Healthcare in France
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Healthcare in France
Subscribing to private healthcare in France is always a safe option. The quality of national healthcare fluctuates from country to country. The price of the most fundamental care is often very high and this is supposing you find a suitable hospital or doctor to begin with.
Private healthcare, on the other hand, often adheres to a standardisation of service. Consequently, as an expat, it is probably wise to invest in private healthcare at least until you are completely familiar with the national health system. Getting medical treatment for you and your family without comprehensive health insurance could prove arduous, and no-one wants the hassle of bureaucracy in an emergency. You may even find that the country you are emigrating to has no national health service.
The benefits of private healthcare include:
Peace of mind
Better efficiency and quality of service
Could save large sums money (possibly thousands of pounds) in the case of an emergency
A vaster choice of services and practitioners
No waiting lists or bureaucracy
Ensures you do not have to settle for local, possibly inadequate or unhygienic, services
Request an English-speaking doctor / nurse
Necessity, not luxury
In recent years, private health insurance enquiries have soared in popularity amongst emigrants. By way of policy comparison, people and businesses are continually looking to reduce the cost of their private healthcare. For many, this is because private health cover is not considered an extravagance, but a requisite for living overseas.
However, it must be acknowledged that the rules and regulations associated with international private healthcare are often complex, and attempts to find realistic costs and cover can be both timely and tedious. Therefore, it is vital to approach private health insurance with a few certainties in mind:
Who can provide it and what you should expect
Many private health insurers now provide cover for most countries, so your options are vast. However, if you are emigrating to a country without nationalised healthcare, there are many factors to consider when choosing an insurance company and policy many of which differ by location and cost.
Will the insurer cover:
A chronic illness / condition?
A country at war?
You will have to weigh-up the costs of such services as private doctors, outpatient medicine, and dental cover. But that's not all. You may also have to decide where you'd like to receive treatment in the case of a serious health problem or injury. Does your adopted nation meet requirements, or would you prefer to return to the UK for treatment?
Your chosen destination
All though a policy may meet your medical requirements, a country's health service may not. Therefore, wherever your business takes you, it is important to consider:
Laws and regulations of the country
Accessibility and availability of treatment
24-hour emergency treatment
Case management and service delivery
Choosing your health insurance policy
When deciding upon a suitable private health plan, will you require any of the following benefits? If so, will you be able to receive them?
The region / country of relocation
Emergency evacuation and transportation
In-patient and day case management
Chronic and existing illnesses and conditions
Dental / optical requirements and treatment
You will find that many policies include a small standard excess, which will be charged either per year, or per claim. However, if you choose a higher excess plan these premiums can be remarkably reduced.
Do I have any other choices?
Depending on where you decide to relocate, there are other health care options available to you:
European Health Insurance Card (EHIC)
Providing you are within the European Economic Area, UK citizens are eligible for emergency treatment with a EHIC. It entitles you to exactly the same standard of healthcare as a national. However, the card does not cover the cost of repatriation should you need to be flown back to the UK.
In some instances, the EHIC will cover you for pre-existing conditions, and it is often possible to prearrange treatments. Do remember, however, that an EHIC will not cover treatment at a private clinic or centre: always ask where you are being referred to for any treatment.
Treatment in the UK
It is a general truism that emigration is fraught with significant costs. As a result, people often consider private health insurance one cost too many especially if they are on a tight budget. They are all too willing to run the risk.
Consequently, many emigrants and travellers opt to return to the UK for medical treatment, but often overlook the fact that this too can be a very risky option. Firstly, you still need to be registered with a UK doctor to be eligible for treatment upon your return. If unprepared, you could find yourself in the same situation back in the UK.
Secondly, you need to account for medical emergencies which would require immediate attention. Is it really worth the risk?
The healthcare system in France is funded by contributions made by both employed and self-employed workers.
On arriving in France, expatriates should register with their local CPAM (Caisse Primaire dAssurance Maladie) office, taking their E106 or E121 if they have one, and they will receive a Carte Vitale (credit card style card with a chip linked electronically to the French Social Security) which they will present to their doctor or other medical practitioner when they receive treatment. Unlike the NHS in the UK where treatment is free at the point of delivery, in France they will have to pay the majority of healthcare providers up-front and then be reimbursed.
The French Social Security normally reimburses approximately 70% of medical expenses and the remaining cost of treatment can be borne by the patient or covered by a top-up policy (assurance complémentaire maladie or mutuelle).
The French Social Security defines the cost of virtually every type of medical treatment using the Tarif de Convention (official rate). For example, the Tarif de Convention for a consultation with a doctor is 22.00 Euros. If their nominated GP was conventionné, they would pay him the 22.00 Euro consultation fee directly and be reimbursed 15.40 Euros by the French Social Security.
It should be noted that treatment received from healthcare providers who are non conventionné will not be reimbursed by the French Social Security and that if they do not have nominated GP and/or go to see another doctor without referral from your GP, they will only be reimbursed on the basis of 50% of the Tarif de Convention.
Persons moving to France who do not intend to work, and who do not have a valid E106 or E121 form, will now be required to take out private health insurance until they have been living in France for 5 years, at which time they will qualify for State healthcare as a resident.
An E106 form is issued by the Department of Work and Pensions to persons who have been paying National Insurance contributions in the UK for the 2 years prior to moving, and gives the holder rights to healthcare in France for a limited period of time (usually around 2 years) via the reciprocal agreements between the UK and France. On reaching British retirement age, if the expatriate qualifies a State Retirement Pension, the DWP will issue an E121 form which works in a similar way to the E106.
A person taking early retirement and moving to France with an E106 faces a potential gap in cover when this document expires. They will therefore have to take out private medical insurance until they have either been resident in France for 5 years or they become entitled to an E121.