An EHPAD (établissement d'hébergement pour personnes âgées dépendantes) is the French residential care home for older people who need help with daily life. Paying for a stay means covering, each month, the accommodation charge and the resident's share of the dependency charge; medical care itself is funded by Assurance maladie, the state health insurer. When the pension falls short, the gap is closed with public grants, by drawing on the family's assets and, less often, with credit designed for very old borrowers.
The guidance service Cap Retraite puts the average bill at €2,000 to €3,000 a month, and well above that around Paris, while many pensions sit below that level. Families then look for a loan, but ordinary consumer credit with instalments running at 88 is rarely the answer. Better-suited tools exist, and they apply whether the resident is French or a British, Irish or American retiree who has settled in France.
Grants to claim before any financial arrangement
The APA en établissement (personalised independence allowance paid in care homes) lowers the dependency charge for residents assessed in GIR groups 1 to 4, the French dependency scale. It is not recovered from the estate. Housing benefit from the CAF or MSA, the family and agricultural benefit funds, reduces the accommodation charge where income is modest. The two can be combined and should be requested on admission.
A tax reduction worth 25% of dependency and accommodation costs applies up to €10,000 of spending a year, so at most €2,500, but only for households that actually pay income tax. Finally, the département's ASH (aide sociale à l'hébergement, accommodation social aid) can pay the balance in an approved home, though it is recoverable from the estate.
The main funding routes compared
Once grants are in place, the remaining cost can be met in several ways. The table compares them by resident profile, advantage and trade-off. The choice mainly depends on whether there is a property, whether a spouse still lives in it and how long the stay is likely to last.
| Solution | Suits | Advantage | Trade-off |
|---|---|---|---|
| Accommodation social aid (ASH) | Low income, approved home | Covers all or part of the balance | Recovered from the estate; children's maintenance duty |
| Letting the home | Owner whose house is empty | Monthly income, asset kept | Management, repairs, empty periods |
| Viager sale | Owner with no priority heir | Lump sum plus a lifetime annuity | The property leaves the estate |
| Lifetime mortgage (prêt viager hypothécaire) | Owner aged 60 or over | No repayments during the borrower's life | Interest rolls up; debt settled at death |
| Pawn loan (prêt sur gage) | Holder of jewellery or valuables | Immediate cash, no income check | Limited sums; item sold if unpaid |
Selling en viager once the house is empty
A viager is a French life-annuity sale: the buyer pays an upfront sum, the bouquet, then a monthly rente for the seller's lifetime. In a viager occupé the seller keeps the right to live in the property for life. Renée Costes, a viager specialist, explains that if the seller moves out early, the annuity is increased according to a scale written into the deed. For a future care home resident this clause is essential and must be negotiated at signature.
If the house is already vacant, a viager libre (vacant-possession sale) produces a higher bouquet and annuity. On tax, the same firm notes that only 30% of the annuity is taxable when the seller is 70 or older. Indexed each year, the annuity is added to the pension to pay the home.
Building the funding plan for the stay
- Work out the exact monthly balance with the official EHPAD price comparison tool, net of grants.
- File the APA and housing benefit applications without delay.
- List every resource: pensions, survivor's pension, savings, assurance-vie, property, valuables and any foreign pension.
- Bring the children together to share any contribution according to their means.
- Choose a property-based solution while taking account of a spouse who still lives at home.
- Have a notaire check the arrangement, particularly for a viager or a lifetime mortgage.
Where families commonly go wrong
The most frequent mistake is drawing on savings every month without a plan. Within two or three years the accounts are empty and the family has to find a solution in a hurry. It is better to decide early whether to let or sell the house, when market conditions still allow you to wait for a good buyer.
The second is having an adult child take out consumer credit to pay a parent's bill: the instalment weighs on the child's own budget for years, with no idea how long the stay will last. The third is overlooking the early-vacancy clause in an occupied viager, which deprives the seller of a higher annuity just when it is most needed. Expatriate children living in London or Dublin also tend to underestimate how long French grant files take, so start the paperwork before the move.
Additional levers for a long stay
Other, often overlooked, resources can complete these arrangements:
- Pension funds' social action: one-off help for admission or the first month.
- Partial assurance-vie surrender: lighter taxation after eight years, with nothing to repay.
- Long-term care insurance: if a policy was taken out, its annuity starts according to the level of dependency.
- A structured family contribution: a written agreement between siblings avoids conflict; since the 2024 loi Bien vieillir, grandchildren are no longer called on for social aid purposes.
- A home approved for social aid: accommodation charges are often lower, and departmental aid is available.
A costed example
Madeleine, 87, a widow, receives €1,650 a month from her own pension and her late husband's survivor's pension. Her EHPAD bills €2,800 a month after APA, and housing benefit brings in €150, leaving a monthly gap of €1,000. The tax reduction barely helps: her income tax is small and the benefit is not refundable beyond the tax due.
Her empty house is worth €220,000. Her two children rule out a sale and choose a Foncier Reversimmo lifetime mortgage, distributed by her Caisse d'Épargne. The capital released funds several years of care with no monthly repayment. On her death, the heirs will choose between repaying the loan to keep the house or selling it.
Questions families ask about care home costs
Will a bank lend to an 85-year-old resident? For standard credit, rarely, because of insurance. The lifetime mortgage, with no repayments and no health questionnaire, is designed for exactly this profile when the person owns property.
Do the children have to pay? French law imposes an obligation alimentaire, a maintenance duty towards parents in proportion to the children's means, particularly when social aid is claimed. The family court judge decides if they disagree. Children living abroad can still be asked to contribute.
Do the heirs have to repay the ASH? The département may recover sums paid from the estate, unlike the APA. That should not stop you applying when resources are genuinely insufficient.
How much can a lifetime mortgage release? The sum depends on the property value and the borrower's age and sex; according to Meilleurtaux it ranges from 15 to 75% of the estimated value. The older the borrower, the larger the share.
Can we let a parent's house once they move into the home? Yes, with their consent, or that of their legal representative under a protection measure. The rent adds to their resources for the fees, although it can reduce housing benefit.
Organisations and offers to contact
- Cap Retraite : Free care home placement service helping families find an EHPAD, with a guide to the grants and lesser-known ways of paying for a stay.
- Portail national pour les personnes âgées : Official CNSA website explaining how an EHPAD bill is built up, with access to the government comparison tool for prices and remaining costs.