Moving to France: What is the current healthcare situation?
Our expert Steven Grover explores French healthcare for expats.
So what has changed?
Since 23 November 2007, if you were moving to France and were not planning to work, or did not have the appropriate documentation to show that your healthcare costs are being covered by your previous country of residence, you were not allowed to join the system until you either reached state retirement age so that your cost were covered by your previous country of residence or had lived in France for five years.
Following pressure from the EU, a circular was issued in June 2011 by the French government explicitly withdrawing the November 2007 changes to allow early retirees to access the healthcare system. This is because, under European law, European nationals legally resident in France for at least three months are entitled to be treated in the same manner as French nationals, which includes access to the health system.
However, there still seems to be much confusion on this issue at a local level. Many early retirees are still refused cover, and while some centers are granting access to the healthcare system without a problem, other are insisting on full health insurance or being resident in France for 5 years before granting full access.
So what should you do if you are moving to France now?
If you are making the move to France from another EU country, and you were either previously affiliated with their social security system or are currently receiving a state pension from that country, you should contact the appropriate governing body to see which of their measures can assist you with joining the French system.
For example, if you previously lived in the UK, you would contact the Department of Work and Pensions (+44 191 218 1999), and find out if you are eligible for an E106, which would give you cover in France for up to two years. Then if, after this cover has expired, you are not yet at state retirement age and therefore eligible for cover via your EU state pension, it is possible that you might need to purchase private healthcare until you have either been resident in France for at least five years or reached state retirement age.
If you are not an EU national and you have no cover from another EU country, then it is likely that you will need a full healthcare policy. That is, unless the 3 month rule is fully applied or you are working, have reached state retirement age or have lived in France for over 5 years.
What if you started working after your initial cover had run out to give you access to CMU?
To give you an idea of the minimum requirements for an employee, you must have worked at least:
- 60 hours per month
- or 30 consecutive days
- or 120 hours in salaried employment during three consecutive calendar months
- or three months start date to finish date
- or 1200 hours in salaried employment during one calendar year (the latter will get you two years' cover).
Self-employed is less complicated because there is no minimum income so, in theory, you can register as an Enterprise Individuelle, earn no money and only pay your healthcare contributions, which are about EUR 1,300 a year and will enable you to obtain a carte vitale. However, while this option could work for a limited time frame, in the long-term you may be seen as committing fraud and you need to take into account the cost of registration and the continuing costs of being self-employed (legal, accountancy, business taxes). These are significant in France and you would have to add these costs onto your health social charges.
Another option to consider could be the new ‘Auto Entrepreneur' scheme, which was set up at the beginning of 2009 to make setting up a business easier. Unlike the ‘Enterprise Individuelle' system where you pay social charges based on an estimated income, with the ‘Auto Entrepreneur' you pay tax and social charges as you earn, either monthly or quarterly.
What will it cost if you need private health insurance?
As you can imagine, costs will vary greatly due to age and circumstance, but you are unlikely to be looking at less than EUR 2,000 a year. And, if you have a pre-existing medical conditions, private insurance may be difficult to obtain as most private insurance companies usually do not allow such conditions to be covered. However, under the new legislation, it could be possible to appeal to the CMU for access as long as you can provide evidence that you have been unable to obtain private cover due to this condition.
Steven Grover / Expatica
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.
Steven is a Partner with the Spectrum IFA Group in France. He specialises in assisting expatriates moving to France or already living here with tax efficient solutions for savings, investments and pensions, as well as other areas like mortgages and estate planning. You can contact him at +33 (0)325461631, via his website or via e-mail.
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