The role of the CPAM

What is the CPAM?

The CPAM (Caisse Primaire d’Assurance Maladie) is a body within the general Social Security scheme responsible for health insurance and occupational risks.

Social Protection and health insurance are not synonymous. Social Protection is made up of several branches, such as the family branch, managed by the Caisse d’Allocations Familiales (CAF) under the general scheme, and the health branch, managed by the CPAM under the general scheme.
There is not just one CPAM, but several local offices spread across mainland France, with one in each department. An insured person’s CPAM is determined by their place of residence, except in specific cases.

The CPAM is not, however, the only health insurance scheme in France. Other schemes exist, such as the Mutualité Sociale Agricole (MSA) for agricultural professions, or the Caisse Nationale Militaire de Sécurité Sociale (CNMSS) for military personnel, which cover insured persons who do not fall under the general scheme.
An insured person cannot be affiliated with two health insurance funds at the same time. Anyone eligible for a special scheme will be affiliated with that scheme instead of the general scheme.

What is the role of the CPAM?

The CPAM is responsible for the following branches of the general Social Security scheme:

• Health;
• Maternity and paternity;
• Disability and death;
• Occupational accidents and work-related illnesses.

As such, CPAM offices are responsible for managing insured persons’ health insurance rights. This includes, in particular, handling initial health insurance affiliations, as well as the reopening and closure of insured persons’ rights.

CPAM offices are also responsible for paying benefits and daily allowances, and for reimbursing insured persons’ healthcare expenses.