[greenandpleasantland]

Hi

It has been brought to my attention that someone I know is in a difficult and subsequently very stressful situation...

The person lives in France, for aprx 5 yrs. Is not working and is 2 years from UK state pension age.

The fact is that they have been told on a couple of occasions by the doctor that they have to go to hospital, but have not been because they are afraid of the costs.

When the person moved here they were not informed or aware of the correct procedure. Therefore, if they have ever needed an appointment they have paid the 22 Euros, without requesting a refund. The big problem, however is should something more be required like a stay in hospital for example. They do not have a carte vital, nor are they covered by the HNIC, or private insurance and they do not have a disposable income.

I have read that since November 2007 people who didn't already have a Carte Vitale are not automatically entitled to it anymore, you have to have been on E106 or E121 or retired already. None of which apply to the person in question, although they were here before that date. I have heard of another option the CMU, whereby anyone one has been here a minimum of 3 months can apply for health cover, as long as they can prove they have been here... Although it asks for details of income etc I believe if you are on RSA the new benefit scheme then it is fine and you must have an income of less than 8/8.5k a year. Yet this person does not claim benefit from France and is just waiting 2 years until state pension age, but things need doing before then.

That is another area for concern, what happens with regard to the UK pension, if you move abroad before you claim it, is it safe or is it at risk? I think they are also finding this very worrying if there is a possibility that they will lose their right to the pension that they earned just in order to enable them to get covered on the French system - does anyone know because that seems very unjust!

So in summary...... They are 2 years off state retirement - been in France for appx 5 yrs (but have not taken French nationality) - they have been told by the French Dr they should go to hospital (I believe there is some relatively serious health issue/pre existing or not I do not know) - they do not have private health care - they do not have a Carte Vitale - They have not ever been on E106 etc - They do not have a large income - They are stressed as have to see Dr next week and they will be given a letter to go to hospital (but they won't go) - They have CMU forms not yet completed - They are married to someone still residing in th UK who works part time but has reached pension age - They do not want to lose the right to the UK state pension...

By the way someone had mentioned that if you have someone working in the UK that you are entitled to a reciprocal health cover??

Thanks everyone

 

[Bevdeforges]

Is this person hiding from something? If their spouse is working in the UK, I don't understand why they wouldn't simply get the E106 or E121 now and sign up for the French plan.

Or simply go in to the Sécu and ask about coverage, given all the facts of the case. (Check with the local mairie - they sometimes have a weekly visit from a sécu employee to try to handle questions and problems on site.)

At some level, the person has to be willing to help themselves. You know, fill out the CMU forms or get the proper paperwork. But if they refuse to go to the hospital under any circumstances, there's not much you can do for them. (And, no, living in France should not affect their British state pension - but even that you have to jump through a certain number of hoops to file for.)
Cheers,
Bev

 

[greenandpleasantland]

Hi Bev

Firstly, no this person is not hiding from something....they are not bad, but they have been very ill before and that spurred their re-location to France, to improve their quality of life - so they thought.

I do not see how it is so simple to get an E106 (this doesn't give them free health care) that is basically claiming through the UK after you pay, so not off French budget. Also an E121 as far as I know is for someone who was on benefit/disabled in UK - they do not claim or receive benefit.

They would like to be able to help themselves but they find it all very overwhelming, confusing and distressing. TBH I can't say that I blame them, it seems unclear what is the best thing to do, by best thing I mean what will benefit that individual most and harm them least.

I'm lucky I got my Carte Vitale through marriage.

Are the CMU forms the 'right thing'? The reason they won't go to hospital is because everyone else has health cover or significant money, which enables them to get routine and emergency care without stress. I empathize totally that the are afraid o being ill but even more of not having the means to treat it.

They have not taken French nationality because all though Britain is now unbearable they still feel they want to hold on to their roots. Furthermore, with 2 years until state retirement pension entitlement they do not want to forfeit that for the sake of a free stay in hospital - they should have both, no question.

Their partner is now 60 able to draw pension but was working part time (which really makes no significant difference) They have been living apart therefore. If that partner moved to France they could claim Carte Vitale as at retirement age - but they are not in a position to do so and are not here.

2 other questions.....

1) what would happen if you lived 6 months here 6 months UK?

2) how much is private insurance 100%?

Thanks again

 

[greenandpleasantland]

By the way it's important to note we're talking about Europeans & the EU reciprocals

I know things are different for expats from the rest of the world

 

[Claire la richarde]

Hi Bev
2) how much is private insurance 100%?

Thanks again

I'm still living in the UK so have only ever bought travel insurance. Looking on the web, most insurance companies won't give prices and just provide forms to ask for a quotation.

I did find a rough figure from late 2007, so two years out of date, I'm afraid:
"Costs start at around £1,200 a year for a healthy 60-year old person who only requires basic insurance for hospitalisations etc, and is willing to pay a part of treatment. For the same man requiring full cover, insurance would be in the region of £1,800 a year."

However, in giving the example of "a healthy 60-year old person", evidently these figures are for policies which don't cover pre-existing conditions - and obviously there is a pre-existing condition in this case. I think you'd have to get a quotation for the individual in order to find the actual cost.

 

[Claire la richarde]

Hi Bev
I do not see how it is so simple to get an E106 (this doesn't give them free health care) that is basically claiming through the UK after you pay, so not off French budget. Also an E121 as far as I know is for someone who was on benefit/disabled in UK - they do not claim or receive benefit.

Regarding the E106, if the person has been in France for 5 years, I'm not sure it would apply anyway.

"..the entitlement to full E106 cover only applies if you have a satisfactory national insurance contribution record in the UK.

To assess your entitlement the UK authorities will examine your contribution record over the three full tax years prior to your departure. That is to say, if you were leaving the UK in 2009, the authorities would look at your contribution record for the three years ending 2008. You need to have paid sufficient contributions over this period.

Accordingly, if you have paid into the UK social security system for (say) 25 years, but you have not done so in recent years, you would not have any entitlement to cover from an E106! In these circumstances, until you find employment, you would need to take out private medical insurance.

Note also that it is 'full' tax years, so those contributions you pay in the year you leave the UK will not count in the initial calculation, although they would be taken into consideration if you had obtained a basic right to entitlement from previous years."


Also, even if the person had an E106 on arrival in France, it would have expired by now:

"The precise duration of the E106 will also depend on when you vacate the UK, and few would get the full 2.5 year cover. Those with a full contribution record up to the point of their departure, and vacating the country mid way through the year, would normally be the only ones entitled to 2.5 years. The entitlement always run from January to January, ie January 2009 to January 2011."

Not very much help, I'm afraid.

 

[greenandpleasantland]

I'm still living in the UK so have only ever bought travel insurance. Looking on the web, most insurance companies won't give prices and just provide forms to ask for a quotation.

I did find a rough figure from late 2007, so two years out of date, I'm afraid:
"Costs start at around £1,200 a year for a healthy 60-year old person who only requires basic insurance for hospitalisations etc, and is willing to pay a part of treatment. For the same man requiring full cover, insurance would be in the region of £1,800 a year."

However, in giving the example of "a healthy 60-year old person", evidently these figures are for policies which don't cover pre-existing conditions - and obviously there is a pre-existing condition in this case. I think you'd have to get a quotation for the individual in order to find the actual cost.

Hi

Thanks for letting me know that anyway - I think it would definitely cost more in this case and that it would cause more financial strain still therefore. I had no idea how much it would be at all thanks again Claire

 

[Claire la richarde]

Further to my earlier message, a possible get-out clause:


"If you relocate to France under the age of retirement with the intention of living off your capital, and/or early retirement pension, then, when cover under the E106 expires, you will need to take out private health insurance. You will need to maintain this private health cover until you have lived in France for 5 years, or you reach the age of retirement, and thereby become eligible for E121 health cover, whichever is the sooner."

Having said that, I'm not sure what the situation would be if the person in question has never appeared on the radar of the French health system. Does anyone have any idea about this?

 

[greenandpleasantland]

Regarding the E106, if the person has been in France for 5 years, I'm not sure it would apply anyway.

"..the entitlement to full E106 cover only applies if you have a satisfactory national insurance contribution record in the UK.

To assess your entitlement the UK authorities will examine your contribution record over the three full tax years prior to your departure. That is to say, if you were leaving the UK in 2009, the authorities would look at your contribution record for the three years ending 2008. You need to have paid sufficient contributions over this period.

Accordingly, if you have paid into the UK social security system for (say) 25 years, but you have not done so in recent years, you would not have any entitlement to cover from an E106! In these circumstances, until you find employment, you would need to take out private medical insurance.



Note also that it is 'full' tax years, so those contributions you pay in the year you leave the UK will not count in the initial calculation, although they would be taken into consideration if you had obtained a basic right to entitlement from previous years."


Also, even if the person had an E106 on arrival in France, it would have expired by now:

"The precise duration of the E106 will also depend on when you vacate the UK, and few would get the full 2.5 year cover. Those with a full contribution record up to the point of their departure, and vacating the country mid way through the year, would normally be the only ones entitled to 2.5 years. The entitlement always run from January to January, ie January 2009 to January 2011."

Not very much help, I'm afraid.

Thanks Claire

I think you have a better understanding of the E106 than some

Yes, as I saw it the E106 was not a permanent thing and also you had to be in receipt of UK benefits already or paid relevant contributions and you're right it would have expired anyway. However in this case the person in question is 63 has not worked for at least 5 yrs, took early retirement, but now has no disposable income to speak of. It's clear things will improve at retirement, but have to find a solution for the 2 yrs before......

I'm sure though if they had an E106 before November 2007 they could have had the reciprocal Carte Vitale arrangement - before France decided to deny people who were under retirement age and not working that right!

What about this CMU thingy? for those here min 3 months........

It seems e have no problem finding what you can't have, but struggle to find what you can!

 

[Claire la richarde]

All the websites I've looked at so far say the same thing

"The CMU Protection Complémentaire (CMU–C) provides free health insurance cover for those on a low income, whether unemployed, employed, or self-employed.

'Inactive' expats are entitled to access to the CMU-C, provided they have lived in France for at least five years..."

The gross income threshold entitlement to the CMU-C for a one-person household up to July 2009 was €7,447 + a 'forfait logement' if you don't pay a mortgage or rent on your home.

"Application can be made to your local Caisse (normally the Caisse Primaire d’Assurance Maladie) to whom you should provide proof of your income."

Even if your income is too high to receive entitlement to CMU-C, you may still be entitled to assistance with your voluntary health insurance costs.

It looks as if it's definitely worth enquiring at the Caisse.

 

[Claire la richarde]

I think you have a better understanding of the E106 than some

Can't really take the credit - I just looked around on the web.

 

[greenandpleasantland]

Further to my earlier message, a possible get-out clause:


"If you relocate to France under the age of retirement with the intention of living off your capital, and/or early retirement pension, then, when cover under the E106 expires, you will need to take out private health insurance. You will need to maintain this private health cover until you have lived in France for 5 years, or you reach the age of retirement, and thereby become eligible for E121 health cover, whichever is the sooner."

Having said that, I'm not sure what the situation would be if the person in question has never appeared on the radar of the French health system. Does anyone have any idea about this?

Right so pay for private health insurance after E106 expires then get carte vitale after retiring or after 5 yrs residence....

yes a bit ugly again, as had no E106 or insurance and has always paid for DR appointments.... so effectively not on the 'radar' ......E121 cover, not carte vitale? I thought E121 was for people with severe diablement or incapacity.....

how confusing.....

 

[greenandpleasantland]

All the websites I've looked at so far say the same thing

"The CMU Protection Complémentaire (CMU–C) provides free health insurance cover for those on a low income, whether unemployed, employed, or self-employed.

'Inactive' expats are entitled to access to the CMU-C, provided they have lived in France for at least five years..."

The gross income threshold entitlement to the CMU-C for a one-person household up to July 2009 was €7,447 + a 'forfait logement' if you don't pay a mortgage or rent on your home.

"Application can be made to your local Caisse (normally the Caisse Primaire d’Assurance Maladie) to whom you should provide proof of your income."

Even if your income is too high to receive entitlement to CMU-C, you may still be entitled to assistance with your voluntary health insurance costs.

It looks as if it's definitely worth enquiring at the Caisse.

Hello again Claire

That is helpful

I think the CMU looks like the most likely/easy option so far.....

Thanks for letting me know the part about low income and 5 yrs residency

He doesn't pay rent....

I believe where the CMU states low income for french residents they mean those on RSA (the replacement to RMI) Not sure why it mentions 3 months residence min to qualify? I think that france expects foreigners to be working or retired to be here and that's it- they can't claim benefits like the french.

 

[Claire la richarde]

I thought E121 was for people with severe diablement or incapacity.....

E121 is for retired people ("someone of the age of retirement of the country of origin, with no professional activity, and in receipt of a State pension from their home EEA country") as well as those on long term incapacity benefit.

Anyway, check out my message on CMU-C. May be a ray of hope.

 

[greenandpleasantland]

E121 is for retired people ("someone of the age of retirement of the country of origin, with no professional activity, and in receipt of a State pension from their home EEA country") as well as those on long term incapacity benefit.

Anyway, check out my message on CMU-C. May be a ray of hope.

Ok, I get it now - will do thanx

 

[Claire la richarde]

One last detail that might be useful

CPAM - French Health Service (English language service): +33 (0)8 20 90 42 12

 

[greenandpleasantland]

One last detail that might be useful

CPAM - French Health Service (English language service): +33 (0)8 20 90 42 12

thanks - i'll pass it on

 

[parsnips]

Hi,
If this person has lived in France for 5 years they would have been here before the CMU cut-off point. If ,as is legally required ,they have been making a tax declaration here they can produce proof of their residence going back to 2005 ,and so qualify for the CMU (free if they have a low income).
If however they have chosen to remain "invisible" to the french system for some reason, then they are in a serious mess of their own making and unless their spouse takes their pension and lives in France with them to get E121, they will have to take full private health insurance. I suggest they contact "Exclusive Health Care" for quotes.

 

[Bevdeforges]

I'm not trying to say the person is bad or doing anything wrong. Just that it seems like they are making some wrong moves that seem to go against their best interests.

Had a long discussion some months ago with a British friend of mine where we were talking about "problem solving styles" of the various nationalities. The French have a tendency in cases like you're describing of going to the mairie, whereas most Brits and most Americans would do anything to avoid getting "the government" involved.

Most mairies in France are a real valuable source of information about what programs and benefits may be available. You may have to put up with a bit of "officious" treatment at first, but usually for an older person in difficulty, they'll do whatever it takes to get them what they need. And they can find out precisely what documents your friend needs to present in order to qualify for public services.

The mairie is generally the organizer for home delivered meals, for organizing transport for shopping for the elderly, and as I think I mentioned, for having a sécu representative available on a regular basis to help residents sort out problems. The French health care system normally only pays 60 - 70% of most health care bills, but in the case of someone on limited income, this can be changed to cover 100% and even to avoid having to pay up front and wait for reimbursement.

Your friend is legally living in France. He or she has nothing to fear. Take him or her to their local mairie and ask what can be done. You may be pleasantly surprised.
Cheers,
Bev

 

[greenandpleasantland]

Hi,
If this person has lived in France for 5 years they would have been here before the CMU cut-off point. If ,as is legally required ,they have been making a tax declaration here they can produce proof of their residence going back to 2005 ,and so qualify for the CMU (free if they have a low income).
If however they have chosen to remain "invisible" to the french system for some reason, then they are in a serious mess of their own making and unless their spouse takes their pension and lives in France with them to get E121, they will have to take full private health insurance. I suggest they contact "Exclusive Health Care" for quotes.

Hi
- that is very informed and useful
thank you