In summary…
A self-employed midwife who declares €55,000 of benefit affects, while on sick leave, approximately €75.34 per day from the primary health insurance fund (CPAM) from the 4th to the 90th day, then €49.70 per day From the Autonomous Pension Fund for Dental Surgeons and Midwives (CARCDSF), starting on the 91st day: the allowance decreases by 34.% on the 91st day. Over 12 months of sick leave, she receives €20,222 and is short €34,778, before office expenses. In the event of total and permanent disability, the CARCDSF pension is €13,460 per year (January 2025 table, the last one published), i.e., 24 % of the profit: it is missing €41,540 per year. A group pension contract, known as a Madelin contract, is deductible from profits up to €5,426.70 per year at this income level (article 154 bis of the General Tax Code).
1. A self-employed midwife is indeed covered by the CARCDSF, but her amounts are not the same as those of dental surgeons.
The CARCDSF is the professional branch of the National Old-Age Insurance Fund for the Liberal Professions (CNAVPL), which covers two professions: dentists and midwives. A self-employed midwife therefore contributes to it for her retirement and her disability and death benefits. The eligibility requirements are the same as for dentists (starting on the 91st day, same waiting periods, same exemptions)., but the amounts are those from a table specific to midwives.
| Performance 2026 | Midwife | Dental surgeon |
|---|---|---|
| Daily allowance from CARCDSF, starting from the 91st day | €49.70 per day (€18,140.50 for 365 days) | €113.22 per day |
| Free points awarded in case of total and permanent disability | 400 points in the basic scheme, 5 points in the supplementary scheme | 400 points in the basic scheme, 6 points in the supplementary scheme |
This difference in amount is the first thing to remember: reading an article on the insurance of a dental surgeon and applying it to a midwife overestimates the compensation from the fund by more than double.
2. Sick leave: the CPAM, then the CARCDSF
A self-employed midwife does not have an employer who maintains her salary. Her leave is compensated in two stages, by two organizations, and nothing is paid during the first three days.
| Stoppage period | Who pays? | Amount for a profit of €55,000 |
|---|---|---|
| Days 1 to 3 | Person (3-day waiting period) | €0 |
| Days 4 to 90 | The CPAM, since July 1, 2021 | €75.34 per day, or 1/730th of the average annual income of the last 3 years (€2,292 per month) |
| From the 91st day, up to 3 years old | The CARCDSF, disability and death benefits scheme | €49.70 per day (€1,512 per month), regardless of income |
The CPAM The midwife receives 1/730th of her average annual income over the last three calendar years, which is half her income over a 365-day year, according to the Centre for European and International Social Security Liaison (CLEISS). CLEISS does not specifically mention midwives; it deals with regulated liberal professions, which include midwives, and caps their income at three times the annual Social Security ceiling (PASS), which was €144,180 in 2026, with a maximum of €197.51 per day. Eligibility requires 12 months of uninterrupted contributions. The CPAM (French Health Insurance Fund) pays a maximum of 87 days per sick leave, from the 4th to the 90th day.
A contradictory ceiling between two official sources. The service-public.gouv.fr information sheet on daily allowances for self-employed professionals shows a maximum of €65.84 per day, which corresponds to one PASS (48,060 € ÷ 730). The CLEISS (French National Council for Social Security Information) gives €197.51 for regulated liberal professions. We are using the CLEISS ceiling of 3 PASS for these professions. At €55,000 in profit, the difference is significant, as the income exceeds one PASS: with only one PASS, the allowance would be €65.84 per day instead of €75.34, or €5,728 instead of €6,555 over 87 days. Your health insurance statement will determine the amount for your case.
The CARCDSF takes over. Its 2026 page shows a single amount for midwives, €49.70 per day, without any income-related formula. A midwife with €55,000 in profit therefore receives €75.34 per day until the 90th day, then €49.70: the allowance drops by 34 % overnight, and the fund only pays out 33 % of the profit. Whether the profit is €30,000 or €90,000, the amount paid by the fund from the 91st day onwards is the same.
- Statement The declaration of cessation of activity and the notice of work stoppage must be sent by registered mail no later than 90 days after the end of the initial 90-day period. A late declaration only grants entitlement from the first day of the calendar month following its receipt.
- Up-to-date membership fees : if contributions remain due, benefits start on the 31st day after their payment, without retroactive effect.
- Term A maximum of 3 years, continuous or cumulative, counted from the start of payment. Benefits cease upon resumption of activity, even partial, and upon payment of a retirement pension.
- Nature of the incapacity Illness or accident that prevents the practice of the profession in all its forms, including occasional, advisory, or teaching activities. The midwife remains registered with the Order.
- Relapse For the same condition, if it occurs within a year, there is no further waiting period and payments resume from the first day. The certificate must reach the fund within 30 days.
- Exemption from contributions After more than 6 months of incapacity, a midwife can request to stop contributing. For the basic scheme, 400 points and 4 quarters are credited; for the supplementary scheme and supplementary old-age benefits, the corresponding rights are lost.
- Taxation : the allowances are taxable (declared as pensions and annuities) and subject to 9.10 % of social levies (general social contribution 8.30 %, contribution for the repayment of the social debt 0.50 %, additional solidarity contribution for autonomy 0.30 %), according to the 2024 guide of the fund.
The firm's expenses (rent, equipment loan, professional insurance, replacement) continue to accrue during the shutdown: neither of these two schemes compensates them.
3. Disability: an annuity of €13,460 per year, provided that the individual permanently ceases to practice
The CARCDSF pays a disability pension to midwives who obtain approval from their incapacity commission. The conditions set by the fund are strict.
- Age : be under 62 years old.
- Agreement of the incapacity committee : it rules on total and permanent professional incapacity.
- Permanent cessation of freelance activity The proof is the P4 form from the business formalities center or a certificate from the professional body. In the event of resumption of activity or replacement, the disability benefits are reinstated only after a new agreement from the commission.
- Up-to-date membership fees on all schemes of the fund (a debt of up to two years of contributions is tolerated, to be settled within one year of recognition).
- Benefits : exemption from all contributions, 400 free points to the basic scheme and 5 free points to the supplementary scheme.
| Component of the annuity | Value published by CARCDSF |
|---|---|
| Annual pension of the midwife (employee) | €13,460.00 per year, or €1,121.67 per month (January 2025 table) |
| Annual pension for the collaborating spouse | €6,730.00 per year |
| Contribution | Monthly, starting from the month following the cessation of activity, until the minimum legal retirement age. |
| Taxation | Taxable, subject to social security contributions |
| 2026 contribution to the disability and death benefit scheme | €384.00 per year (the fund's page does not detail the share of each benefit for midwives) |
The pension is a fixed amount: it is not income-dependent. It is 26% lower than the CARCDSF daily allowance over 365 days (€18,140.50, or €4,680.50 less): the transition from sick leave to disability therefore further reduces replacement income. The documents reviewed do not provide for a partial pension: a midwife who can work part-time is not eligible for this scheme. The online table from the pension fund dates from January 2025, and we have not found a 2026 table: the current amount for your file should be requested from the CARCDSF.
4. The difference with a profit of €55,000
| Situation | Replacement income | Profit share | Lack |
|---|---|---|---|
| Days 4 to 90 (CPAM) | €2,292 per month | 50% | €2,292 per month |
| From the 91st day onwards (CARCDSF) | €1,512 per month | 33% | €3,072 per month |
| Total and permanent disability | €1,122 per month | 24% | €3,462 per month |
Typical case
Situation. A 38-year-old self-employed midwife, based in Lyon, single, with no children, earns €55,000 per year, a figure that has remained stable over the last three years, according to a tax return. Her taxable income is €55,000 before any optional insurance premiums. She is up-to-date with her contributions and has not taken out any insurance policies other than the mandatory ones.
Issue. On sick leave for 12 months, she received €75.34 per day for 87 days (€6,555, CPAM), then €49.70 per day for 275 days (€13,668, CARCDSF). She received €20,222 out of €55,000 (37 %): there is a shortfall €34,778, before the firm's expenses. If the disability becomes total and permanent, the annuity is €13,460 per year (24 % of the benefit): there is a shortfall €41,540 per year, or €3,462 per month. Over 10 years, this represents €415,400 of lost income (illustration period, hypothetical).
Strategy. She takes out a group insurance policy under Article 154 bis of the French General Tax Code. The deduction limit is the sum of 3.75 times the profit (€2,062.50) and 7 times the annual social security ceiling (€3,364.20), i.e., €5,426.70, up to a maximum of 3 times the annual social security ceiling (€11,534.40). The applicable ceiling is €5,426.70, that amounts to €452.23 per month. She calculates daily allowances starting on the 4th day (or after a waiting period), and a disability pension that remains payable even if she maintains reduced activity, then sets the premium below this ceiling. Her mandatory contribution of €384 to the disability-death scheme remains fully deductible in addition (BOFiP, BOI-BNC-BASE-40-60-50-20).
Result. At €55,000, a single person falls into the 30 % tax bracket (from €29,579 to €84,577 per share, Law No. 2026-103, Article 4) and, after deductions, their profit remains at €49,573, in the same bracket. A bonus of €5,426.70 saves €1,628.01 of tax (€9,603.99 before, €7,975.98 after): the actual cost is €3,798.69 per year, or €316.56 per month. The amount of compensation and annuity that this budget covers depends on the insurer's quote: it compares the difference above (€3,072 per month for long-term sick leave, €3,462 per month for disability) to what each quote provides.
Hypotheses. The calculation assumes a stable income of €55,000, a single person, a CPAM (French National Health Insurance Fund) benefit calculated at 1/730th of average income with a cap of 3 times the annual social security ceiling (PASS), a full year of leave without resuming work, and gross amounts: neither social security contributions nor income tax are deducted. It freezes the 2026 CARCDSF (French Pension Fund for Civil Servants) amounts for benefits and the January 2025 pension, and does not take into account any bonuses or benefits from a specific contract.
5. The group insurance contract (Madelin): what the deduction allows
Article 154 bis of the French General Tax Code allows self-employed individuals subject to non-commercial profits (BNC) to deduct contributions to a supplementary insurance contract taken out on a voluntary basis from their profits. The Official Bulletin of Public Finances (BOFiP, BOI-BIC-CHG-40-50-40-20, No. 90) sets the limit: 3.75 % of taxable profit plus 7 % of the PASS, without exceeding 3 % of 8 PASS, with a floor of 7 % of the PASS. The PASS used is that in effect at the end of the fiscal year: €48,060 in 2026, i.e., a floor of €3,364.20 and a maximum of €11,534.40. The reference profit is that before deduction of these contributions.
- The contract is a group insurance contract in accordance with Article L. 144-1 of the Insurance Code, or an optional scheme of a Social Security fund (BOI-BNC-BASE-40-60-50-10, No. 400).
- The services in question : daily allowances in case of illness, capital or annuity in case of death or permanent disability, benefits in kind beyond the mandatory scheme, dependency.
- The beneficiary The following are eligible: sole proprietors, partners in a partnership, sole shareholders of a single-member limited liability company not subject to corporation tax, and collaborating spouses. Retired business owners are excluded.
- The counterpart Compensation payments that replace income are taxed as non-commercial profits (BNC) if the business activity continues, and as pensions and annuities if it ceases (BOI-BNC-BASE-40-60-50-30, no. 50). The deduction cap does not change this taxable status. Therefore, the calculation of coverage is based on the net amount after tax.
The limit for supplementary insurance is separate from that for retirement: the BOFiP (French Official Tax Bulletin) treats retirement, supplementary insurance, and unemployment insurance separately. Retirement savings plans have their own limit, detailed on our page. PER deduction limit, and the individual PER is managed in parallel with the planning and insurance.
6. In what order should the topic be addressed?
- Check your contributions The CARCDSF only grants supplementary benefits if all contributions are up to date. This is the first condition, before any calculation.
- Measure the gap With your figures: average income of the last three years (visible in the Health Insurance section), fixed costs of the practice, outstanding loans, family situation. This is the only basis that provides a useful coverage amount.
- Choose the contract based on the definitions Deductible (the mandatory scheme leaves 3 days without compensation), definition of disability (CARCDSF requires the permanent cessation of all self-employment activity), duration of the annuity, coverage for partial disability. Two quotes at the same price can cover very different situations.
- Anticipate the firm's expenses : overhead coverage or a replacement is dealt with separately, as no mandatory scheme compensates them.
- Place the remaining effort Excluding insurance: see our article on wealth management for a self-employed healthcare professional in Lyon, or the solutions of tax exemption and SCPI to build an income that does not depend on your presence at the office.
Frequently asked questions
Does a self-employed midwife fall under the CARCDSF for disability benefits?
Yes. The CARCDSF covers dentists and midwives, and manages their disability and death benefits. The rules are the same, but the amounts are specific to each profession: €49.70 per day from the 91st day for a midwife, compared to €113.22 for a dentist. The 2026 contribution to the disability and death benefits scheme is €384 for a midwife.
How many days does a midwife have to wait before being compensated?
Three days: the CPAM (French National Health Insurance Fund) pays benefits from the 4th to the 90th day. From the 91st day onwards, the CARCDSF (French Pension Fund for the Disabled) takes over, at €49.70 per day, for a maximum of 3 years. In the event of a relapse of the same condition within one year, there is no further waiting period and the CARCDSF resumes benefits from the first day.
What disability pension does CARCDSF pay to a midwife?
€13,460 per year for the pension holder, €6,730 for a collaborating spouse, according to the January 2025 table published by the pension fund. It requires an age of under 62, approval from the disability commission, and the permanent cessation of self-employment. It is taxable and subject to social security contributions.
Up to what amount can contributions to a Madelin pension contract be deducted?
Up to 3.75 % of taxable profit plus 7 % of the PASS (annual social security ceiling), within the limit of 3 % of 8 PASS, with a floor of 7 % of the PASS. In 2026, this amounts to €5,426.70 for a profit of €55,000, a floor of €3,364.20 and a maximum of €11,534.40 (Article 154 bis of the General Tax Code, BOI-BIC-CHG-40-50-40-20).
What does CARCDSF pay to the family in the event of the death of a midwife?
The health insurance fund's website displays a one-time immediate allowance of €14,831 (2025 value), paid to the spouse (provided they are neither divorced nor separated), or failing that, to the descendants, and then to the dependent. For a spouse who is a business partner, the allowance is €7,415.50. It is not taxable. If the midwife was practicing, the CPAM (French Health Insurance Fund) can also pay a maximum lump sum of €11,775 for 2025, according to the same website.
Our position
We do not replace mandatory pension plans: they form the foundation, and their amounts are those of the CARCDSF (French pension fund for civil servants) and the national health insurance system. We do not draft documents or provide legal or accounting advice: the chartered accountant validates the tax deduction on your tax return. Our role is to assess the gap between the plan and your actual income and expenses, to compare group insurance contracts based on their terms and conditions, not just their price, and then to allocate the remaining savings. We receive commissions on contracts purchased through our firm.
Book an exchange with Balmont Conseil
Alexis Sagnier, financial and real estate investment advisor, insurance broker, AMF certified. ORIAS 13003497. Updated on 28/10/2026.
Official sources consulted
- CARCDSF, page "Daily allowances" (midwives: €49.70 per day from the 91st day, €18,140.50 for 365 days, declaration, duration, relapse, exemption): carcdsf.fr
- CARCDSF, page "Disability Pension" (conditions, incapacity commission, cessation of activity, free points for midwives): carcdsf.fr
- CARCDSF, table of the amount of the disability pension for midwives, January 2025 (€13,460 per year; collaborating spouse €6,730): carcdsf.fr
- CARCDSF, "Death" page (immediate allowance for midwives, 2025 values; CPAM capital): carcdsf.fr
- CARCDSF, "Amount of contributions" (2026 contribution to the midwives' disability-death scheme: €384): carcdsf.fr
- CARCDSF, midwives' handbook 2025: carcdsf.fr
- CARCDSF, guide to daily allowances 2024 (CPAM from the 4th day since July 1, 2021, taxation, social security contributions): carcdsf.fr
- CNAVPL, presentation of professional sections (CARCDSF: dental surgeons and midwives): cnavpl.fr
- CLEISS, page on the French social protection scheme for self-employed workers (daily allowances from the CPAM for regulated liberal professions: 1/730th, ceiling of 3 PASS, €197.51 per day, 87 days): cleiss.fr
- Service-public.gouv.fr (entreprendre), «Daily sickness benefits for self-employed professionals» (maximum of €65.84 published, i.e., one PASS): entreprendre.service-public.gouv.fr
- BOFiP, BOI-BIC-CHG-40-50-40-20, limits on the deduction of supplementary pension contributions (article 154 bis, II, 2° of the General Tax Code): bofip.impots.gouv.fr
- BOFiP, BOI-BNC-BASE-40-60-50-10, scope of application of optional contributions for self-employed individuals in BNC: bofip.impots.gouv.fr
- BOFiP, BOI-BNC-BASE-40-60-50-20, unlimited deduction of mandatory disability-death contributions: bofip.impots.gouv.fr
- BOFiP, BOI-BNC-BASE-40-60-50-30, taxation of income replacement benefits: bofip.impots.gouv.fr
- Law No. 2026-103 on finance for 2026, article 4 (income tax scale); annual ceiling of Social Security 2026: €48,060.
