ASK THE EXPERT Q - « We’re planning on moving to France permanently in the next few years. Aiming on spending half the year in our French home and the other in the UK until then. Is it possible to keep our existing private insurance, or are we better off relying on the state health provision and how would we go about registering? We are both in our fifties and will be earning in the UK until we officially “make the move”.Alison McCARDELL, by email
A - It is said that the French system is the best in the world.
Fortunately, I have not had the misfortune to experience the other countries hospitality but the French health services have an excellent reputation for the care provided but on the other hand has the reputation of being VERY expensive and complicated if you get things wrong.
The French system bears no resemblance to what you have been accustomed to as many expats realize when they make their first claims.
Expats that have tried to get into the “Sécurité Sociale” by themselves have found it sometimes very complicated and longwinded if they “step off the garden path.”
When you are on “holliday” in France, (this is how you will be regarded until you become French resident), your “EHIC” (European Health Insurance Card) will cover you for any unplanned eventualities. You will be asked to pay upfront for minor medical acts but the larger hospitalizations will be taken care of between “CPAM” ‘(Caisse Primaire d’Assurance Maladie) and/or the NHS.
When you eventually stop working and decide to move, apply for an S1 from the NHS. Formerly known as but still referred to as an E106.
This will give you normal French social security cove as long as you have worked and paid NI contributions in the last 3 years. The validity of the S1 depends on when you stopped working and when you apply for the forms.
The normal French system is only partial reimbursement so it is strongly advisable to take out complimentary insurance (top-up) to reimburse what the “CPAM” does not cover.
At the end of your S1(E106) period, if you are not or have not been employed or self-employed and you are still under your state of origins retirement age then you are OBLIGED to take out FULL private insurance. This cover MUST REPLACE your French “Sécurité Sociale” and possibly your complimentary insurance depending on the level of cover chosen. Policies recognized by the French system are the “NON ASSUJETIS SOCIAUX” or “NA”, expressed as a PERCENTAGE to the “TARIF DE CONVENTION” (set rate given to a particular medical act or treatment). The “NA” covers do not have FINANCIAL LIMITS nor can they refuse certain medical conditions, again replacing the French system. Depending on your medical condition, the company will increase your premiums to cover any known ill health risk or simply refuse you. As long as you have made the effort to get private cover but have been refused, there could still be a way into the system.
You will only need the “FULL COVER” option for a few years.
When you can prove to “CPAM” that you have lived in France for at least 5 years with the adequate requirements you are granted access to the “CMU” (Couverture Maladie Universel). BECAREFUL, the “CMU” is NOT FREE but depending on your income.
The “CMU” is not obligatory, I have often maintained people on “FULL COVER” as some levels with reasonable cover are cheaper than the “CMU” and “Top-up” cover.
At any period, If you are diagnosed with anything serious after your arrival in France you will probably be accepted into the French system with an “ALD” (Affectation de Longue Durée, (long term ill health)). This means that you are put back into the system and your medical needs regarding your particular condition are covered by the state but you will still need a “Top-up” for the rest.
Finally, an S1(E121) will be issued when you reach your state of origins retirement age, 66 for men and between 60 and 66 for women, depending on the NHS. This form entitles you and your spouse or partner (whoever reaches retirement age first) to normal “CPAM” cover like the S1(E106) when your originally moved to France. You will be issued with a “CARTE VITALE” and with your “Top-up” papers are no longer required to pay for the majority of your medical needs.
It is recommended to seek professional advice through companies that specialize in the expat community. Only a handful of “HEALTH INSURANCE SPECIALISTS FOR EXPATS” like SOFICAS really exist. The services and information provided should be FREE OF CHARGE regarding the state “Sécurité Sociale” when you take out a COMPLIMENTARY or FULL insurance with them.
Tony MASON - SOFICAS