In the first of a new monthly series of articles, the Overseas Guides Company will provide Homes &Travel readers with authoritative and expert advice on a wide range of topics
For Britons living in France – and other parts of Europe – or travelling there for extended periods of time, healthcare is a key consideration. Many assume that the European Health Insurance Card (EHIC) will suffice when health issues crop up outside of the UK, but the reality can be very different – as our writer in France, Alexis Goldberg, has discovered since she moved to the Languedoc.
“Most doctors expect you to have a ‘carte vitale‘, which of course they understand,” said Alexis. “When you present the EHIC, they simply give you what is called a ‘feuille de soins’, which is basically a receipt for your appointment and any treatment while there, and tell you to claim back from the UK. I remember doing this once some years ago when I was not a resident, and since the cost for the appointment was then only €18 and no other treatment was needed, I let it go.”
Essentially, the EHIC is for emergency or urgent healthcare treatment for Europeans travelling within a different European country. It offers subsidised or sometimes even free treatment at public health facilities and is available in all countries within the EEA – which comprises EU member nations as well as Norway, Iceland and Liechtenstein. It is also recognised in Switzerland. In practice, in many countries such as France, most doctors expect you to pay your bill in full at the time of treatment and claim a reimbursement through your EHIC from your home country.
Claiming a refund
Claiming the refund can differ depending on which country you reside in. For UK residents, the EHIC is issued by the NHS, which recommends you submit your claim before returning from your trip. If that’s not possible, you can phone the Overseas Healthcare Team (0191 218 1999) on weekdays to make your claim – you’ll need your receipts, NI number and bank details. Remember too, an EHIC is not a substitute for travel insurance – it will not cover costs such as private medical expenses and non-essential treatments, or the loss or damage of any of your belongings.
If you are relocating permanently to the Continent you should register with the healthcare system of your new country of residence – don’t even contemplate getting by on an EHIC. The French healthcare system is arguably one of the best in the world, with modern hospitals benefiting from the latest equipment and technology, and general practitioners who are usually excellent diagnosticians. Appointments tend to be relatively easy to obtain with shorter waiting times. You will find that many small villages have at least one resident GP.
Healthcare system in France
The healthcare system in France is funded by the working population; each French employee pays about 20 per cent of their salary to the social security system and a large part of this goes towards public healthcare. As far as British expats go, before 23 November 2007 all were eligible to join the system. With the new rulings however, those who have not yet reached retirement age are not now allowed to join until they have lived in France for five years, but with fully paid up National Insurance contributions, the UK will fund medical care in France for a period of up to two years. After this time, if retirement age is still not reached, then private insurance will be needed.
Understanding E121 and E106 forms
As stated, the new rulings do NOT affect those who are retired and hold an E121 form or those who plan to work in France, since in the latter case, contributions will be deducted at source and in the former case you will be able to receive your ‘carte vitale‘ and have the normal 70 per cent of your medical costs paid back (as is the case for French nationals).
If you are under retirement age and hold an E106 form, issued by the UK’s Department of Work and Pensions to those who have paid their National Insurance in full, you will be able to access the French healthcare system for up to two years as the costs will be covered by the UK Government. To reiterate, once your form expires, you will have to take out private insurance until you are of retirement age or until you have lived in France for five years.
Each town in France has a CPAM office (Caisse Primaire Assurance Maladie) which is where your carte vitale will be issued once you furnish them with either the E121 or E106 form, as well as proof of identity, domicile etc. Your carte vitale has a chip in it and means that although you pay initially for any treatment or prescriptions, you will be able to claim back about 70 per cent of this.
Most French people take out top-up insurance called ‘mutuelle’ to cover the balance of what is not covered by their carte vitale. Again, many insurance providers will offer competitive rates for a ‘mutuelle’. You are likely to find several insurance companies providing this health cover in most French towns as well as companies in the UK.
Richard Way, Editor, Overseas Guides Company (OGC)
OGC Guides cover all aspects of the buying process, tax liabilities and benefits, local customs, rental potential, retirement, laws and land ownership.