French healthcare system – changes for expats
The proposed changes in the French healthcare system applying to expats in France are a source of much discussion at the moment, and it is still not quite clear exactly who will be affected, and to what extent.
Nonetheless the implications could be serious, above all for those expats living in France who are below state retirement age but not actively working or contributing to the French social security system.
The following article has been contributed by Steven Grover (see contact details below) and explains the current position:
The current changes to the French healthcare system are a knock-on effect of EU directive 2004/38, which has been brought into the French administrative system by law 2006-911 (24/07/06) and decree 2007-371 (21/03/07). This change is not exclusive to France as other EU countries including Spain and Portugal have also recently adopted this directive.
So how will it affect you ? As it stands at the moment the situation is as follows:
• If you are over the legal retirement age (60 for a woman & 65 for men) then you are completely unaffected, as part of reciprocal agreement between EU member states the UK E121 guarantees this.
• If you are under the legal retirement age, working legally and continue working in France (at least 60 hrs per month) and have been paying cotisations (Similar to NI contributions) you will be unaffected.
• If you are under legal retirement and are not working, but currently hold a valid UK E106 you will continue to be covered by this until its expiry (depending on your UK NI contribution levels it will cover up 2 Years) but after its expiry you will be in a situation where you need to purchase private health care until you reach the legal retirement age and the E121 kicks in. Private healthcare for a couple in their mid-fifties will cost around €300 per month depending on the level of cover you require.
• If you are under the legal retirement age, and are not covered by the E106 because its expired then you will need to purchase private health care until you reach the legal retirement age and the E121 takes over. Even if you have voluntarily been paying cotisations and currently hold a Carte Vitale (French health service card) you will still need to purchase private healthcare. Securite sociale confirmed (24/09/07) that expatriates who are already in the French healthcare will continue to be covered by the French health service system until 31st March 2008 to enable them to find a suitable private policy to cover their healthcare needs from this date.
• If you are planning on permanently moving to France new arrivals will now have to register with their Marie (Town Hall) within 3mths of arriving, and provide evidence that they have medical coverage from either an E106, E121 or a private healthcare policy as well as evidence of sufficient financial resources to live on after which you will then be given a Certificate of residence.
One thing that still remains unclear is what the situation will be if one of the couple is at state retirement age and the other is not. We know that if the husband has reached state retirement age and has an E121 that the wife will automatically be eligible for a carte vitale, but if the wife has reached state retirement age but the husband has not it is still unclear as to whether the French government will be willing to accept that the husband is a dependant of the wife and be issued with a carte vitale. Another point that has not been confirmed is what the situation regarding access to the state healthcare system would be if an Expatriate was to gain French citizenship which can be applied for after 5 years of uninterrupted residency.
Useful Telephone numbers:
CPAM – The French Health Service (English language service): +33 8 20 90 42 12
CLEISS – (France’s helpdesk for international mobility and social security): 11 rue de la tour des Dames 75436 Paris cedex 09 Tel: +33 1 45 26 33 41 www.cleiss.fr
DWP Overseas Medical Benefits line (+44 191 218 1999) (Monday to Friday 8am-8pm) International Pension Centre Department for Work and Pensions Room TC001 Tyneview Park Whitley Road Newcastle upon Tyne NE98 1BA http://www.dh.gov.uk/ or for press enquiries: Department of Health Press Office: +(44) 207 210 5221
The Securite Sociale statement can be read in French here – http://www.securite-sociale.fr/comprendre/europe/europe/cmu_inactifs.htm
This information is only provided as a guide and, if you need assistance in this area you are strongly advised to seek the help of a specialist in this field as each individual case is different.
If you have a question, want to arrange for a free financial review or just want further information I can be contacted on +33 (0)325461631 or Steve@financialexpat.com
Financial expat is registered and licensed in France under the European wide “umbrella group” of TSG insurance Services (The Spectrum IFA Group).
TSG Insurance Services S.A.R.L. Siège Social: 34 Bd des Italiens, 75009 Paris « Société de Courtage d’assurances » R.C.S. Paris B 447 609 108 (2003B04384) Numéro d’immatriculation 07 025 332 – www.orias.fr
I can sort of see the logic in this from the French point of view – but aren’t there also European directives regarding male/female equality? To say that if I were dependant on my husband and therefore qualify for healthcare but not the other way round does seem to contradict all we have understood about the spirit of EEC equal opportunities legislation. Why shouldn’t my husband be my dependant? I would like to see a test case go to the European court.
Hi Linda,
Since this was a guest article I’m not able to comment specifically, but I would certainly imagine that no new law would be permitted to impinge on existing equality laws, nor would that be the intention of the new law.
Really I’d be inclined to wait if possible until the situation has been clarified before taking any important decisions (I understand our local insurance office is getting a great deal of requests for health insurance). Everything I hear one day seems to contradict what I heard the day before, so I think we are still some way from a clear understanding.
Cheers
Hi Linda,
As Boris points out some of this is still unclear, as France has yet clarify a few points which is why I highlighted them in the article. However I think within the coming weeks the situation is going to be made clear with regards to cover for spouses under partners E121s and cover for those with a disablity. So keep an eye out for an update.
Is there a more worrying aspect to the proposed changes to health care for UK expats.? My husband has been recently turned down for 2 stents at Rennes Hospital. Both a Cardiologist in Thailand and France have acknowledged he requires them……!*?
He is covered by an E121 but is under 65. I (the spouse) am under 60. I both take care of my husband, who has a long history of major heart problems and work seasonally in the UK. Are we covered?
We’ve owned and lived in France for 16years.
Rona,
If you have a look back on this site next week we should have an update as there are a few big changes that have come through on the 23/11/07 but we are just awaiting confirmation from the British Embassy before putting it in print. But if you have both been living in France full time and paying tax here you should be able to stay in the French system – do you both have a Carte Vitale at the moment ?
Steve
Even after the latest French Directive has been issued (in November) by the French authorities it is unclear to me what prevails in case a pensioner with a statutory pension from another EU state has lived for more than 5 years in France: 1) direct CMU insurance under the fRench law, or 2) right to benefits in kind under the CMU system on the basis of submissionm of an E121 form to the local insurance agency.
My question may also be formulated in another way: suppose you have been living in France for more than 5 years and been insured under the CMU system, and only after these 5 years you will receive a statutory pension from another EU country , will you have to submit an E121 form which may also imply that you have to pay your premiums to your pension state? This may be relevant fro UK pensioners (as they do not have to pay premiujms to the UK) and for Dutch pensioners (who have to pay higher premiums to the Netherlands than to the French system)
alors! zut
update: EU has great debts, all benefits in danger of
‘austerity.”