Healthcare options for young couple?

[philv]

Hello all.

We have just sold up in the UK and moved permanently to the Limousin area.

We are currently renting.

We're extremely confused and frustrated about the conflicting information about the French health care system.

Some are saying as 'residents' we're covered under this CMU thing, some are saying we haven't contributed so are entitled to nothing, some are saying we're not entitled until we're been there 3 months etc etc.

The situation:

We're in our 20's, don't currently work but will be looking for employment. I will also probably be looking into starting up my own artisan business (small income at best).

We're currently 10 weeks pregnant but haven't had any of our scans etc yet.

We have enough money to survive short-term in France but not for years and years.

What do we need to do with regards the health cover?

Would i be better setting up a small business? Would this entitle us to basic health cover? If so, how much do we need to pay for it/how much mandatory income tax would i have to pay?

Would it be better to 'sign on' as looking for work? Would this entitle us to cover? For example one site says:

 "EU expats arriving in France without an S1 and who do not work or

‘inactive’ are in a vulnerable situation. If they have no right to any

other State health cover whatsoever, they can apply to CPAM (French

health office) for basic CMU Couverture Maladie Universelle"

What does 'inactive' mean? Does this mean you're not looking for work actively?

Would it be better to just take out private insurance? What level of cover do we need to cover pregnancy for my wife?

Hopefully someone can help or point us in the direction of where we need to go to sort this nightmare of a bureaucratic merry-go-round out.

Many thanks.

[lindal1000]

You could sign on with the pole d'emploi, but they will insist that you apply for jobs. You could apply for CMU, but a condition of being accepted is that you have enough income to not be considered a burden on the state. If you are planning to start up a business at some point you might need to bring these plans forward a bit. If you search the forum for AE you will find discussions about this simplified structure, that might work for you in the short term and will give you and your wife health cover for 25% of your turnover (not profit),

[philv]

Thanks very much for your response.

I'm still very confused.

I don't get what the point of all this EU stuff is if it actually makes zero difference when we try to move abroad. EU nationals come to the UK and get everything that UK nationals get but it doesn't seem to work the other way.

We have meagre savings but not an actual 'income' per se.

What happens if i start a business but business is slow? What if i turn over €1000 or something? Is there a minimum limit to it?

I'm not too bothered about health insurance for me anyway, mainly for my wife because of the pregnancy thing.

Does anyone know of how i can get an insurance quote from a French insurance provider and not some expat thing?

And do you know what the relevant English-speaking department is that we could speak to in France about our situation? I'm a stickler for speaking French when in France but on something this important too much would be lost in translation i think.

Thanks again.

[Hereford]

The English speaking helpline for CPAM is (or was so if it has changed I am sure someone will be along to correct me):

0811 36 36 36

You should telephone them ASAP!

[Patf]

Looking at the worse case scenario - your wife could return to the UK for the birth. Give relative's address.

France is nothing like the UK when it comes to eligibility for healthcare.

[andyh4]

I can understand the confusion about the EU, it seems to be rarely explained in the UK.

Essentially what it guarantees is that anyone from the EU arriving in another EU country has the same rights to health care as a local. What you are now finding out is how difficult it is for a French person to get healthcare compared to someone in the UK.

Life in the UK is certainly much easier in this respect than any of the other countries I have lived in in the EU.

As for health insurance, just about all of the insurance companies will be able to give you a quote - search for assurance sante (accent over the e) on google.fr. You will be inundated with links.

[EuroTrash]

People sometimes forget that the EU is basically about economics, and the famous EU freedom of movement is all about freedom of movement for labour, ie for people who are making an economic contribution.

Each state has to balance its books, and the services it provides have to be paid for by the people who work and contribute there. Most states' health services are pretty stretched and they can't afford to subsidise treatment for people who have never paid into their system and towards whom they have no responsibility.

A bit like breakdown services - if you've paid your subscription to the RAC, it's no good trying to call out the AA to rescue you. If you've paid into the NHS, you can't expect France to pick up the tab.

[idun]

Your post has rather shocked me. When I look at the problems my son, born in France and and working in France had to get a rented property, then that you are renting is, rather amazing.

All the information is on the web. This site is essential concerning foreigners in France. It is the

french government information site and helps with many aspects of

everyday living.

(sorry about the gobblydy gook above two of the links, please ignore)

https://www.service-public.fr/particuliers/vosdroits/N123

You are inactif, and that is on the next link, which says that you

have to have Assurance Maladie Maternite. (I've copied it below)

https://www.service-public.fr/particuliers/vosdroits/F12017

Conditions

Vous devez disposer pour vous et votre famille :

• d'une

  assurance maladie-maternité,

• et de ressources suffisantes pour ne pas devenir une charge

  pour le système d'assistance sociale français.

Le caractère suffisant de vos ressources est apprécié en tenant

compte de votre situation personnelle. Dans tous les cas,

l'administration ne peut pas exiger que vos ressources dépassent les

montants suivants par mois :

Ressources suffisantes

Conditions			Montants
Si vous avez moins de 65 ans	Si vous vivez seul(e)	Sans enfant	524,16 €
		Avec 1 enfant	897,44 €
		Avec 2 enfants	1 121 €
		Avec 3 enfants	1 346 €
		Avec 4 enfants	1 571 €
	Si vous vivez en couple	Sans enfant	786,24 €
		Avec 1 enfant	943,49 €
		Avec 2 enfants	1 100,74 €
		Avec 3 enfants	1 310,40 €
		Avec 4 enfants	1 467,65 €
Si vous avez plus de 65 ans (sauf exception)	Si vous vivez seul(e)		800 €
	Si vous vivez en couple		1 242 €

As is stated France owes you nothing, you can move to France if you can support yourselves and pay for your own health care........ and that would be a very good thing for the UK to adopt too.

So IF you can set up a business or start work immediately, then I would suggest that you do so, as that is the only way you will get state french medical care and even then it is not 'free' in the sense that the NHS is. There again, it is all on the web too, and most french people take up top up health insurance. And I have a feeling that private insurance is going to be very expensive, the pregnancy probably upping the cost.

[lindal1000]

Philv, it's to do with the different ways healthcare is organised in the member states. The NHS is entirely state funded and to access it you must be UK resident. That is the only requirement, so everyone who lives full time in the UK is entitled to NHS care free at the point of delivery.

In France healthcare is essentially a private enterprise (heavily regulated) that survives though a system of assurance. So to access French healthcare there are a number of routes, and the most usual one is through the contributions that you make through your salary. (There are other ways as well, but most people get their coverage as part of being employed).

Signing on for benefits in France is no different to in the UK.. if you sign on you will be monitored and expected to look to for work. The rights of free movement in the EU mean that you do have the right to come and look for work, but you need to show that you have a reasonable chance of getting work or enough income to live on, otherwise you lose the right to residence.. This doesn't mean someone will deport you, but they can refuse to pay you any benefits on that basis. Despite what you may think, the rules in the UK in relation to EU citizens claiming benefits are much the same.

One of our neighbours in a similar situation went back to their home country to have their baby, as Patf suggested.

[philv]

Appreciate the info.

If what i've read is right, and every French person has to have healthcare legally, then what about people who leave school and never pay into the system? Surely they get some form of basic healthcare?

What about migrants who move there, they must have some form of healthcare?

I read an official page last night from the French government that says anyone not eligible can go onto CMU de base which covers over 2 million uninsured people in France currently.

Any info about that?

[philv]

Hi linda thanks for your info.

Just to clarify, i'm not looking to receive any benefits. I'm looking for a way to contribute to the system as everyone else does without necessarily having to get private insurance or a 'cards in' paid job.

Even if there is a basic CMU with a payment every month, we're willing to do that.

[philv]

Also, how do i know whether i'm getting full insurance or not?

We've just searched for assurance santé like advised, i did a comparison quote for my wife and the premium came up at €19 per month. Surely that can't be right? Seems too cheap.

Are there any terms etc i should be looking out for to make sure it's full coverage we're getting? For example, i don't want to sign up for something at €200 a year or whatever to be told at point of care that it's only supposed to be complimentary to a main policy and can't be used in and of itself or something.

[alittlebitfrench]

You are entitled to healthcare put you have to pay for it. You can go and see a doctor tomorrow but you will have to pay.

Even if you found a job (which is very very unlikely) you still need private medical insurance or a mutuelle.

I am going to be kind here, go back to the UK before you lose all your savings. That sounds harsh, but France is a difficult and VERY expensive country to live in. Especially with kids. If you think being an 'artisan' is going to pay for the bills think again.

Sorry

[NickP]

[quote user="alittlebitfrench"] You are entitled to healthcare put you have to pay for it. You can go and see a doctor tomorrow but you will have to pay. [/quote]

Not quite true if you have a European health card. We've used the medical facilities here a few times and got back from the local social services the appropriate percentage. If you take the invoice back to the UK you get 100%. Plus of course emergency treatment in any European country is 100% free. OK you may pay up front but it is reimbursable, according to the regulations

[EuroTrash]

Phil - You say you're not looking for any benefits - but healthcare is a benefit, surely you can see that?

Part of the problem is that Brits who have grown up with 'free' NHS care just take it for granted that free healthcare is the norm, it's their 'right', and they expect it and don't value it. It's not the norm, Brits are very lucky to have this. So you need to think very carefully before leaving the UK and throwing away that safety blanket - you wouldn't be the first not to realise how lucky you were to have it, until you don't have it any more.

It is a condition of legal residence in France that you have sufficient financial resources to support yourself AND that you have healthcare in place. As has been said you can apply to join CMU after you've been living in France legally for 3 months, and if accepted you will pay contributions based on income (savings don't count), BUT there is a minimum income level below which, your application will not be accepted. Technically, you don't have the right to stay beyond three months if you have no healthcare provision in place, ie you can come here as a UK resident on holiday for 3 months, with the UK still your 'competent state' as they call it, but France will not agree to become your competent state unless you either find work here, or if you are inactif (ie not working) you meet the income conditions.

I'm afraid I agree with ALBF here. Your healthcare is your own responsibility and this is a big factor in deciding whether you are in a position to make a permanent move or not; a lot of Brits do delay their move or decide against for just that reason. Just rocking up - especially rocking up pregnant - and assuming "somebody" will look after you, is not a great idea if you have limited savings.

[EuroTrash]

NickP - a European healthcard issued by the UK is valid for people who are covered by the NHS.

If the OPs were here on holiday they could use their EHIC, although not to give birth. But if, as they are saying, they no longer live in the UK, then their EHICs are no longer valid.

[EuroTrash]

Re your quote for assurance santé at 19€ a month, that sounds like top up insurance. If you are in the state system you are covered for usually around 70 per cent of the cost. Many people take out top up insurance to cover some or all of the remaining 30 per cent. But you can only take out top up if you are covered by one of the state caisses.

[lindal1000]

As far as I can see from what you have said, your easiest option would be to set up as an Autoentrpreneur for the activity you wish to do. To do this you will need to register with the appropriate people and do a course, which you will have to pay for. Once registered you will get your healthcare (basic cover) as part of that and your wife can become your dependent. There is no minimum turnover in order to get cover but you must have some turnover in two years or you automatically get shifted to the next regime, which will be much more expensive. You could try and apply for CMU but expect them to go through your finances with a fine toothcomb and the outcome may not be positive. If you have a large amount of savings they may take that into account.

The good news is that basic trips to the doctor are not that expensive (23 euros a time). However, your wife really does not want to be giving birth in France without adequate health cover. If you can't sort it out I would honestly suggest you go and stay with friends and family in the UK until she is safely past the delivery.

[philv]

Oh ok, so France is a country where you can 'think again' because being self employed is some crazy pipe dream that only people like you can achieve.

Got it.

I'll probably ignore your 'advice' though.

Do you have anything to offer on the actual questions i've been asking?

This was directed at the person who told me to merely 'go home'.

[EuroTrash]

Which questions do you feel have not been answered yet?

[idun]

Firstly when I first got to France, there was no safety net with health care, or with unemployment benefits either. When your rights ran out, then you were literally on your own. No health care rights and no unemployment benefit.

There was the Red Cross ofcourse, but that is a charity isn't it!

Then they introduced the RMI and cover for health care for those in dire straights and I was delighted, I saw how hard it was for people. And I knew a lady with two daughters who had no health care, could not get a job in spite of a BAC+6, really could not get a job. The menial jobs they didn't want her as she was too qualified and at 42 was too old to re-start her career!!! Eventually someone took her on, but it literally took years and they lived on a small amount the children's father provided every month.

And as children can come under their parents 'charge' until they are 25, then the young people then and now are under the umbrella of their parents payments until they get jobs.

France is France and many things are quite different to the UK, and somethings I literally hate, BUT others seem very reasonable and this seems very reasonable to me.

And just going back to have a baby, there are lots of tests one needs, not only for one's own health but that of the baby too. I personally would not risk it.

We moved to France when we were young in the early 80's. Unlike now, where every last bit of information one could ever need is available on the internet, we knew nothing, but we would never have moved without a job in place. So not only are you not working, but you haven't done your research either by the sounds of it.

ALBF gave good advice, go back. And if you want to live in France, do your research, get a job in advance or a good business model set up that you can start immediately......... and make sure that you speak good french.

[Chancer]

I understand your concern regarding the birth, pre and post natal care, you certainly want to have something in place to avoid recieving what could be a crippling bill, your statement "We have meagre savings but not an actual 'income' per se. " is more worrying, will you have the resources to keep a roof over your head and food on the table until the birth?

Finding a job would be the most expedient in the short term as you will qualify for a raft of benefits not just healthcare.

 

Good luck.

[idun]

Re the go home thing.

Well ALBF has lived in France for a long time. And I used to.

It isn't ALBF with no health care and wearing blinkers thinking that he has moved to little Britain, where as you apparently rather struggling with it all and and have a baby on the way.

Yes, go and see which ever toubib, (that is a Dr incidentally) that you want and pay up and that is it. You can pay for all the tests you need doing to, no problem the system in France is set up to 'pay as you go', but that ofcourse is expensve.

Re the £19 a month, well, what will that be for, maybe top up insurance perhaps, but for that to work, they will want your health insurance number otherwise it simply will not work at all. (Lots of things in France are joined up).  And what would  that be for anyway, if it is only top up, because that is not 'simple' either. With our top up we always had 300% and dental and optic, which maybe you wouldn't need for the time being? But I am sure that that is just top up. And you will need completely full private insurance, and how much that would cost with a pregnancy I have not got a clue. Someone like Amariz, perhaps. Could be several hundred €'s a month.

Also even if your baby is born in France, said child is not automatically french, there are hoops to jump through and residency to go through before that happens or not.

[EuroTrash]

What do you want us to say?

It's just that from what you've said, it's hard to see what your long or even medium term plan for survival is. Your own words were "I will also probably be looking into starting up my own artisan business (small income at best)". Take a quarter off that small turnover straight away because that's what you'll pay in cotisations, will the other 75 per cent of your turnover be enough to fund a decent lifestyle for a couple with a child (the first child in France does not get a full family allowance) including rent, food, heating (it can get cold in Limousin), after paying for your tenants property insurance; business taxes after the first year (you are exempt for the first calendar year only, so if you set up in Nov 2015 you start paying business tax for the calendar year 2016); obligatory trade insurance if you're trading as an artisan (policy details have to be provided on all quotes and invoices so you do need it from day one); presumably a car or van and insurance for that... sorry, but you can see why it sounds a bit like a pipe dream.

Like Chancer says, try and get a job.

[Chancer]

[quote user="EuroTrash"]. Take a quarter off that small turnover straight away because that's what you'll pay in cotisations, will the other 75 per cent of your turnover be enough to fund a decent lifestyle for a couple with a child[/quote]

 

Not wanting to add more woes but I must be pedantic and point out that after paying 25% (of the turnover) out of the net profit unless you can make wine out of water and have a free supply of water it wont be the remaining 75% of your turnover remaining to live on.

 

To take the two extreme examples you turn over €50K making wine without incurring any costs of materials or production, then you would indeed be left with €37.5K (75%) after charges, although it does vary according to whether you are providing goods or services.

 

The other example is that you turn over €50K but actually make a loss of €5K, you still have to pay out €12.5K in charges leaving you with a loss of €17.5K