Healthcare in France (for chronic condition) for EU-passport holder

[seansaf]

Hi all,

My name is Sean. I'm 24 and live in QLD, Australia. I have a question pertaining to healthcare rights for EU passport-holders moving to France and I'm very much hoping someone here may be able to help me. This issue is fairly fundamental to my ability to make this transition.

Just to give a bit of background.

I have 3 passports - Irish, UK and Australian. Australian from birth and Irish/UK from my father and his family, who were all born and raised in Belfast, NI. I am going into my 4th year of taking Alliance Francaise language courses and am hoping to pass the DALF C1 or C2 exam at the end of next year, which will certify my proficiency with the French Ministry of Education for work purposes. I work as an Occupational Therapist and am planning to find similar work in France.

My issue.

I have Severe Haemophilia A. This is a hereditary disease meaning my blood does not clot. This requires regular treatment 3 x week by way of transfusions and general check-ups at the hospital 6-monthly. I receive free public healthcare treatment in Australia for this and have my product home-delivered each month. The product I receive is extremely expensive and costs the system over $500, 000 per year.

I am wanting to ascertain whether I will be entitled to the same treatment in France based on my EU passports and my intention to settle and work as a permanent resident.

I have lived in Ireland for 2 years previously in 2008 and 2009 and received my treatment free from the hospital I attended home-delivered each month as in Australia. Prior to moving, I determined that I should be eligible for free healthcare for my condition. When I arrived at the hospital to register and organise my product, they told me that while I am an EU citizen, it is largely up to the specific hospital I am attending to decide whether they want to provide treatment for me. And that my intention to settle long-term and my Irish passport helped in their decision.

I have investigated the French system somewhat but have not been able to find a definitive answer on this issue. If the answer is that it is the same as Ireland and I will need to prove to the hospital that I intend to work, live and settle in France permanently, that is fine. But I'm not sure if there is some sort of residency rule involved.

Please, if anyone can help, I would appreciate it very much. Even if you know of a few links I could investigate, it would be great.

Thanks a mill,

Sean

[seansaf]

Hi everyone again,

Just a quick aside to my Q. I know there have been a few healthcare Q's previously regarding expats in France but I decided to make mine a new thread because it is a chronic condition requiring ongoing treatment and I thought this may be different, maybe not?

[Bevdeforges]

Actually, you're not entitled to anything based solely on having an EU passport. In France, you have to be paying into the system or have been enrolled in the system of your EU home country sufficient to entitle you to an EHIC (European health insurance card), which would normally cover you in the French system for a transitional period of up to (I believe) 2 years.

Since you're not enrolled in either the Irish or the UK health care systems, you aren't automatically eligible for the French system.

Once you have a job in France, you will be contributing to the system, and thus eligible for coverage. Normally, the French system is one of reimbursement - you pay for your treatment (except for hospitalization) and then you are reimbursed for 60 to 70% of the cost. Most people have a mutuelle (a sort of top-up policy) to reimburse them the rest of the cost.

As a hemophiliac, you may be entitled to 100% reimbursement from the State plan, once you're registered as someone with an "affection de longue durée." But as with all things bureaucratic in France, filing all the correct paperwork and waiting for the cards to be issued may take a few weeks or a few months.
Cheers,
Bev

[seansaf]

Originally Posted by Bevdeforges

Actually, you're not entitled to anything based solely on having an EU passport. In France, you have to be paying into the system or have been enrolled in the system of your EU home country sufficient to entitle you to an EHIC (European health insurance card), which would normally cover you in the French system for a transitional period of up to (I believe) 2 years.

Since you're not enrolled in either the Irish or the UK health care systems, you aren't automatically eligible for the French system.

Once you have a job in France, you will be contributing to the system, and thus eligible for coverage. Normally, the French system is one of reimbursement - you pay for your treatment (except for hospitalization) and then you are reimbursed for 60 to 70% of the cost. Most people have a mutuelle (a sort of top-up policy) to reimburse them the rest of the cost.

As a hemophiliac, you may be entitled to 100% reimbursement from the State plan, once you're registered as someone with an "affection de longue durée." But as with all things bureaucratic in France, filing all the correct paperwork and waiting for the cards to be issued may take a few weeks or a few months.
Cheers,
Bev

Hi Bev,

Thanks for your response.

I gather that if I secure employment and pay for a top-up policy, I will be able to seek healthcare coverage for my condition. I am surprised the situation is different in Ireland, as another EU member state, but perhaps this was influenced by the fact that I am an Irish citizen.

I can probably take several months worth of product (perhaps 3 or 4) with me initially and hopefully find a job within that period. Do you know if there are any restrictions on how long you have been resident in France or how long you have been working there as far as healthcare entitlements go?

Or, if, as soon as I secure a position there, I would be able to request my treatment and register to pay for any health insurance top-up policy's? Am I basically in the same situation as a non-EU citizen or would my EU passports be beneficial in any way at all?

Thanks a lot!

Sean

[seansaf]

Originally Posted by seansaf

Hi Bev,

Thanks for your response.

I gather that if I secure employment and pay for a top-up policy, I will be able to seek healthcare coverage for my condition. I am surprised the situation is different in Ireland, as another EU member state, but perhaps this was influenced by the fact that I am an Irish citizen.

I can probably take several months worth of product (perhaps 3 or 4) with me initially and hopefully find a job within that period. Do you know if there are any restrictions on how long you have been resident in France or how long you have been working there as far as healthcare entitlements go?

Or, if, as soon as I secure a position there, I would be able to request my treatment and register to pay for any health insurance top-up policy's? Am I basically in the same situation as a non-EU citizen or would my EU passports be beneficial in any way at all?

Thanks a lot!

Sean

That is, as you say, if I require a top-up policy at all. Hopefully, once I secured a position, as a legal resident, I would be entitled to 100% coverage for a chronic condition.

[Bevdeforges]

Actually, you won't ever be refused treatment in France - even if you're illegally in the country, there is a program for handling your medical needs. (I kid you not - it's on the Service Public website: it's called Aide Medicale de l'Etat AME)

Generally, they'll treat first and work out the money later on. (In fact, you may not even need to bring the product with you. But sometimes the French have a different treatment regimen or product than what you've been using back home.)

If you're planning on just coming over and starting your job search when you get here, you may want to contact a doctor or hospital in the area in which you'll be staying to work out the details for the treatment you'll need ahead of time - and figure out the financial arrangements.
Cheers,
Bev

[TOdoc]

Originally Posted by Bevdeforges

Generally, they'll treat first and work out the money later on. (In fact, you may not even need to bring the product with you. But sometimes the French have a different treatment regimen or product than what you've been using back home.)

If you're planning on just coming over and starting your job search when you get here, you may want to contact a doctor or hospital in the area in which you'll be staying to work out the details for the treatment you'll need ahead of time - and figure out the financial arrangements.

This question relates to my industry, so please allow me to pipe in...

In the present age of biological therapies and advanced blood products, many of which can be quite pricey, you would be VERY wise to follow Bev's advice and find a doctor and get a consultation in France BEFORE you move. The approved formularies for certain drugs may have specific access stipulations that might limit your ability to get the drugs in a timely fashion. For example, some French formularies require that for treatment B you may have had to demonstrate that you tried and failed treatment A for a certain period of time. Previous medical records will prove invaluable for the doctor in France to expedite a request for the treatment.

You might also want to connect with the patient associations in France for people living with hemophilia. They can give you a lot of information about the hoops you may have to go to initially. They can also refer you to physicians in the area you intend to live who specialize (or who have an interest) in treating this condition.

W.

[seansaf]

Originally Posted by TOdoc

This question relates to my industry, so please allow me to pipe in...

In the present age of biological therapies and advanced blood products, many of which can be quite pricey, you would be VERY wise to follow Bev's advice and find a doctor and get a consultation in France BEFORE you move. The approved formularies for certain drugs may have specific access stipulations that might limit your ability to get the drugs in a timely fashion. For example, some French formularies require that for treatment B you may have had to demonstrate that you tried and failed treatment A for a certain period of time. Previous medical records will prove invaluable for the doctor in France to expedite a request for the treatment.

You might also want to connect with the patient associations in France for people living with hemophilia. They can give you a lot of information about the hoops you may have to go to initially. They can also refer you to physicians in the area you intend to live who specialize (or who have an interest) in treating this condition.

W.

Hi TOdoc, thanks for that info.

This has all reaffirmed the fact that I will need to do a great deal of prep before I leave. I will contact the French Haemophilia Society to get details on the main treatment hospitals and contact the Haematology units to discuss my options.

I will be able to have my file from Australia sent over ahead of time. I can bring enough product to last me a few months so hopefully I will be able to find a job in that time and the hospital will be able to start providing the product.

Thanks again! Will revert back to here for more advice as I go.

Sean

[Shelagh]

"Am I basically in the same situation as a non-EU citizen or would my EU passports be beneficial in any way at all?"

They make a world of difference. As an EU citizen you have a perfect right to come here and spend 3 months looking for work without any form of registration. If during this time you register as employed or self-employed then you immediately qualify for health care to the same extent as French people.*

As an Australian citizen, you can't enter the country at all without jumping through hoops.

Shelagh

[Las-Cobas]

Originally Posted by seansaf

Hi TOdoc, thanks for that info.

This has all reaffirmed the fact that I will need to do a great deal of prep before I leave. I will contact the French Haemophilia Society to get details on the main treatment hospitals and contact the Haematology units to discuss my options.

I will be able to have my file from Australia sent over ahead of time. I can bring enough product to last me a few months so hopefully I will be able to find a job in that time and the hospital will be able to start providing the product.

Thanks again! Will revert back to here for more advice as I go.

Sean

Sean, You will find that the treatment that you need will only be done at a CHU, which is basically a University Teaching Hospital. Each region has one. Toulouse, Montpellier,Nantes, Grenoble etc.
The other main point to remember, without wanting to "P" on your chips, with the World wide recession our unemployment rate in France is climbing every week. The right for an EU citizen to look for work, applies if that EU citizen is resident in another EU state and worked or looking for work. The optimal word is Resident. I like you hold 3 Passports, an English one ( Yes issued by an English Government not British) an Irish and French. Yet if I visit the Republic or the UK, I am only able to receive emergency treatment or treatment to allow me to continue my holiday without the need to return to my country of residence.

A few years ago I was on a different treatment to now which required weekly injections of a specific drug. This drug whilst freely available at CHU to treat my illness, it was far too expensive to be available in the Republic or England.

I had a hell of a job getting treatment in England, appointment week in advance etc,which obviously I could not make and needed the injection at a specific time and date. In the Republic I had to go to a large Specialist Hospital for treatment.

You will find that any French hospital will only use drugs that are listed on their data base and approved for use in the country.
Be positive.


If the worst comes to the worst, we can swap houses, I will live in yours in QLD ( Hopefully it is the tropical side, Cairns, Palm cove, etc and you can live in Perpignan in mine) I can dream Sean