Are you covered for treatment in France?
The subject of health insurance in France is something which you should address sooner rather than later, if you are considering a move to the region, because it is very different to places such as the UK where the NHS offers a universal health-care system for everybody. There are also differences between the French health insurance system and that available in other countries, which you need to be aware of before you arrive in the country.
Medical care in France
While there are many issues to consider regarding medical care in France the bottom line is that there is no NHS system although there are elements of state assistance for those who contribute to the French taxation system, although those on low incomes are often fully covered by the state as well.
There are many factors to consider which include:-
European Health Insurance Card
The European Health Insurance Card (EHIC) is the new name for the E111 and effectively allows those from one European country to claim free or reduced cost emergency treatment when in another European country. The EHIC is something which you should always be aware of when first moving to a foreign land although there are other aspects to consider as and when you gain residence in your new homeland.
In effect the EHIC is invalid as soon as you gain permanent residence in your country of choice and you must therefore look towards the private health insurance market at this point. It is worth noting that in order for your EHIC to be valid you need to have been paying into the system and ensure that your health insurance status is up-to-date in your original homeland.
However, while the EHIC will cover you for appropriate health care in any EU state, it does not cover those looking to move overseas specifically for medical treatment and some types of treatment, such as dental care, which could in theory wait until you return home and are not officially classed as an emergency. You must be careful not to assume the EHIC is a replacement for travel insurance because it only gives you statutory health care rights and is not a one stop shop for any medical emergencies.
The EHIC has replaced the E110, E111, E119 and the E128.
The French health insurance system
According to the World Health Organisation, France has the best health insurance system in the world which ensures enormous patient freedom and a very high quality of care. The state system goes back to 1945 and is something of a hybrid of the NHS in the UK and the privatisation of the health care service in France. In simple terms each and every person working in France has to contribute a portion of their salary into a state controlled health insurance fund.
Obviously these funds are enormous in value, covering the risk of illness and setting out a stringent table of costs and reimbursements available to those who use the scheme. As you would expect, spouses and children of those who contribute to the health insurance fund are also covered where medical treatment is required.
Even though the system works very well and has received widespread applause the French government still has to keep a tight control of the system to cut down the risk of abuse and significant cost rises. There are three main roles which the French government has taken on, which include:-
Negotiating with healthcare companies
The French Ministry of Health is in charge of negotiating the price of medical supplies across the board and does this by simply taking the average cost of similar items and similar services in neighbouring countries. At this point they will then enter into negotiations with the major medical supply companies with an agreement (either way) likely to be reached in a relatively short space of time.
Reimbursements of medical costs
In order for any treatment to become part of the French state health insurance system there needs to be some benefit to the French population and value for money. A board of doctors and medical experts will between them decide if the cost of any specific treatment should be reimbursed and at what rate. There are various ways to set tariffs to ensure fairness across the system and fairness to those involved in the scheme.
Overseeing the health care insurance fund
The French government also has a very important responsibility to ensure that the health insurance fund is used to its maximum capacity and makes use of the public hospital network, as well as offering value for money.
Employer funded private healthcare
While there are many people who move to France for a new life there are also many who move there on short-term contracts with their existing employers. The vast majority of these people will pay into their home land tax system and thereby excluding them from the state French system, even if they were officially residence of France, which can in some cases cause problems.
While it is vital you continue to pay into your homeland health-care system, as this would be required when you finally return home, you also need to ensure you have sufficient cover in your country of work. The vast majority of employers will offer some kind of employee private healthcare although you need to confirm this and also confirm exactly what is covered. The last thing you want is to be stuck in a foreign land needing medical treatment which could literally cost thousands of pounds.
If you are in any doubt about the cover available from your employer, or indeed there is no cover available through your employer, you will need to take out private health care insurance in France to cover your stay. You will have no difficulty finding a health insurance company in France because the sector is very competitive and one of the largest in Europe.
The French health care system v The NHS
While there is no doubt that the UK NHS system is one of the highest regard healthcare systems in the world, it is also one of the more expensive (to tax payers) with medical costs and medical expenses moving higher and higher each year. Indeed there have been rumours for some time that that certain areas of the NHS will be transferred into private hands and the UK government will at some point try to push everybody towards a certain degree of private healthcare cover.
As you would expect, due to the NHS and the services available, the UK seems to attract more than its fair share of so-called “medical tourist” many of whom have been known to leave the country without contributing a penny to their treatment. When you compare this to the French system, you could argue the French health care system offers better value for money and is indeed something which will continue on a similar basis well into the future.
Under the French system each and every person who is eligible for state medical health care, with the exception of those who have not contributed or are on low incomes, will be required to contribute a certain percentage of the cost of some medical expenses over and above their tax contributions. This figure can be anywhere between 20% and 30% and is often payable at the point of treatment which can be very awkward if this is something which you are not aware of.
Payment of medical expenses in France
When putting yourself in the hands of the French healthcare insurance system you need to be aware that the vast majority of insurance schemes will insist that you pay for your medical treatment at source and then present receipts to your insurance company for full reimbursement. The same applies with regards to prescription charges and other medical related issues where money changes hands. You need to have evidence, such as prescription labels, to receive the full amount from your medical insurance plan.
When you consider that some medical procedures can cost tens of thousands of pounds it is vital that you have health insurance in place and short-term finance, where possible, to pay for the treatment.
Researching medical treatment abroad
While the vast majority of countries around the world will have some form of basic health care system in place you do need to research this in great detail if you’re looking to move overseas. It is dangerous to assume that the healthcare in the country you are moving to will be the same as the healthcare you have experienced at “home” as they could be, and ultimately are, massive differences in cost and treatment levels around the world.
As we touched on above, it is also vital that you do not mix up travel insurance with medical insurance because these really are two different animals and differ greatly.
Expats from the UK beware!
While there are significant differences between national healthcare systems around the world, there are few which can match the NHS for value for money and the extent to which free treatment is available. This is a problem which many expats from the UK encounter because mistakenly many of them automatically assume they will receive similar medical care under the same conditions wherever they may be.
Private healthcare is an area of the insurance market which has literally exploded over the last few years as more and more people begin to realise that the cover they are used to is unlikely to be replicated exactly overseas. There is also a need to bring in your family if you move overseas as a unit and ensure that everybody, whether working and contributing to the local tax system or not, is covered for any medical treatment they might require in the future.
Movement within Europe
As we touched on above, various EU regulations and rulings have made it much easier for EU citizens to move around European countries. There have also been developments in the area of health care and medical treatment with the EHIC a vital element of everyday life for many European citizens. However, you still need to be aware of the local practices and medical systems when moving around Europe to ensure you’re not caught short and are fully aware of the potential cost of treatment overseas.
Medical treatment outside of Europe
Medical treatment outside of Europe is a whole new ballgame and one which can become very complicated if you do not do your homework. Countries such as the US have long been seen as a pay before treatment medical system which is alien to the vast majority of Europeans. It is the same in many other countries around the world where lower government income has in some countries seen the total disintegration of local state medical services to the detriment of the local population.
Conclusion
Health insurance in France is something which is very much part of everyday life for many people in the country and many visitors from overseas. Even though there is a state medical service there are many people who may not be eligible immediately, or indeed ever, and there may be times when top-up private healthcare insurance is essential. As we suggested above, the French health care system is something of a hybrid between the NHS and private healthcare insurance and has been widely regarded as the number one European healthcare system for some time.
As with any venture overseas, whether short-term or permanent, you need to be aware of your local surroundings and local practices regarding areas such as medical treatment. It is very dangerous, as many people do, to assume that the country you are moving to will offer a similar standard and similar cost of service to the one which you are leaving. This has caught many people out and when you consider that some treatment can cost potentially tens of thousands of pounds to complete, simple mistakes and lack of research can be costly to say the least!
As ever, those who move overseas for any length of time are putting themselves at significant financial and potentially life-threatening risk if they do not make themselves aware of local practices and local regulations before they move. To be forewarned is to be forearmed!
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