Loss of French Healthcare

[stan]

I am one of these early retirees who decided to come and live in France,

but have an "underlying entitlement" to UK Incapacity Benefit, and

therefore an E121, and consequently healthcare for myself and my wife. I

do not get paid any benefits and fund myself via my UK Govt ill

health/injury pension.

The UK DWP are presently moving everyone on Incapacity Benefit,

including those entitled to it, towards ESA`s. Soon I have to undergo a

medical here in France, to decide whether I am migrated to ESA to retain

my healthcare here, or to lose my entitlement as being deemed fit to

work. (Now the anomaly...I was judged unfit to work which is why I was

awarded a pension, so do not need to work even if I could, and

in any case would never be able to work in France due to the nature of

my previous employment and the fact my French is still not that fluent).

My question is that..if I lose my healthcare and have to hand back our

Carte Vitales, can I still subscribe to the French system via payment of

some social charges (my pension is our only income, taxed in the UK and subject to

the Double tax Treaty).? I have read somewhere that the French govt may

allow persons in this situation to directly access their healthcare

again via payment of social charges.

I have been here for just over 2 years and have looked into how much

private healthcare  would cost for almost the 3 years up to the

statutory 5 year period and it is horrendous, certainly un-affordable

for me. This means I would have to sell the house (if I could in the

present housing climate) and return to the UK where I obviously would

not have to pay for healthcare. In effect this would be forcing me to

return to the UK and lose about £25K in capital gains tax (as the house

would no longer be my primary resdience) and currency conversion costs.

Nightmare.

[cooperlola]

Theoretically, reading your post, you would not qualify as you were aware that you had your medical problems before you moved and that was after the cut-off date.  However, I reckon that you'd have a good case to apply under the accident de vie provisions, since you were not aware that your E121 would be withdrawn, and this all asssumes that it will be!

What I don't know either is whether it's possible for you to sign on (or do the equivalent) over here if the French medical authorites say you're fit for work.  At the very least, you might be able to consider some sort of small business and set up an AE.  If none of these options work then yes, I reckon you'd be deemed a burden on the social security system so you'd have to sell up and go back to the UK - just the scenario which was predicted when those of us who already lived here before the cut off date were faced with five years ago.  Very grim, I remember it well.

That having been said, there's a new government, and there is probably a little more wriggle room than there was, although that's unproven.  But to me it would be a clear case of discrimination since, whatever the cost, you can't get full private insurance which will cover your condition so you don't comply with the regs anyway if you get thrown out.  In that event, I think that the European Commission would help you to make your case.

Whatever happens, don't panic.  If you do get ejected from the system there is a lot of right of appeal and they can't budge you from it until all the avenues have been exhausted.  How old are you both, if you don't mind my asking?

[Sprogster]

Stan, if you were judged fit to work and lost your E121, as an inactif I think you would need to wait until you had been in France 5 years until you could apply to join the French health care system. I don't believe you would fall under the accident of life provision if you had been medically assessed as fit to work.

What you have highlighted is the risk anyone takes in moving to France on incapacity benefit as if you are judged fit to work and loss your E121, private medical insurance is probably not an option due to your medical history and the French authorities in the current economic climate are not accommodating to foreign inactifs who want to join the French health system.

There has been some interesting reports from Spain that the authorities are seriously cracking down on unemployed and inactif Brits and other non Spanish EU citizens resident there, using a provision under EU law that free movement within the EU is subject to an individual not becoming a financial burden on another member State. As a result there is speculation that this sentiment will spread to other EU countries, making it much more difficult for early retirees to move from one EU country to another, unless they can clearly prove they have adequate financial means and private medical insurance, if not covered by their country of origin.

[cooperlola]

Sprogster, the accident de vie provisions are not solely concerned with those who are unfit for work, they are also for those unable to get private insurance.  Thus our o/p may still have a medical condition which makes him eligible, even if he passes the medical, that is the point.  Whatever anybody's personal opinions about the EU regs, in his shoes I think he should try it.

[Sprogster]

Coops, I would not rely on the new French government being more flexible with foreign early retirees in France, quite the contrary as I believe that with the dire economic situation in Europe they are vunerable, as governments will be looking at every way to cut costs and don't forget Brits in France cannot vote! Hence my reference to the Spanish precedent.

What probably does not help the situation is that the government perception in France is that most Brits moving to live there are low income retirees, which rightly or wrongly are seen as a potential financial burden to the State.

As a result my guess is that increasingly the movement of inactifs and retirees between EU member States will become subject to strict means testing and private medical insurance requirements, which it would appear the EU law allows.

[AnOther]

[quote user="stan"]My question is that..if I lose my healthcare and have to hand back our

Carte Vitales, can I still subscribe to the French system via payment of

some social charges[/quote]I believe there was a time you could voluntarily contribute to secure health but currently it is not possible.

[Sprogster]

Coops, but Stan moved after the change in the rules and therfore arguably knew the risks if his incapacity was of a nature that it could improve and allow him to return to work.

Clearly it is worth a try, but Stan's potential predicament should be a warning for those contemplating a move to France in a similar situation.

[cooperlola]

I don't really want to start all this stuff again, Sprogster, as it's not going to help Stan at all.  I did say it was unproven but I can tell you that the PS was very supportive of us during our campaign, especially the MEPs.  However, as you say, things are different when you're in government.  I still believe that the law discriminates against Stan because he has a medical problem - if he did not his private healthcare would be much, much cheaper - and that is the sort of thing which a socialist has much more trouble ignoring than the previous lot did.  So my advice remains that he should appeal under the provisions, at least as a starting point.

[stan]

[quote user="Sprogster"]

Coops, but Stan moved after the change in the rules and therfore arguably knew the risks if his incapacity was of a nature that it could improve and allow him to return to work.

Clearly it is worth a try, but Stan's potential predicament should be a warning for those contemplating a move to France in a similar situation.

[/quote]

Cooperlola, we are 50 and 39 years old (in response to your previous reply).

Sprogster, that is not strictly true about  my "incapacity being of a nature that it could improve and allow me being able to return to work". When I was pensioned off I underwent an extensive medical which gave me an "injury" pension in the "high bracket" meaning that returning to work was not possible. That pension amount is for life and cannot be changed under current UK legislation (and a recent court case).

The medical I am about to undergo will be based on another doctor`s opinion (bearing in mind that he does not have access to any of my UK medical records) as to whether I am fit enough for work, and consequently if he finds "yes", I lose my healthcare.

[woolybanana]

Surely, a doctor can only give an opinion if there is access to your health records?

[cooperlola]

I agree with you so strongly, Woolyb but this seems to be quite common in the way these assesments are going to be done/have been done here and I think it stinks.

Fwiw, Stan, I would still - in your shoes - try to get access to the report done in the UK by the medics involved in your diagnoses over there, perhaps even going to the length of having them translated.  At the very least, get a fluent French speaker to go with you (sorry, that's a bit of an insult as for all I know you are one!) so that you have your say in full.  I doubt whether the medical staff involved in these asssesments truly appreciates that it's not so much about money, but your right to remain in France.

[NormanH]

Don't panic stan.

If anything make sure that your health problems are well assessed and documented in France.

I have Romanian (therefore only half -European in status)  neighbours who have absolutely nothing, but as she has had horrendous health problems she has been given the Aide Medicale D'Etat (AME) and even an allowance for help with her living costs

I suspect that your income will be too high to qualify for this, but it does show that, for the moment, sick people are not being sent away, at least in my region. I accept the points that things will get harder but you have been here 5 years..

You should see an Aide Sociale  and even the CIMADE who may be able to point you in the right direction in a really difficult situation even though they are intended for even worse cases than yours.

http://www.cimade.org/

Hope things go better than you fear...

[Sprogster]

Stan, I sympathise with your situation. Presumably, the medical is to determine your suitability for any type of work, not necessarily just the line of employment you were in before? If that is the situation and your condition is a stable injury caused disability, rather than progressive illness, then at your relatively young age my understanding that it can be difficult to be ruled as unfit for any type of work, unless profoundly disabled, as the qualifying parameters have been tightened.

[stan]

Yes I suspect that may be the case, however, from what I can gather re the assessments in the UK, the examining body seems to either confirm or rule out that  a person is incapacitated, based on previous information that has been submitted in the questionnaire that everyone had filled out in the migration from IB to ESA. I also presume that there will be a bit on the response to DWP that asks for an opinion re work.

I do have a translated report of my condition and how it affects me daily, so will take that along when it happens.

[idun]

I realise that things were slowly changing in France re health records. But I have witnessed recently someone getting a medical report whereby the Doctor they saw had most certainly no knowledge and never ever seen any medical record from this person and the Dr in question had made a full and comprehensive report that was purely based on what the person had told them and that they had believed them. And in this case the person had made most of the stuff up.

So I would hazard a guess that personal medical records in France are still rather a vague notion as this Doctor did not see them.

 

I suggest that before your appoirntment, you make a very comprehensive list of what is wrong with you and from when it started and get hold of UK medical records too if you can. You should have anything french anyway from the last two years?

 

[stan]

[quote user="idun"]

I realise that things were slowly changing in France re health records. But I have witnessed recently someone getting a medical report whereby the Doctor they saw had most certainly no knowledge and never ever seen any medical record from this person and the Dr in question had made a full and comprehensive report that was purely based on what the person had told them and that they had believed them. And in this case the person had made most of the stuff up.

So I would hazard a guess that personal medical records in France are still rather a vague notion as this Doctor did not see them.

 

I suggest that before your appoirntment, you make a very comprehensive list of what is wrong with you and from when it started and get hold of UK medical records too if you can. You should have anything french anyway from the last two years?

 

[/quote]

I have a 4 page document/diary of my medical information which was submitted and copied by all the doctors involved in my medical retiral. I have a translated copy of that too as well as the Occupational Health "goodbye"certificate from the doctors certifying the ill health pension (also translated). As for any medical information in France for the past 2 years...there is none apart from the 3 monthly prescription of pain relief medication, taken on a daily basis.

I have asked the NHS office for the area I used to live in the UK for a copy of medical records pertaining to my injury, but this was refused on the basis that it was their property and they would not send it overseas.

The doctor had offered an MRI scan (when I had asked about a blue disabled badge for the car) in order to establish a French medical record, but I declined this on the basis that my condition had remained unchanged for the past 4 years and so there was little point, having been told by previous doctors that my injury is what it is and would not get better. Furthermore, I had retired to France to relax, not to duplicate costly (did not want to further burden the UK economy!) medical tests, however, now in hindsight, I probably should have.

Maybe I am just panicking and that my forthcoming medical will be in my favour and we can keep the healthcare entitlement, but being prepared for bad news has served me well in the past!

[Chancer]

I think this government is more sympathetic towards those without access to healthcare but critically it may depend on whether you are judged to be in financial difficulty or aisé dependant on your inactif income.

They have just done away with the €30 charge (was it annual?) to access the A.M.E.

[Debra]

Stan - is your injury covered 100% by the UK government when you live abroad?  I know that injuries caused by service in the armed forces, for instance, are covered in this way - you apply to the consulate for reimbursement of charges if the medical care received is for that injury.  If this is the case, you could still be covered 100% by a combination of private healthcare with that injury excluded by the policy but covered by the consulate.  In which case you wouldn't be able to access the CMU like cooperlola suggests (by reason of being unable to be covered fully otherwise) and then it's the expense that is the problem rather than actually being able to be fully covered. Is the this case for you; that it's the expense that would force you to move rather than being unable to be fully covered for healthcare?

[cooperlola]

I watched this morning, the Panorama programme, mentioned on a recent thread by Quillan, about the assessment process and the French company responsible for doing the tests.  What was very interesting was that, even in the UK, it seems that little or no reference was made to any medical records so that people who could perform the tasks asked of them (one was moving an empty cardboard box, ffs) were deemed fit for work, even if they had underlying problems which would not affect said performance.

Stan, I don't know what to tell you, except to say - as mentioned in said thread which I linked above - that you need to get a good idea of what will be asked and the nature of the examination.  It may well be that no matter what your medical history, nor the nature of your problems, that the unfair nature of the system (and I don't mean the French one but the way these tests are being carried out and the company's motivations whilst doing them) could get you into problems not of your making.  I know that it was TV but some of those turned down had horror stories to tell so get as prepared as you can.  There was a solicitor in the UK mentioned on the prog' who has had 100% (honestly!) of the claimants' rejections which have been referred to him, overturned, so there's a lot you can do if the worst happens.

Cr*p for you if it's ruining what should be a relaxing time and the chance to recuperate.  I know how you feel.  4 years on, I am still fighting  against the derisory award which I have been offered following a road accident.  It's bloomin' exhausting and not what you need when you're less than fit, for work or whatever else you want to do with your life.

[Russethouse]

I think if you search under ESA on the 'grumpy old gits in France forum' you will find reference to some guides to assist with the form filling, or I found this: http://www.benefitsandwork.co.uk/forum?func=view&catid=10&id=82821

which might be useful.

[NormanH]

I misread the OP and thought stan had been here over 5 years [:$]

I still think the key might be to be assessed here not for any UK benefit, but to establish  your needs and disability clearly in French terms, since in the end you are in France and  naturally they always prefer their own methods. This might be ammunition for future battles about being in the system.

[Pommier]

[quote user="stan"] In effect this would be forcing me to return to the UK and lose about £25K in capital gains tax (as the house would no longer be my primary resdience) and currency conversion costs. Nightmare.[/quote]

You wouldn't need to worry about CGT on your French home as, so long as it's been your primary residence for the last two years (tax returns completed etc), you get a period of time after return to the UK (I think it's two years) to sell the house before CGT is payable, providing you haven't rented the house out after you leave France. 

[stan]

[quote user="Debra"]Stan - is your injury covered 100% by the UK government when you live abroad?  I know that injuries caused by service in the armed forces, for instance, are covered in this way - you apply to the consulate for reimbursement of charges if the medical care received is for that injury.  If this is the case, you could still be covered 100% by a combination of private healthcare with that injury excluded by the policy but covered by the consulate.  In which case you wouldn't be able to access the CMU like cooperlola suggests (by reason of being unable to be covered fully otherwise) and then it's the expense that is the problem rather than actually being able to be fully covered. Is the this case for you; that it's the expense that would force you to move rather than being unable to be fully covered for healthcare?

[/quote]

The injury has been deemed an "ALD" here in France if that is what you mean. Unfortunately my injury is such that I generally need no treatment other than prescription pain relief  for which I receive my "ordonnance" every 3 months, other than that I receive daily medication for a related medical condition which is not classed as an ALD here. My wife has not visited the doctor at all other than first registration since we got here.

Prior to my medical retirement, I was in receipt of Industrial Injuries Disablement Benefit, but due to the legislation of the pension scheme, the amount I receive for that (£180 per month) is incorporated in the injury pension award, the downside of this is that I would have been entitled to 2 years healthcare in France for that injury via the IIDB route. As it is, I was advised (by the DWP) to claim an underlying entitlement to Incapacity Benefit which gives myself and my wife the healthcare in France via the E121. Now the big hand of the DWP may taketh that away!!

Cooperlola suggested a small business set-up. We have a cottage on our land which was formerly a gite, which we could probably do up in the event we lose our healthcare, and maybe get back into the healthcare system that way if feasible.

As I have said though, it is possible that I may retain the healthcare following my medical, but it is good to be prepared if it all goes t*ts up.

[Grecian]

Hello Stan, sorry to hear of your situation and the possibility you may lose your healthcover  if your E121 is taken away, I can fully sympathise as my wife is in the same situation, awaiting a medical here in France to see if she is deemed 'fit to work'. After watching the Dispatches and Panorama programs that were on Monday evening, it is a total disgrace the way in which this government is treating sick and disabled people, using a private company to fail as many people as possible irrespective if they are fit or not. The undercover doctor who secretly filmed a training session by the private company was told that not more than 13% of people tested were to be placed in the support group, based on the fact that they are meant to test 8 people a day, that means that only 1 person out of the 8 has any chance of being placed in the support group irrespective as to what is wrong with them, disgraceful. Sorry to ramble on about the injustices disabled people in the UK are now facing on your thread, but I personally think the fact yourself and my wife will have their medicals here in France rather than the UK is to my mind a plus point, as I cannot believe a French doctor would be allowed to act in such a manner, if the person they were examining was clearly unfit for work. I know we have the problem of the language barrier, but it seems that it is potluck if the doctor examining you will speak to you in English, I do not expect the French doctor to speak English but on another forum I follow some are speaking English, whilst other do it all in French.

I am providing a link to another forum, to a thread I think would interest you, as it is a thread about people like ourselves living here in France who  have been through a medical here in France. It is rather long I am afraid.

Link:

http://www.benefitsandwork.co.uk/forum?func=view&catid=10&id=77958

Sorry the thread has not 'lit up' you will have to copy and paste it to get connected.

The advice that the people on that thread are giving is to take any medical records or specialist reports and even a letter from your own French GP, as it seems any French documentation sent to DWP with your form mysteriously disappears. So take copies of anything you have relating to your medical condition, and ask your French GP for a letter of support if possible.

Can I ask you if you have an appointment for your medical yet, and if so how long did it take for CPAM to send you the appointment. My wife has been waiting 4 months since being informed by DWP that she will have to have a medical here in France. We are in no rush, but to have such a life-changing event hanging over you is not very nice at all. We will have lived in France for 4 years in September, so just trying to hang on in there for as long as possible.

One thing I am not sure about is if you are placed in the WRAG group contribution based, as you are probably aware it is now time-limited to 12 months, thanks a lot tories I thought 'work pays' was your mantra, obviously not after my wife and myself have paid in over 50 years national insurance contributions between us, is after the 12 months obviously the money will stop, but will they still have to provide an E121, as they are continuing to pay national insurance credits for your state pension after the 12 months has lapsed.

Anyhow easy to say but try not to worry too much, until the situation arises.

[idun]

You have raised a very interesting point Grecian and that is in what language should such an important medical visit be held in?

I would without any hesitation say in french. The Doctor is french and medical french is their working language, I would never want something so important to be left to the vagueries of a french Doctor misinterpreting and consequently losing out.

If I had any doubts about my french being up to it, I would employ a translator. And I would always ask for a compte rendu of the appointment.

 

I note with interest that you said that anything french that goes to the DWP disappears. Which department 'loses' this paper work exactly? The DWP is an enormous organisation.