Compulsory health insurance (AMO) for the self-employed and liberal professions: who is covered and how contributions are set

The universal social protection programme extended compulsory health insurance (AMO) to people working on their own account. The scheme is governed by Law No. 98-15 on AMO for self-employed, independent and liberal-profession workers, as amended, and it is managed by the CNSS.

Who is covered?

The scheme applies to people with a non-salaried activity, in particular:

• liberal professions: doctors, pharmacists, dentists, lawyers, architects, consulting engineers, notaries and other regulated professions;
• traders and craftspeople;
• auto-entrepreneurs and taxpayers under the single professional contribution;
• other categories of self-employed workers defined by decree.

The insured person’s dependants, spouse and dependent children under the conditions provided, are also covered.

How is the contribution set?

Unlike an employee, whose contribution is based on actual salary, a self-employed worker contributes on the basis of a flat-rate income:

• a decree sets a reference flat-rate income for each professional category or sub-category;
• the contribution is a percentage of that flat-rate income;
• for some categories, the contribution takes the form of subscription fees.

When a person falls into several categories, the contribution is calculated on the highest flat-rate income.

The amount therefore depends on the category you are classified in, not on your actual income. Check your classification with the CNSS: the wrong category means the wrong contribution.

Entitlements

Under the scheme’s rates and conditions, AMO covers care, consultations, medicines, hospital stays and tests for the insured person and their dependants.

Benefits require contributions to be up to date. A person who stops contributing for a long period may face a waiting period before regaining entitlements, after settling arrears.

Practical obligations

1. Register with the CNSS, where this has not been done automatically from tax administration data.
2. Pay contributions on the due dates, online or through the CNSS payment channels.
3. Declare dependants.
4. Keep the certificate of regular payment, often requested in administrative procedures.

And tax?

Health insurance contributions paid under a compulsory scheme are in principle deductible when determining taxable professional income, under the rules of the applicable tax regime. Their treatment should be checked when preparing the annual return.

Ascensu supports liberal professions and self-employed workers with their social and tax obligations, as part of their bookkeeping and tax returns.

This article is provided for general information, as at its publication date. It is not personalised advice: the rules change and every situation must be reviewed on its own facts.