form. They will then each receive a questionnaire about their income.
There is no national scale for the minimum or maximum contribution. Departmental councils have their own rules. For instance, in some departments no contribution will be expected for those on an income below the minimum working wage (SMIC). Tougher or more generous rules apply in other cases.
An appeals system is in place against the contribution level demanded by the council, which can ultimately end in judicial proceedings, when a judge will make the final decision. Enforcement of the process across international borders is flaky but sums owed can be later recovered from the succession.
A resident cannot be asked to sell their home to pay for the accommodation, although such a decision may be made in tandem with family members. Similarly, although capital funds are taken into account, a resident cannot be obliged to use funds in an assurance vie policy to pay for their accommodation and care.
Social Benefits
The main means-tested social benefits available are:
- Allocation Personnalisée d’Autonomie (APA) - This is payable to those who need assistance with daily tasks such as washing and dressing and regular monitoring. Around 80% of residents benefit from assistance towards their care costs through APA.
- Aide Sociale à l’Hébergement (ASH) - The benefit is used to provide a degree of independence for those who need day care or specialist equipment.
- Aide Personnalisée au Logement (APL) - In the same manner it is also possible to claim assistance towards accommodation costs through APL. The benefit is payable based on the level of dependency.
Tax Relief
Tax relief is available both to those who are resident in a home and to family members who contribute to the costs of that care.
In the case of residents, they are entitled to a tax reduction of 25% of the costs they meet, up to a maximum of €2,500. It applies irrespective of age.
Accordingly, as it is a tax reduction (not a tax credit), only those who pay income tax can benefit. The reduction is not granted automatically so must be included on the income tax return, for which there is specific provision.
The tax reduction is also available to those in a nursing home, called Etablissement de Soins de Longue Durée.
Provided the person is also fiscally resident in France, this tax break is also available to those who are in any residential home in the EEA.
Children who provide financial support (pension alimentaire) can also claim a tax reduction, up to €6,386 a year (2022). This tax reduction is not, however, available unless you are resident in France.
Inheritance
Where such social benefits are received, on the death of the recipient they can be recovered from the inheritance. We will be looking at this topic at a later date.