Latest News: Health Care in France
The recent confusion concerning health insurance for British people who have retired to France has been clarified by the French government in an announcement on their social security website.
As from 1 October 2007 British expats taking early retirement to France are no longer allowed to pay contributions (around 8 per cent of their income) in order to get treatment through the French health-care system via the ouverture Médicale Universelle (CMU).
Health insurance is also being withdrawn from those early-retired expats on low-incomes who were claiming free health insurance via the CMU, as well as from those who have reached UK retirement age but do not qualify for a UK pension.
Retired people in receipt of a state pension from the UK are not affected by the changes. They will retain their health insurance in France via form E121 as these costs are in fact met by the UK.
New arrivals in France in possession of form E106 are also unaffected in the short term, and remain entitled to health insurance for their first two years in France as these costs too are met by the UK.
In both cases however, they are advised (although not obliged) to arrange top-up insurance or a mutuelle because state health insurance in France only covers approximately 70-80 per cent of medical expenses.
Those who are employed, self-employed or who are living with or married to a French person are unaffected as are those who are living with or married to a person in possession of an E121 or an E106.
The change therefore concerns those people who have retired to France, are not working, but are not yet old enough to receive a UK pension. The British government estimates that about 6,000 people fall into this category.
The authorities have however extended a period of grace of six months to those expats already insured via the CMU, and these people now have until the end of March 2008 to find private health insurance.
This will include those people with preexisting medical conditions who are already insured via the CMU. They are
the worst affected because they are likely to find treatments for such pre-existing conditions excluded from their private health insurance policies.
The French government points out that these rules are not specifically aimed at British people but apply to all non-French EU nationals living in France. It is not clear however, if the rules will also apply to non-EU nationals – for example Americans who, it appears, currently remain insured via the CMU.
Meanwhile, the French government points out that, as laid down in EU Directive 2004/38, it does not have any obligation to pay the health-care costs of non-French EU nationals who have never worked in the country, and nor does it have any obligation to let them pay to join the French health-care insurance system via the CMU.
This directive was implemented into French law in 2006 and again by decree n° 2007-371 on 21 March 2007 and so, although his scorn of early retirement is well-known, the changes cannot be laid at the door of the new French President.
Furthermore he and the Prime Minister Francois Fillon are under huge pressure from the European Central Bank to cut public spending (the highest in the EU) in order to reduce France’s deficit which is currently 2.4 per cent of GDP.
It is therefore unlikely that any move will be made which could be seen by opposition parties as increasing public spending in order to benefit immigrants.
On the other hand, the French authorities are well aware of the negative publicity which would result from stories
circulating of infirm elderly people being denied health treatment in France.
It is conceivable therefore that a concession might granted by the end of March 2008, allowing expats taking early retirement in France to continue paying their health insurance contributions via the CMU. This however remains to be seen.
In the meantime, people taking early retirement and moving to France without either a form E106 or a form E121 will need private health insurance. Those already covered should start investigating private health insurance.
Costs start at around £1,200 a year for a healthy 60-year old person who only requires basic insurance for hospitalisations etc, and is willing to pay a part of treatment. For the same man requiring full cover, insurance would be in the region of £1,800 a year.
Those visiting France occasionally throughout the year will continue to be covered (for emergency treatment only) by the European Health Card (which has replaced the old E111).
For personalised information about individual cases, two English speaking help lines have been set up: on 08 20 90 42 12 or 01 45 26 33 41.