French healthcare changes affect expats

The expat community is in uproar over changes to the French healthcare system that mean some Britons are being forced to move back to the UK

Some Britons suffering from cancer who have retired in France are being forced to move back home for treatment because of radical reforms that block their access to the French national health system.

Rules brought in five weeks ago by Nicolas Sarkozy, France's new president, have withdrawn access to the country's state health system to any foreign residents who are under normal retirement age. This means British men under 65 and women under 60 who are living in France, but not working, are no longer given free healthcare.

Before September, early retirees were allowed access to the system by contributing 8 per cent of their income, but two months ago the French health ministry wrote to expats withdrawing their cover from March 30, 2008.

For Vanessa and David Brown, who took early retirement and moved to France at the end of 2003, this is literally a matter of life or death. Their dream retirement to the south of France turned into a nightmare when Vanessa, a non-smoker, contracted a rare form of lung cancer in 2004 that has left her in need of regular chemotherapy.

She has been told that from the end of next March her life-saving treatment will be withdrawn unless she pays the £2,500 a month it costs, something the Browns are unable to afford.

David had a private medical healthcare policy with Bupa International that would have covered his wife's treatment but he cancelled it when he moved to France. Until the rule change, foreign nationals moving to France could sign up to the country's healthcare system by paying 8 per cent of income to the state. Under the French system individuals are also required to contribute part of the costs of the care, with the amount of that contribution dependent on income. So as well as paying into the state system the Browns took out a policy of top-up cover – the so-called "mutuelle" – to cover this excess.

They now have to give up an affordable private medical insurance policy to fit in with the French system. But Vanessa's medical condition has deteriorated drastically since they surrendered their policy with Bupa , so now no insurer will offer them cover.

There has been confusion between governments and confusion at national and local level in France over the healthcare changes. It has created concern and dismay across a large swathe of the EU expatriate population, mainly British citizens. It is a mess for residents who moved to France under a system that allowed them access to France's state healthcare system by payment but have now been denied that access and they are unable to get private health insurance because of existing illnesses.

Not all British expats are excluded from French state healthcare. Any Britons over the UK's state retirement age, 65 for men and 60 for women, are covered by getting a form E121, which means their fees are paid by the UK government under a reciprocal agreement.

Expats can also get cover for the first two years they are living in France by obtaining a form E106 from the Department of Health before leaving the UK, and anyone who has lived in the country for at least five years is entitled to care as a resident of France. But for the thousands of Britons who have taken early retirement to live the dream in rural France the rule change has come as a bolt from the blue.

For those who are healthy, it is possible to get an international plan to cover the three years between the expiry of your E106 and the five-year residency qualification period.

International plans are generally more expensive than UK plans but they will also cover you wherever you travel in Europe as well as in France.

The first rule is not to give up a healthcare plan in the UK if you have one until you have checked out exactly where you stand. Cancelling a policy over here would be a disastrous mistake because many insurers will let you change from a UK plan to an international plan that covers Europe, while keeping you on the same underwriting terms.

If you want to relocate to France and know you are going to need some treatment in the future, the current situation is that you will have to pay for your own care once your two years E106 benefit runs out.

British Members of the European Parliament are lobbying the French over the issue, but for now the country's hospital doors remain firmly closed to thousands of British expats.


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