Health Care when moving to France

Hello, I’m new to this forum and joined it to see if I can prepare the way for an impending move to France.



I have heard that if my wife and I need to visit the doctor for anything, maybe an infection, that we need to pay in to an insurance, until we have been in France for 5 years???



I am hoping someone on here may be able to help…



Kindest regards.



Tony

It is a good point. There are not only UK people but also other EU plus USA, New Zealand, Canada, Australia and doubtless others who I hope will come to your aid. I think the starting point will always be your country's consulate or embassy to find out whether of not the there are bipartisan or reciprocal agreements. If not, then let's hope indepdent immigration advice helps with a bit of support from here.

So, what about those who are not from the UK? I plan on retiring to France in three years or so. I may find work, just for something to do, but it is not a high priority. Who would non EU citizens contact to find out about applying for health care?

Richard - it took us 2 years to get our carte vitales after we had the attestations from RSI. You must keep asking them to push along the process. I've blogged about my experience - have a look through my blog posts and I think there was a contact name at RSI somewhere in there...who finally got ours issued.

I think this is a technical issue, I'm looking into it!

thanks

James

Joan did you press send too soon?

Hi Tony

Your age is the first important stage in deciding on your health package. Are you retired or not, and are you intending to work in France or not?

Also a great deal of how you approach what you will need, depends on the priorities of health care for you. If you will need medical attention when you arrive, you should ‘sign up’ with any French equivalent of a GP - médecin traitant or médecin généraliste - who will take you. You will always pay in cash when you visit the doctor - 23€ is the rate at present - 1€ is not reimbursed under any circumstances.

Until you are ‘in the system’ of social security, and have been issued with your own French social security number - the French NI number - there are a number of important things to note. Any care needed, such as a visit to the doctor, should always be covered by a ‘feuille de soin’, a care sheet by any other name, issued by the doctor in receipt for your payment, which states what care you have received and how much was paid.

Keep this document carefully! You will need to reclaim from the CPAM - caisses primaires d'assurance maladie - the social security system. I understand different offices of the CPAM vary, but ours preferred us to make a periodic claim, rather than each individual item.

If the doctor gives you a prescription - 'ordonnance' in French - I suggest you keep a copy before you take it to the pharmacy. Medicines not available over the counter will attract reimbursement, and again make sure the pharmacist gives you a ‘feuille de soins’ for a reclaim from the CPAM.

The amount of treatments you need will determine decisions about top-up insurance - a ‘mutuelle’ in other words. We discovered you must sign up with a company which is fully incorporated into the CPAM system. Our first choice insurer was not, and we had to submit monthly claims to them as well as to the CPAM - fairly straightforward, but something of an extra chore, even if you are fully computer literate! Until you have a mutuelle you of course pay the balance from your own pocket!

About 35% of the French health service is private. I have to have a monthly blood test, so I go to a ‘laboratoire’ of my choice. I’m usually in and out within minutes, and get the results the next day. No more taking a number, waiting for hours for your turn, and often days and sometimes weeks for the result!

Both my wife and I have had shoulder surgery in a private Clinique, to which we were referred by our then médecin traitant. We didn’t pay for the surgery, but always had to pay for any consultations. More recently, our latest médecin traitant refereed me to a CHU for consultation, which led to surgery for a biopsy, where we didn’t pay for anything.

We get a monthly CPAM statement, and the one relevant to my biopsy showed the cost to have been 2,352€ - not important, but interesting to know!

Eventually they send you a letter which asks for passport photos and then if you send that off you get your carte vitale. I waited 2 years for mine despite countless visits to the offices. One important thing to remember if you post anything send it lettre recommande avec avis de reception otherwise 9 times out of 10 it disappears.

You have to visit your local CPAM (look in telephone directory) for a short interview/form filling session then wait until your CPAM sends you the carte vitale - I've known some people wait for over a year ! You have to make a nuisance of yourself and keep calling in to ask for your carte. I understand some departments are now issuing carte vitales with your photo on it - so you may need a passport photo or six !

Judith, We're about to move to France in the New Year, but because we have spe

We moved here a few years ago, we applied for and received a Carte Vitale that covers us for 70% of healthcare c osts and it is free. The remaining 30% is picked up by our insurance with Axa, I am ex NHS senior Manager and we have better cover here, contributions for dental and specs as well. Recently my husband had an ECG, brain scan and MRI, the 70% is covered by the State and Axa picked up the rest which incidentally is a fraction on UK charges. You will be covered immediately with your Carte Vitale for the 70% there is no wait for it and no 5 year condition.

Hi Tony,

Yes you could use the E111 plus travel insurance but don't forget that your S1 will be based upon your work record in England immediately before you apply for your S1 so you would posssibly be reducing your future entitlement to cover if you then decide to move to France permanently. You could confirm what your S1 entitlement would be now and then if you didn't work for six months whilst staying in France by talking to the very helpful people at the Department for Work and Pensions Overseas branch in Newcastle. Tel 0191 21 81999.

In deciding whether you like it or not Just remember also that France has a very different personality in the six months from October to April than for the rest of the year so choose the months you are going to rent carefully. The snag is that six month rentals are generally available in the winter months but winters can be very very quiet which if you live in a tourist area like me is a nice change and a big contrast to the busy summer months. Also the winter in France is generally a lot colder although shorter than say most parts of England as it is a continental climate. You will need central heating in your rental property. Hope all goes well

Tony

My fault. I should have made it clear that the www.amariz.co.uk & the www.amariz.fr site is fully bi-lingual and the company has both English and French staff all of whom speak both languages. Open either site and click on the correct flag icon.

Good luck

Ian

The CPAM lady explained to me that once I received the attestation I had to either send to or take to the CPAM the form that came with the attestation ( or it might just have been the attestation) and a photo so they could produce my card. I have also read elsewhere that you also have to nominate your GP so that you are registered with one doctor when they ask you too, not sure at what stage they ask for that. I always prefer to go to the CPAM in person so they can tell me there and then what extra piece of paper I need to bring that I didn't know about!!

Two more things I forgot to mention forTony one of which tripped us up is that if you are applying jointly then you have to have a RIB from a joint bank account, separate ones wont do. Also you only get the coverage from the state if the specialist or hospital or treatment that you get is conventionee ie approved by them as they wont pay the extra of more expensive treatments.

It’s waiting and waiting and waiting. Try going to the CPAM, there may have been a hitch somewhere.

Tony

If you contact - amariz.fr - freephone from France - 0800 900 258 or 0117 974 5770 they will be able to give you advice and help. Amariz has been providing medical expenses insurance for persons living in France for over 20 years.

Good luck

Ian

Janet, you say that "You will then get an attestation which is a document that says you are covered and then after a bit more form filling your Carte Vitale...."

I have received my attestation from RSI over a month ago but there is still no sign of a carte vitale, nor have they asked me to complete any more forms.

Is there something else I need to be doing or is it just a game of patience do you think?

Hi Tony,

How the system works if you are not working in France and only once you are covered in the French system is that unless you have a chronic or very serious illness the state only pays for up to 70 or 75% of the cost of medical treatment and you either pay the other 30% yourself or what most French and English people do is buy a top up policy from a mutuel insurance who then reimburse you for the 30 %. I am saying 70 or 75 because I am not quite sure which it is.
BUT if you are not working in France and are under the state retirement age of the country you come from you can only get French state health cover if you are not working in France for a limited period of up to two years from arrival in France depending on when you last worked in the UK. This two year cover called an S1 is obtained from the UK govt and is based on your employment NI record. So depending on your age even if you can get the maximum two year cover S1 cover there could be a gap of several years from when that cover runs out until you reach your UK state retirement age. Once you reach UK retirement age you are covered but still have to buy insurance top up for the 30% .
That means to cover the period until you reach retirement age you have to pay for a mutuel policy for 100% cover rather than 30% which can make it fairly expensive. Once you reach UK state retirement age you get 70 or 75 % cover. In France they said last year that they will correct the situation for early retirees but so far have not done so. Not sure if they will now as budgets so tight.
If you are part of a couple whoever reaches state retirement age first can cover the other which is what my partner and I do. I worked until I came here in Jan 2012 so I have full 2 year S1 cover that carries me past my state retirement age which luckily was for me 61.5 in May 2013. My partner would have had a gap of 4 years as he only qualified for one years cover until Jan 2013 as he retired a year before we came when he was 60 and his retirement age is 65. But he is covered on my entitlement.
The other option which a lot use is to retain a property in England and only live here from say March to October which means you stay in the UK system covered in France by travel insurance and an E 111.
Please note also that when you send or present your papers to the CPAM you now need a translation of your birth certificate from an official translator in France. CPAM will give you a list or you can ask around but the translater must be an official one. I would advise you to start applying for cover as a top priority when you move to France as it can take a few months and there can be many bureaucratic hurdles. You now have to register with a GP in France which you do as the next stage at CPAMs request after they have accepted your application. You will then get an attestation which is a document that says you are covered and then after a bit more form filling your Carte Vitale which is the credit card sized card that most doctors and pharmacists swipe to save you paying the 70% up front and then claiming it back. Once you receive your attestation you are covered even without the green card. Note also that all visits to the GP are chargeable and currently costs 23 Euros of which you get the 70% back.

Check here, Tony. There's a lot of info on health care http://www.survivefrance.com/page/useful-links

HI Tony,

Depending on your work situation you have different options. I am no expert but I can tell you how it works for me in case that is of use.

I am an employee in France so when I moved here, I informed the NIC that I was leaving the UK and moving permanently to France. I then applied for my carte vitale with the local Assurance Maladie. They will reimburse up to 75% of your medical costs but it does depend on what things are as levels of reimbursement are different. It also depends on your "statut". My director, for example, is fully reimbursed by the government. I then took out a Mutuelle with my bank who make up the difference. Some items are not reimbursed, (certain medicines tablets, dressings and even treatments). It will also depend on the type of cover you take out with your insurance company. I am allowed 6 osteopathic treatments a year that are reimbursed by my mutuelle at 90%. The assurance maladie does not reimburse any part of the treatment.

The best thing is to find out what your "statut" is and the level of cover that you will get through the Assurance Maladie. I would strongly advise getting a mutuelle. Some of my friends cannot afford to pay a mutuelle and they struggle enormously to pay their medical expenses. Visit http://www.ameli.fr/ and http://www.ameli.fr/assures/soins-et-remboursements/cmu-et-complementaires-sante/aide-a-l-acquisition for more information.