The Expat's Guide to Healthcare Arrangements in France

Making the permanent move to France for a new life is always a big step, as there are so many emotional and practical issues to consider. One of the most crucial aspects of making such a move is healthcare provision. If you're moving from the UK, you'll be used to healthcare which is free at the point of use. The system in France is profoundly different, so you'll need to be prepared before you leave in order to protect both your health and your bank balance.

Public healthcare coverage

If healthcare is one of the issues that is stopping you from making the move to France, it's important to bear in mind that the country's network of hospitals, clinics and doctor's surgeries is considered to be one of the most reliable and well funded in the world. In most cases, average waiting times for major surgical procedures are far shorter than they are in the UK and most other EU countries. And perhaps most impressively, the French state-funded healthcare system is available to everyone who pays into it, or to expats who have reached the official retirement age in their home country.

Known in France as the 'Sécurité Sociale', public health insurance covers standard healthcare for the vast majority of diseases, ailments and illnesses. If you have a job in France, or you're registered as self-employed, you will pay anything between six and eight percent of your salary towards state healthcare. The 'Couverture Maladie Universelle' (CMU) is widely regarded as the best option, as it guarantees acceptance for everyone - regardless of pre-existing conditions.

If you have retired, or you plan to do so whilst living in France, you will still be eligible for the CMU, but you'll need to demonstrate your commitment to remaining in the country. If you're from the UK, you can ensure your acceptance to the CMU scheme by producing the E121/S1 form - which can be obtained from the Department of Work and Pensions. If you're retiring early, you may need to produce an E106/S1 form. However, until you've been resident in France for at least five years, public healthcare cover during your retirement will only be granted under some very specific circumstances:

  • You have a chronic illness that precludes you from getting private insurance
  • You're presently undergoing treatment for a serious illness
  • You've suffered an unforeseen collapse in your finances
  • The cost of your treatment has become higher than your income can support
  • Your health cover has been taken away because you've lost your job or spouse
  • Your health cover has been suspended due to circumstances out of your control

If you're taking early retirement in France, you will probably need to pay into the CMU or purchase a private health insurance policy.

Unfortunately, the public health insurance system only pays around 70 percent of medical bills. The vast majority of French residents purchase supplementary insurance in order to cover the shortfall. However, the government in France has made a commitment to ensuring that the sickest people in society have 100 percent of their healthcare bills paid for by the state. For instance, cancer sufferers requiring a combination of expensive surgery, monitoring and prescription drugs will rarely be issued with a bill - as long as they have paid into the system.

Although advance payments for expensive surgical procedures are rarely required from people with coverage, treatment from a specialist that is paid for by public health insurance will usually require a referral from a GP. Failure to get such a referral may result in the state contribution to your medical bill being lowered. You are also be asked to pay for GP appointments upfront, but you can apply for reimbursement at a later date.

You will need a “carte vitale”, which is the equivalent of the national insurance numbercard in the United Kingdom. It will facilitate your reimbursement of your health fees.

Private healthcare in France

There is very little to be gained by disregarding the public healthcare system in France in favour of wholly private coverage. Most people will take out private insurance for sundries such as private rooms, eye care and specialised treatments. The public and private healthcare systems in France operate side by side in a way they simply don't in the UK and most other EU countries. However, you should still have a private healthcare policy in place to cover what could be a 30 percent shortfall in coverage from the public health insurance system. Most reputable employers will include this private coverage as part of an employee's contractual benefits.

The French healthcare system utilises around 11 percent of the country's GDP - the highest level in the EU. And while that means waiting times are lower and health institutions are generally better funded, it comes at a cost. If you're working in France, deductions from your salary will be made to pay for your continued membership of the CMU. However, this cover won't include sundry costs such as those for food, linen and various other 'non-essential' items whilst you're receiving treatment. This makes top-up insurance a practical necessity.

France's healthcare system was recently lauded as the world's most effective by the World Health Organisation. As long as your financial arrangements are in place before you move, you can look forward to some of the best medical treatment in the world.

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