Question about repeat prescriptions and chronic conditions

[man-in-loire]

Hi.

My wife and me are planning to move to our holiday home in the Loire next year and trying to sort out healthcare insurance. In the uk she has a medical exemption for chronic conditions, although she is quite fit and healthy generally. Is there any equivalent for this in France or will we need some insurance to cover for these regular medications?

Many thanks

[Chrissie]

You would have to register with a GP here and get them to certify that your wife has certain conditions that are of long duration ("ALD") in which case the state covers the medications at 100% - once you are recognised by your local Caisse Maladie.  If one of you is in receipt of a UK old-age pension, the affiliation to the CM should be straightforward.

I don't know all the medical conditions that might qualify for this (I'm sure there will be a web link somewhere) but, for example, high blood pressure and the need for anti-coagulants are both in this category.

Chrissie (81)

[lindal1000]

Are you retiring with a state pension or will you still be working? Are you planning on making France your permanent residence?

If you are French resident and in the French healthcare service by whatever means, then treatment for most long term conditions is reimbursed at 100%, and that includes repeat prescriptions. However there are various procedures that you need to go through to set this up. Top up health insurance does not penalize you for having an existing condition.

If you are remaining in the UK and using your EHIC for treatment while in France then I don't know whether you get approval for a long term condition in France. If you are talking of travel insurance or private insurance then many of them do have exclusions for pre existing conditions.

[man-in-loire]

Thankyou, that is helpful. We aren't anywhere near retirement age yet and I will be continuing to work, but I imagine that once we register with a GP that this will trigger the trail we need to follow.

Many thanks, Paul

[idun]

Too confusing this really. IF you are going to become french residents and are working, where will you be working and more importantly, who do you think will be responsible for your health care?

Remember there is no automatic right to french health care, and it will depend literally as to where you are doing your work, as to how you would be registered in France to get health care cover. And that would seem the most important thing to sort out.

You only need to register with a GP if you are in the health care system in France, if you are not, then you simply pay on each visit and see who you want, specialists included, see who you want and pay up.

[man-in-loire]

Thankyou for this, it is very helpful. We (or at least I) will still be working. The plan is for a minimum 2 year move while we investigate/plan some business opportunities before we make it permanent, so we do see ourselves as being 'resident' for that period at least. Our current travel insurance does make for periodic visits back to the UK to ensure its continued validity, but whilst this is okay for untoward events while visiting France it feels a little unsafe for anything more permanent.

Best regards, Paul

[idun]

I reckon you will be resident for that period too, two years is a long time. You had better check that your travel insurance covers your continued absence from the UK during that two years, would it really cover your wife's repeat prescriptions?

I believe your problem will be your wife's medication during your two years. The french will not pay for it and I don't believe that the EHIC would cover it either in fact I think that you will lose that, will the insurance company pay, is it expensive?

There are rules about stuff like this, whether you want to call Newcastle's overseas health care team and ask them what is what is up to you, I know I would.

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http://www.nhs.uk/NHSEngland/Healthcareabroad/movingabroad/Pages/Introduction.aspx

Just looked that up and it looks like you would lose your EHIC too. As I said, if in doubt, call them or maybe you can afford to pay for your health care yourselves.

[man-in-loire]

Thanks, I am self employed and can work from anywhere as it is all internet based, so will be based in France. My feeling is it would be better to set ourselves up as permanent residents, with all that comes with it, such as taxation, healthcare insurance, GP registration etc. This is why we have given ourselves a year to do some fact finding and planning. I will give the Newcastle office a call for some advice.

Thanks, it is all helpful - no such thing as problems, only solutions! Paul

[suein56]

[quote user="man-in-loire"]Thanks, I am self employed and can work from anywhere as it is all internet based, so will be based in France. [/quote]

You do need to do some research as it can be very expensive - compulsory state charges-wise - to run a business in France. And the red-tape involved can be horrendous. France is really not the same as the UK when it comes to ease of running a business without too much state intervention.

Sue

[idun]

You will have to look into registering your business in France. Income tax is not too bad, it really is the social charges that are high, but it is your way into health system, which still doesn't cover all costs, so you should probably still consider taking top up insurance to cover the extra medical expenses.

If you can get your wife covered at 100% that will ONLY cover that specific illness, eg, if she broke her leg, or say  got tonsillitis, then that would be covered as per anyone else.

[man-in-loire]

Thankyou, I have a contact in France who is an independent tax consultant and my income is quite predictable evan as self employed so I can probably get some quite accurate predictions as to what the costs would be re income tax/social charges, and I think it would be prudent to consider top-up health insurance. Yes I had assumed that 100% cover would only be for specified chronic conditions and other health matters would be separate. Clearly I don't have any accurate figures, but when I weigh up what I pay in the UK for council tax, NI and income tax, even with my habitation taxes, social charges, health and top up insurance I don't think I'll be much worse or better off - but I guess some figures will either cheer me up or depress me!

My apologies, I have diverted a little from the original question but it has been helpful. Thanks again.

[Benjamin]

[quote user="idun"]

If you can get your wife covered at 100% that will ONLY cover that specific illness, eg, if she broke her leg, or say  got tonsillitis, then that would be covered as per anyone else.

[/quote]

Not strictly true. If your French GP classifies you as disabled and makes the appropriate  application to CPAM, then ALL your medical care (save for a few minor prescription charges and daily hospital costs (accomodation) are covered 100%.

[idun]

 I have heard about that, but no of no one who has managed to get that amount of cover.

In fact at the moment I know of a couple of people who have simply been discarded by the COTOREP, and in my opinion they are handicapped........ but what do I know, simply know these people and see how they really struggle.

[andyh4]

I hear several alarm bells ringing as we are slowly drip fed information. I am in some cases putting two and two together and maybe not reading the situation correctly.

Some comments therefore which may not be applicable to the OP (and apologies if they are not).

1. By all means ring Newcastle. The most likely response is going to be that if you move and work abroad, you will cease to be under their care. They are not experts in the health care and tax situations across Europe.

2. If you are in France when you do the work, you are tax resident in France. It matters not a jot where your customers are. You will need to register your business in France. If your wife lives in France and you work elsewhere, you will still be jointly tax resident.

3. If your constant and consistent salary is because you are working for / will be working for one single company/customer, this is not allowed long term in France. You may get away with it for a couple of years, but after that there will be tears. Your UK client will be considered as operating in France by virtue of your continued work for them alone and will be requested to register in France - an expensive process for registration and for ongoing (and probably back-dated) employment fees.

4. You seem to take a rather blasé view of the cost of living in France. My architect told me once that it was costing him 75% of his earnings to stay in France, Taxe d'habitation, Taxe foncieres, income tax. social contributions, affiliation fees, top up medical insurance for himself and his wife. At the time I thought this was just exaggerated to justified his (not overly expensive) fees. What I know now makes me think he was being very accurate.

[man-in-loire]

Thanks Andy

What started out as quite a naive opening question has triggered some good trails to follow up on. One of the companies that I do repeated commissions for is an international company that has bases throughout europe, including france, so should be registered as an employer, though I need to check out specifically what this might mean for me as a self employed contractor to them. It is a slightly complicated arrangement as in this instance I am contracted through one company but have honorary positions in the universities they are partnered to, so different universities employ me as faculty. Whether this alters the 'single' employment arrangement is something to be investigated. I work with others too outside of this arrangement. I appreciate what you say about the cost of living, but i am not being blasé about it I assure you, which is why I want to cost it out as thoroughly as i can over the next year.

It is becoming clearer…in a rather cloudy way…Thankyou