Healthcare

IMPORTANT CHANGE IN PROCEDURE FOR 2011

For visitors to the UK, including UK nationals. The overseas Visitors Hospital Charging Regulations are in force. It means that ALL visitors visiting the UK are subject to charges for healthcare. The new rules place an obligation on health providers to ensure that non UK residents are identified, in order that they pay for their healthcare. It is even more important that you follow the following advice.

HEALTH INSURANCE a change to the EHIC - used to be the E 111

Up until now if you lived in France you got CPAM to make you a card.
However the rules change on 1st April, 2010, and it is the country which pays your state pension (if you are from an EU country) which now provides the card.
Holders of cards that expire before April will be getting a renewal form automatically, prior to that date. Holders of cards expiring later in the year will receive their application forms nearer to the date of expiry.

 Britons should apply to
Overseas Healthcare Team
The Pension Service
Room TC 001
Newcastle-upon-Tyne NE 98 1BA
England

Phone - and they are really helpful,  00 44 191 218 1999
fax is 0044 191 218 7376
or email overseas.healthcare@thepensionservice.gs..gov.uk
Website www.direct.gov.uk

The Couverture Maladie Universelle was introduced in France by a law, on the 1st January, 2000, and was of great significance. Many ex pats joined the scheme, glad to be a part of one of the best health systems in the world. However, all this changed dramatically in March 2007 when an EU directive was first applied in France. Since then, and until the December announcement of the relaxing of certain applications of this law, several thousands of beneficiaries received letters from their CPAM, advising them that their entitlement was cancelled, and their carte vitale would be withdrawn after a period of grace lasting until March 31, 2008. SEE IMPORTANT UPDATE BELOW

The position now is summed up below, as it affects students, job seekers, retirees, and early retirees from the EU and Switzerland, who are already resident, or about to become resident in France. This is a simple translation of what the Health Ministry document appears to mean. (Loi 99-641, see www.legifrance.gouv.fr/WAspad/UnTexteDe Jorf?numjo=MESX9900011L)

Official information from CNAMTS (international helpline): 08 20 90 42 12 or the CLEISS 01 45 26 33 41).


Who can now benefit from French state health cover?

In the past all EU expats arriving in France were eligible to join the French healthcare system. However, those arriving in France after 23 November 2007, and who are not planning to work, or are officially retired or in possession of documents which mean their healthcare costs are covered by the government of their original country, will not be allowed to join the system until they reach state retirement age or have lived here for five years. Until then, they have to hold private health insurance.

The right to join the French state healthcover system has been withdrawn from all non-French EU nationals with these important exceptions:

• Those holding a current valid E form. The E forms are not affected by the new regulations. The forms in everyday use which most people will know are the E121 for retired people, the E106 for workers and early retirees, the E109 to cover the family. Questions have also been asked about the continuing validity of the EHIC (previously called the E111) for visitors. This is not affected either.

• Those who were already beneficiaries on November 23, 2007 will not lose it now.

• Those who can prove five years of regular, and uninterrupted residence in France are entitled to benefit from state health cover. The right to permanent residence is subject to examination by the service des étrangers at your local préfecture.

• Those entitled to reside in France because they have sufficient means, and are covered by full private insurance, but who have not lived here permanently for five years, and who have a “life accident”, such as involuntary job loss or the discovery of unforeseeable, uninsurable medical conditions, which either deprives them of their financial resources or their private insurance. They, and their dependent family members living in the same household, will be given access to state health cover.

NB there is a short-term work option by which one can work part-time for 60 hours in one month, which may provide affiliation to CPAM for a whole family for a whole year.

Who cannot benefit from French state health cover?

• Those coming to France from any other country (including Europe) without full health insurance, and without an E form, who are inactive by choice, or have failed to find a job.

• Holders of an E106 after its expiry.



When the Couverture Maladie Universelle (CMU) or Universal Health Cover came into force, the intention was to make sure that all bona fide residents, including foreigners, however poor would be covered by the Social Security for their basic medical expenses.
The law provided that all residents of mainland France, and her overseas departments would have the right to State Healthcare at a relatively low cost, and that it would be free for the poorer sections of the community.

The CMU covers generally about 70% of medical expenses. If you are resident in France you are obliged by law to apply for affiliation to the CMU. There are severe penalties for not doing so. State cover may not be replaced by private health insurances.

The cost of free entry to the CMU is based on the net annual income threshold of the household No cotisation is payable for low income families, who could also be eligible for the free State top up called the Complimentaire.

When applying for the CMU, you will have to supply some evidence of your income to the CPAM (Caisse Primaire d'Assurance Maladie). They will then calculate your cotisation, and subsequently you will receive a demand for payment from URSSAF (Union de Recouvrement des cotisations de Securite Sociale et d'Allocations Familiales) on a bi-monthly basis.
An enquiry of the overseas branch of the DSS, Long Benton, Newcastle upon Tyne, NE98 1YX Tel; 019121 87367, Fax; 0191 21 87376 will be of benefit. There are often big differences in procedure between the different CPAM offices in France, but they should confirm at the time of your first visit to apply for affiliation, that your entry into the scheme and give you a provisional confirmation of your entry to the CMU (attestation provisoire)