Health Insurance Pre-Existing Conditions

[mr ploppy]

I'm trying to get to grips with the health insurance requirements prior to moving to France.  We'll be inactif, have no income, and no E*** from the UK, so will need comprehensive insurance.

I gather from the discussions on here that the definition of comprehensive is not entirely clear - or maybe it is.  I must admit there's so much info on here that it takes ages to wade through, and posts that were made over a year ago may now be OBE.

I have a fairly simple question I think.  When it comes to pre-existing conditions, it's entirely possible that an insurance may not cover you for that.  I read a post by someone (can't find it now) suggesting that since a pre-existing condition could preclude you from "full comprehensive" insurance that people (immigrants) with such conditions could never live legally in France. This may be according to the letter of the law, but even if it is, I find it hard to believe in practice.

As an example, let's say someone has a non-life threatening, treatable condition which requires taking medication daily (let's say migraine ... I don't know).  The medication may not be covered by insurance.  Does that mean the person can't become legally resident?

Can anyone clarify for me?

[5-element]

[quote user="mr ploppy"]I'm trying to get to grips with the health insurance requirements prior to moving to France.  We'll be inactif, have no income, and no E*** from the UK, so will need comprehensive insurance.


[/quote]

 If you are inactif, have no income and no E form from the UK, that would make you  illegal here in France.

What would you be living on? The French authorities would be asking you that question - before you can be a resident, you have to show that you have enough income not to need benefits of any kind....

I am sorry I can't help with the comprehensive insurance, but it is a non-starter unless your circumstances are somewhat different from what you say above.

[AnOther]

[quote user="mr ploppy"]When it comes to pre-existing conditions, it's entirely possible that an insurance may not cover you for that.  I read a post by someone (can't find it now) suggesting that since a pre-existing condition could preclude you from "full comprehensive" insurance that people (immigrants) with such conditions could never live legally in France. This may be according to the letter of the law, but even if it is, I find it hard to believe in practice.[/quote]I echo what what 5-element said although clearly you cannot live on fresh air so I'm presuming when you say no income you mean you will be living entirely off savings or perhaps with family or friends who are supporting you so I think you need to elaborate a bit on your circumstances for anyone to be able to pass informed comment as to the legality, or otherwise, of your residence.

To answer your health insurance question:  Some medical insurance policies will cover pre-existing medical conditions, to a degree and usually subject to qualifying periods. This means that acute conditions present before taking a plan out may be covered after a couple of years whereas chronic conditions are likely to be permanently excluded. You would have to speak to the providers and see what they can offer.

Regarding legality of living in France without comprehensive cover, well you're right to a point, however nobody is going to come knocking on your door demanding to see your policy and frog march you off for deportation if you don't have it. The bottom line is that you must not be a burden to the country's social or health systems and if you had partial health insurance plus the means to pay privately and in full for whatever treatment your excluded conditions might require then I see no real issue. Remember, after 5 years legal residence (and again, nobody is going to ask for proof of comprehensive health cover for those years and disqualify for not having had it), you will be entitled to join the French system and benefit from treatment equal to that which a French person receives.

 

[Will]

The original questioner may not have an E-form because he is not European... There are Americans and others in France with private health insurance, just as there have been for years.

But that means he will have to obtain Titre de Sejour to stay more than three months, which means he will have to demonstrate sufficient resources as well as health cover. I would suggest the best people to answer such questions would be the French embassy in his home country. There could be visa issues too.

 

[Boiling a frog]

I think that a sense of reality has to be injected into this subject .

As you are a UK passport holder there are no controls on entering or leaving France, no stamp in passport, no visa requirements,and at the moment no requirement to register your presence in France with the Mairie ,the prefecture or indeed anyone.

No one is going to come knocking at your door asking if you have comprehensive medical assurance or if you have sufficient funds not to be a burden on the state. It is also highly unlikely( but not impossible)  that the tax people will hunt you down especially if you are only renting a house from friends.

Problems will happen if you fall ill. Due to the new rules you are not entitled to join the French health system so if you do not want to fork out money you will need  health insurance.

The French have stipulated that this health insurance must give the same benefits as their own health system.This is perfectly logical ,ie stipulating what health cover is required.Why stipulate a lesser cover?

If you end up in hospital you will need to pay up front and then claim back the money from you assurers, but I doubt if anyone is actually going to ask you for your medical assurance policy.

Individual assurance coys have differing ideas on what is excluded or included, what are preexisting conditions and what level of cover one gets. It is a simple matter, when asking for quotes for insurance, of telling the insurance coy if you have any medical conditions and then they will determine whether you are or are not covered.  

Regarding having sufficient funds, again no one is going to demand proof but on the other hand, do not expect any hand outs from the French state, because you will not get any.

Lastly the 5 year residency rule.

No one ,at the moment, has any experience as to what proof the French will require that one has lived in France legally for 5 years. These rules have only recently been introduced so it is anyones guess just what type of proof will be required.

 

[mr ploppy]

[quote user="5-element"]

[quote user="mr ploppy"]I'm trying to get to grips with the health insurance requirements prior to moving to France.  We'll be inactif, have no income, and no E*** from the UK, so will need comprehensive insurance.

[/quote]

If you are inactif, have no income and no E form from the UK, that would make you  illegal here in France.

What would you be living on? The French authorities would be asking you that question - before you can be a resident, you have to show that you have enough income not to need benefits of any kind....

[/quote]

We have sufficient savings to live in France for some considerable time.  I presume that if we show evidence of that, we'll be OK.  Is that not the case?

[Clair]

Mr Ploppy has previously stated he and his wife are British nationals who have lived in the US for a while.

http://www.completefrance.com/cs/forums/1481118/ShowPost.aspx

[mr ploppy]

I'm glad you're paying attention Clair [:)].

I presume from your response that you believe that having sufficient savings will satisfy the requirement.

[Sunday Driver]

Just to clarify matters, Mr Ploppy is a UK citizen currently living in the US and wishing to come to live in France.

(see http://www.completefrance.com/cs/forums/1/1487229/ShowPost.aspx#1487229)

As per previous discussions on this subject, the healthcare insurance requirements are set down in the regulations, but as it's too early for any of us Brits to have done the five years 'private' and be applying for state cover under couverture maladie universelle, we don't know what sort of checks will be carried out to confirm compliance with the 'five years legal residency' requirement.  Perhaps one of our US members has been through the process and could advise?

Given the governments determination to sustain their policy of social security exclusion, I shouldn't rule out the possibility that cartes de séjour will become a requirement for EU inactives and that obtaining a 'permanent' resident carte will involve more in-depth scrutiny.

Not a great deal of help to Mr Ploppy, but that's really all we can say at the moment....

(Edit:  Went for a pee and four people got in ahead of me....)

 

[Sprogster]

If you have a pre-existing chronic medical condition that an insurer will not cover, the risk that the French authorities might discover this is not ones main concern, but what it would cost you if you required medical treatment in France for a problem connected to the excluded pre-existing medical condition.

If the chronic medical condition is migraine, the cost of one paying for the medication is probably not going to be an issue. However, if like some over fifties one takes medication for high blood pressure and/or cholesterol, which are increasingly being prescribed nowadays as a preventative measure even if you only have a border hypertension, then one has a much greater concern. The reason being that the insurers are likely to exclude any heart or vascular problem that might arise in the future and if heaven forbid one had a heart attack or stroke and were rushed into a French hospital for emergency intensive care treatment, the costs could be ruineous if you are not covered by medical insurance.

In summary, I don't believe the main concern is what the French authorities may or may not think about the level of medical insurance cover you have, but the personal financial risk you run by not having cover for a chronic medical condition, that could result in expensive medical treatment being required.

[Weegie]

[quote user="ErnieY"]

Regarding legality of living in France without comprehensive cover, well you're right to a point, however nobody is going to come knocking on your door demanding to see your policy 

[/quote]

I wouldn't be to sanguine about that.  As a resident in France the OP is obliged to make a Déclaration de Revenus to the Impôts.  This, of course, even though they state they have no income - interest would still have to be declared.

The Impôts do spot checks of files.  These checks include: "le justificatif de votre couverture maladie".  They do these checks in conformity with the provisions of "article L.10 du livre des procedures fiscale, qui permet à l'administration de demander des renseignements sur les éléments déclarés par les contribuables".

So checks are made and to it would not be wise to depend on it being otherwise.

[cooperlola]

Mr P, I have to say that FHI has come to precisely this conclusion.  In theory at least, if you take the new regulations to their logical conclusion, then yes - any early retired non-French European citizen with any kind of pre-existing condition which his or her insurer refuses to cover - could be deemed to be an illegal resident, or at the very least have problems being accepted into the system once their five years are up.  We just have no idea, as Sunday Driver points out, how this will actually work and how much scrutiny any policy you have had, will be subject to.

Other posters are probably correct in that you're unlikely to be thrown out  because your insurers have precluded some conditions from your policy but that is not a certainty and it is not what the law of the land now states.  Not to mention the very valid point which Sprogster makes, above. It's a risk you just need to be aware of - whether you take it is really up to you.

[AnOther]

[quote user="cooperlola"]...any early retired non-French European citizen with any kind of pre-existing condition which his or her insurer refuses to cover - could be deemed to be an illegal resident, or at the very least have problems being accepted into the system once their five years are up... [/quote]Let's hope that you are fit and well and up for another fight then Coops [;-)]

Would not such a stance only apply to inactifs though and not retirees ?

What with finacial meltdown and s**t like this to look forward to I think I'll definitely be working at least until 'er indoors reaches retirement age in about 5 years time if not for the full 8 until I do [:(]

[Owen]

Hello Coops,

The law 2006-911 is quite clear to me. A EU/Swiss national coming to live in France should have sufficient financial resources and not be a burden on the social security including the “assurance maladie”. If you have a private insurance which gives a level of cover and the rest, such as for minor ailments, paid out of your own pocket then by definition you are not a burden on the “assurance maladie”.

The idea also that, even in theory, after 5 years of residence you will be refused into the system because of existing conditions is incredible in my view. After 5 years you will be regarded as a permanent resident (in accordance with CRESEDA) and therefore be able to apply for affilliation under residence criteria (CMU). I simply cannot see at this juncture how the CPAM could or would discriminate against a EU/Swiss national on health grounds.

My sources inform me that 5 years of French tax returns will be the proof required to prove length of residence. This sounds right to me and is in keeping with the much closer liaison there now is between the “Sécu” and the tax authorities.

By the way, even if you are a non-working EU national and are not required to have a “carte de séjour, there is a requirement to register at your Mairie.

Regards

Owen

[email protected]

[Boiling a frog]

The legislation regarding registration is not yet in force so NO NEED TO REGISTER

L'obligation d'enregistrement en mairie des citoyens de l'Union européenne, d'un autre Etat partie à l'accord sur l'Espace économique européen et suisses s'applique aux seules personnes entrées en France après l'entrée en vigueur d'un arrêté qui doit fixer le modèle de l'attestation d'enregistrement délivrée.  Cet arrêté, du ministre de l'immigration, de l'intégration, de l'identité nationale et du développement solidaire, n'a pas encore été publié.  Nos fiches l'intégreront dès sa parution.

[cooperlola]

Hi Owen.  I think that you are probably correct and that this is how it is supposed to work.  However, if you look at what the various regulations state, one is in theory obliged to have insurance which covers everything that the state system does.  After five years of living here in a "legal and stable manner", one has an automatic right, under EU law, to live here and one also gains the same rights as a French citizen in the same position.  So what if not having had the correct cover is deemed to be illegal?  I'm not suggesting that it will be, simply pointing out the possibility.  I don't think we can predict for an absolute certainty how individual authorities will react, that is all.  I only wish I had your confidence.

Ernie, I did say early-retired.

[Owen]

Hello Coops,

An American, for example, must provide proof of health cover to obtain a long term visa before coming to France. This will be in the form of private insurance which will inevitably have exclusions that would be covered by the state system. Your logic suggests that after having been issued with a visa, going through the whole process again to obtain a carte de séjour and in due course completing French tax returns he could still be regarded as an illegal resident. That is pushing credulity too far.

Regards

Owen

[email protected]

[AnOther]

[quote user="cooperlola"]Ernie, I did say early-retired.[/quote]Indeed you did [:D]