Hypothetical question

[Slippery Sam]

Dragon, I'm please to hear it. Just wondering why you need to tell everyone though, I did say "IF ".....

Quite Cooper, I'm not surprised. I've never 'not paid my way' in life having been lucky to have well paid job until my medical problem. It's not only cost me my job (yearly mandatory medicals then every six months after 40) but is making a permanent move here very difficult. Nobody wants to insure me for reasonable sums due to the condition that hardly affects day to day life at all. I'm not even taking any medication. 

It's human nature to loose interest in a cause if you are an 'all right Jack' but it's another thing to be seen to be having a go at someone who has just posed a hypothetical question (even if it was a wind up!)  If my name was Jack instead of Slippery, I doubt I would feel as passionantly about this as I do although I detest any form of injustice or discrimination. Do I feel discrimated against for having been ill? Yes I do especially as it's unlikely to have been detected in the first place had I not had to have the twice yearly medicals.

If you are a Jack then please refrain from having a go at people who might be forced into thinking of ways around this. Shouting things like low life benefit cheat etc etc is very unfair and it's a million miles from the truth in my case.

[lacote0_0]

[quote user="cooperlola"] From a personal point of view, I just cannot see that the UK is, or can ever be considered to be, in any way my "domicile" - I've left it, all that I have is here.  Just because I was born there I can't believe anybody would think of it as my domicile except maybe some clever lawyer, politician, or pedantic forum member.....[;-)][/quote]

At the risk of being accused of being one or more of those things and/ or of being morbid (may it be far away for you and all of us), would you wish to die or be buried in France or in the UK?

I seem to remember that one of the illustrations of domicile was a lady who was born in India of English parents and had never been to the UK was nevertheless found to be domiciled in England for this reason.

[Will]

I suppose that being classed as 'actif' rather than 'inactif' makes us among the 'all right Jacks', but that does not mean I am not sympathetic to the problem.

But in reality all that France has done is align itself with the majority of nations who only want you to live there if you are prepared to pay your way and/or are in good health. For all its much-vaunted faults, Britain's NHS is in the minority in providing universal health care to all who are genuinely resident (and the distinction between 'residents' and 'taxpayers' is the NHS's, not mine). If you can't afford health cover in most places, or you aren't covered by a reciprocal arrangement (such as you get under E forms) then you are either excluded from living there or you have to wing it, like many of the British in Spain do.

France still has its sights on providing a universal health service for residents; the trouble is that you need a five-year term to prove your residence status, and that, for inactif immigrants, leaves a gap between expiry of E106 and gaining residence.

It still might be possible for some, and cheaper than private health assurance, to start a micro-business in France and pay the minimum cotisations in order to enter the system. It appeared that the autoentrepreneur system provided a short-cut (and it still might - nobody seems to know the answer). But the longer the uncertainty stands the less likely it appears that this will provide the solution. The most likely outcome seems to be that the same rules will apply to autoentrepreneurs (who are not otherwise eligible for health cover) that apply to those in part-time salaried employment: i.e. that you have to earn, and pay cotisations on, the equivalent of about 60 hours per month at minimum wage in order to qualify.

Edit - I see the question of domicile has come up again. As far as Britain is concerned, document HMRC6 takes 10 A4 pages to define the term. As far as France is concerned, domicile and residence mean much the same thing, tax-wise. So there is no hard and fast definition, as Cooperlola mentioned earlier. Nevertheless, it can in some cases prove useful to retain UK domicile for things like inheritance planning and/or wealth tax, but here we are getting into the realms of creative accounting. Like residence, you can't choose where you are domiciled, but you  can arrange your affairs so that the laws and taxation agreements can work in your favour.

 

[cooperlola]

I'll be dead so I won't give a stuff, Lacote.

Will, I guess the sad thing is that I could do it and now people like Sam have to "cheat", or at least be very inventive, to be allowed to do what was very simple for me.  I don't have a problem with what the French government is trying to do in theory but I don't think anybody in authority has really thought about the implications.   In most civilised countries, discrimination on the grounds of disability or ill health is illegal and somehow this ruling has slipped through without anybody acknowledging that it does just that - discriminates against those who are sick. 

[Daft Doctor]

I've got to say that I wouldn't criticise anyone who wanted try to bend the rules a bit on this issue, as long is they knew the risks they were taking, and were prepared to accept any consequences, and I concur wholly with SS's well-put comments on those who take the moral high ground.

The fact is that there is a clear disparity between how French (or other EU) imigrants into the UK are treated in terms of healthcare provision, compared with those of us who wish to go to France to live. That could be argued is more a failure of the UK government to tighten up the UK rules rather than the french being grossly unfair, but the current disparity is irksome. I would not try to bend the rules as I am not that much of a risk-taker, but would simply like the opportunity to pay into the system without being employed, rather than being shut out altogether.

Notwithstanding all that however, surely the things which any prospective emigrant to France should do are to:

1. Time their departure to France to get at least the maximum access to the french system via an E106 (2 years I think)

2. Factor into their emigration costs top up cover for the time on their E106 then at least 3 further years of full private insurance (as near as will meet the french governments definition of full cover), whatever that cost may be.

Regarding the latter, most people emigrating to France will be selling property, probably taking early retirement or selling up other assets, and should be able to make adequate provision, as long as they are aware of this need and (like me) don't want to take the risks inherent in 'blagging it'.

The hope is then to satisfy the rules on 5 year residency somehow to then get access into the french system permantly therefter.

Isn't it as simple as that?

[AnOther]

Lacote raise a good point though. I wonder how many of us, in old age and decrepitude, already deprived of a partner through their earlier death, would not harbour at least some wish to end their days in the company of family back in UK.

Within the UK's interpretation of domicile that sentiment, let alone the deed, could be enough to you classed as such.

[cooperlola]

DD, it should be that simple and possibly is.  But the law says that to qualify for the five year residency rule, you should live here legally and stably during that time.  The latter bit is easy as it's about spending a certain time each year in France and this is specified.  Fine. 

The first bit should be simple but possibly isn't for the sick.  The law states that one must have private health insurance which complies with laid down perameters (sp?) - ie covers doctor's visits, medicines, hospitalisation etc etc (in other words the same level of cover as the state does.)  Now, if you have a pre-existing condition, you can't get private insurance which will cover this.  So you now have two problems.  Even if you get cover for the things not related to your condition, you're still stuck if you get sick and the insurance company can say your sickness is related to your conditions.  This could be expensive for you and you can't go back to the UK to get treated for reasons which have been well covered and argued in this thread already.  The second snag is that your cover -because it doesn't include your pre-existing condition - could (and I say could because nobody knows yet what will happen or how "full" cover will be assessed once the five years are up as this hasn't come up yet and won't until November 2012) be deemed to not be full and thus illegal.  If this is what happens, then you could be denied access to the French state healthcare system even after five years and have to carry on paying for inadequate insurance until you reach UK retirement age.

Not really very simple, is it?

[Daft Doctor]

Coops, you are of course right in all that you say on this, and it just highlights both the frustration that many will feel, and the temptation to be economical with the truth (be it regarding residency, declaring pre-existing conditions or even claiming long term sick in the UK to get an E121) ensuing from a combination for some of having both a desire to move to France and a pre-existing medical condition which doesn't stop them from working but would stop them getting private health insurance.

What I really hoped to say was that you can't realistically expect to emigrate to France on a shoestring, and if you are lucky enough (as I am currently) not to have a pre-existing medical condition, then you can see it through eventually into the French healthcare system if you are lucky and you have budgetted for the inevitable costs. I guess this means commiting to the permanence of one's move as soon one is able, so the 5 year clock can realistically start ticking. In my current circumstances, I would rather do that than risk being denied the chance to stay in France permanently because I had been found to have broken the rules. I however couldn't agree more that for many it is just not that simple and certainly, as things stand at present, not very fair.

[AnOther]

I agree it seems unfair DD and I understand your frustration and that of others but it is not just another symptom of the unwieldy, and frankly IMO, unworkable EU.

The lofty and utopian ideals of common rules and equality is nothing but a pipedream, as far off now as ever it was, and will doubtless be little closer to realisation by the time all of us here are long dead and buried.

[Quillan]

Just two things.

Cancer (used as an example earlier on in the thread) - We have an English friend who lost his wife here in France due to cancer a couple of years back. He never registered for tax or for a Carte Vital, he went the way of Travel Insurance and the European Health card. The Travel Insurance would not cover his wife and neither would the European health card because it was not an emergency. The long and the short of it was that after she had died he got a visit from the Gendarmes (why them I have no idea) about unpaid medical bills totalling some 90,000 Euros. They also gave him a letter from the local Notaire that said he had X time to pay it else they would take the house off him, sell it, take their money and give him the balance. They also took his passport off him so he couldn't do a runner. Fortunately he did have the money but it was in something like a 90 day account in the UK and was waiting for it to arrive in France, once it did he paid the bill. He never considered not paying (the care was, in his words, far superior to that in the UK) but it shows too what extremes they can go to.

Being resident/domicile etc. - If you want something in France that requires you residing or being domicile here the standard way that the French seem to deal with it these days is ask for a copy of your last French tax return. Whether this is right or wrong under European law, dual taxation rules, human rights or whatever it seems thats what they ask for and if you don't have one they just give the old shoulder shrug and say Non.

So to the OP I would say fine go down that route if you think it will work but if something serious happens you could loose a lot more than you could possibly imagine financially. Most people of 50+ years want to do it right because as we get older we have more chance of something happening and its just not worth the risk of finding yourself in 'limbo land' and possibly dying as a result. You won't know if your 'system' works or not till that happensand its a very big, potentially expensive gamble. To be honest I don't know of anyone who has ever gotten away with it.

[KathyC]

Just to add to this,although you mention the European Health Card, you also say a couple of years go, so I assume that the E111 still applied. You can use the EHIC for non emergency treatment so this situation wouldn't arise to this extent now.

[cooperlola]

The E111 has been dead for rather longer than than, I think.  IIRC, it was an EHIC when I moved here over five years ago.  But I could be wrong.  Whatever, the EHIC is not available for non emergency treatment regardless, there are still many caveats, best explained by Will, above.  I don't think the man Quillan refers to would be treated any differently now - clearly he was not registered here when he should have been (and he could have paid into the system with no problems.)

[Quillan]

[quote user="KathyC"]Just to add to this,although you mention the European Health Card, you also say a couple of years go, so I assume that the E111 still applied. You can use the EHIC for non emergency treatment so this situation wouldn't arise to this extent now.[/quote]

No it was definatly the EHIC card and he thought the same as you, that he was covered and he wasn't in France at that time. The new card was available from the 1st Sept 2005, E111 ceased to be issued on the 31st August 2005.

However whilst trying to discover the exact date the card was issued from I found the following which is why I specifically mentioned "France at that time". Although he had to pay 'up front' he was able to claim the money back from the NHS afterward but that does depend on your local area health trust. The thing is not many have the money at hand to pay and then claim back. Also as somebody else said in France the state pays 70% so thats what you would get back and you would still be out by 30% of the value of the treatment given.

What is Covered?

The EHIC is normally valid for three to five years and covers any medical treatment that becomes necessary during your trip, because of either illness or an accident. The card gives access to state-provided medical treatment only, and you'll be treated on the same basis as an 'insured' person living in the country you're visiting. Remember, this might not cover all the things you'd expect to get free of charge from the NHS in the UK. You may have to make a contribution to the cost of your care.

The EHIC also covers any treatment you need for a chronic disease or pre-existing illness. You need to make arrangements in advance for kidney dialysis and oxygen therapy. To arrange for kidney dialysis while you're away, contact your NHS renal unit in the UK before you travel. For limited information on oxygen supply services in the EEA countries and Switzerland, call the Department of Health's Customer Service Centre on 020 7210 4850.

Remember that the EHIC won't cover you if getting medical treatment is the main purpose of your trip. You are advised to take out comprehensive private insurance for visits to all countries, regardless of whether you are covered by your EHIC.

Your EHIC should cover you for routine maternity care while you are away. However, if you are going to an EEA country or Switzerland specifically to have your baby, you will need an E112 form.

In Summary, the EHIC will cover:

• Any medical treatment that becomes necessary during your stay because of either illness or an accident.

• The card gives access to reduced-cost or free medical treatment from state healthcare providers.

• It allows you to be treated on the same basis as a resident of the country you are visiting i.e. you may have to pay a patient contribution (also known as a co-payment). You may be able to seek reimbursement for this when you are back in the UK if you are not able to do so in the other country (and limited to the equivalent cost on the NHS).

• It includes treatment of a chronic or pre-existing medical condition that becomes necessary during your visit.

• It includes routine maternity care, (provided the reason for your visit is not specifically to give birth).

• It includes the provision of oxygen, renal dialysis and routine medical care.

It does not cover:

• The EHIC is not a substitute or replacement for private travel insurance. You should always take out an appropriate private policy in addition to carrying your EHIC.

• It will not cover the costs of private healthcare or services that are not part of the state healthcare system.

• It will not cover the costs of being brought back to the UK.

• It will not allow you to go abroad to specifically receive treatment (including going abroad to give birth).

• The card may not be used in some regions, as there may be no state provided healthcare available.

Source - http://www.e111.org.uk/cover.html

As to your eligibility to get one then read the following.:

Who Can Apply?

If you are a UK resident, you are entitled to medical treatment that becomes necessary, at reduced cost or sometimes free, when temporarily visiting a European Union (EU) country, Iceland, Liechtenstein, Norway or Switzerland. Only treatment provided under the state scheme is covered.

However, to obtain treatment you will need to take a European Health Insurance Card (EHIC) with you. Please note: Not all UK residents are covered in Denmark, Iceland, Liechtenstein, Norway or Switzerland. Click on the 'Health Advice for Travellers' link below, if you are unsure whether you are covered.

People who are ordinarily resident in the UK are entitled to a UK-issued EHIC. It is not valid for people who are going to live abroad. There are some restrictions, depending on your nationality:

• UK and other EU nationals, stateless persons and refugees are covered in all EEA countries and Switzerland. However, if you are a national of Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Slovakia and Slovenia, your EHIC is not valid in Switzerland.

• Nationals of Iceland, Liechtenstein and Norway are covered in all EEA countries but not in Switzerland.

• People who do not have UK, EU, EEA or Swiss nationality are covered in all EU countries but not in Denmark, Norway, Liechtenstein or Switzerland. In Iceland, these people are covered for emergency treatment only.

• Swiss nationals are covered in all EU countries but not in Liechtenstein or Norway. In Iceland they are covered for emergency treatment only.

• Dependants of EEA nationals who are ordinarily resident in the UK are covered in all EEA countries and Switzerland, irrespective of their own nationality

Source - http://www.e111.org.uk/eligibility.html

Applying for a European Health Insurance Card

You can apply for an EHIC for your spouse/partner and any children up to the age of 16 (or 19 if they are in full-time education) at the same time as applying for your own. If you are a foster parent or guardian (including boarding school teaching staff), you can apply on behalf of any children you are looking after.

You must be over 16 to apply as a main applicant.

Before you apply, you will need to have the following information to hand for everyone you are applying for:

• Name and Date of Birth

• NHS or National Insurance (NI) Number.

In Scotland the NHS number is known as the Community Health Index (CHI) number and in Northern Ireland it is known as the Health and Care number).

The EHIC is issued by the Prescription Pricing Authority (PPA) and is free of charge.

Source - http://www.e111.org.uk/requirements.html

 

[Scooby]

[quote user="cooperlola"]

The first bit should be simple but possibly isn't for the sick. 

[/quote]

Also what if you get sick when you do have valid cover (either via E106 or PHI) but before you meet the five year rule? Your new condition will be excluded as soon as your policy comes up for renewal - you are left stuck between a rock and a hard place.

[Will]

I would point out, just for the sake of correctness, that the source quoted by Quillan, is not an official government or European one (it is from something called "Online Review & Forwarding Service for the EHIC Medical Card" operated by IMAP (UK) Ltd - though why this exists and how it is funded is a mystery to me). The official version, at least for the UK, can be found at http://www.nhs.uk/NHSEngland/Healthcareabroad/Pages/About.aspx .

Having said that, on a quick glance, I don't see anything wrong in the passages quoted by Quillan, and the other points he makes are valid, but if forum users are arguing a particular point - such as whether or not the EHIC can be used for non-emergency treatment (it can) - it is probably safer to refer to the official site.

I would also point out that the period of vaidity refers only to the UK-issued card. Other equivalents, such as the French CEAM, have different periods of validity. The UK-issued E111 ceased to be valid on 31 December 2005, after which it (and several other forms) were replaced by the EHIC. Although as Quillan says, the EHIC had started to be issued before then.

 

 

[ontheway]

[quote user="cooperlola"]The E111 has been dead for rather longer than than, I think.  IIRC, it was an EHIC when I moved here over five years ago.  But I could be wrong.  Whatever, the EHIC is not available for non emergency treatment regardless, there are still many caveats, best explained by Will, above.  I don't think the man Quillan refers to would be treated any differently now - clearly he was not registered here when he should have been (and he could have paid into the system with no problems.)[/quote]

 

 we  need  an  e 1 1 2  to  have  exisiting  conditions   treat  in  another  eu  country  rather  than  an   e h i c.   original  poster  seems  to 

want  to  do  as  he  pleases,  just  don,t  get  ill  and  don,t  get  caught  or  you  will  wish  you  had  not  tried  to  be  so  clever.

[Tony F Dordogne]

And also hope that the DWP don't extend their benefit fraud office from Spain to France or that a neighbour doesn't put two and two together and report you either to the French or the UK authorites.

[Russethouse]

What about the costs of hospital stays ? Would an EHIC always cover those ?

[Will]

The E112 covers costs of pre-planned treatment carried out overseas (typically, though not necessarily, something like a hip replacement operation) when your local health authority has agreed in advance to you doing this. If you just need routine treatment for an existing condition, such as, for example, blood pressure tablets, this should be covered by the EHIC.

See http://www.nhs.uk/NHSEngland/Healthcareabroad/Pages/E112.aspx

 

 

[Russethouse]

[quote user="Tony F Dordogne"]And also hope that the DWP don't extend their benefit fraud office from Spain to France or that a neighbour doesn't put two and two together and report you either to the French or the UK authorites.[/quote]

I thought the DWP had recently started working in Spain and had already uncovered fraud there ?

I saw something on 'Breakfast' a few weeks ago

 

[Bluebell]

[quote user="Russethouse"]

I thought the DWP had recently started working in Spain and had already uncovered fraud there ?

I saw something on 'Breakfast' a few weeks ago

[/quote]

Yes, the DWP have representatives working in the Consulate offices of the most expat-populated areas of the Spanish Costas (to "help" expats claim their rightful allowances as well as deal with benefit fraud). The BBC covered the story with interviews, including those who admitted to fiddling the system: http://news.bbc.co.uk/2/hi/uk_news/8015229.stm

[Tony F Dordogne]

[quote user="Russethouse"]

[quote user="Tony F Dordogne"] And also hope that the DWP don't extend their benefit fraud office from Spain to France .[/quote]

I thought the DWP had recently started working in Spain and had already uncovered fraud there ? I saw something on 'Breakfast' a few weeks ago [/quote]

My point exactly and with so much emphasis on this from the UK Government at the moment together with the French push against having to pay for social and medical costs for the fit inactives, it doesn't take much to work out that this sort of imaginative thinking could cause real trouble for the imaginative thinkers.  Come to think of it, didn't we broadly have these conversations about 18 months ago when the French brought in their new restrictions?