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E121 & Retired


runningdog
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Hi All

I appreciate that those on the E106 and inactive and those on an E121 and disability benefit are the ones with the real problems but I am suffering from extended confusion syndrome after all the conflicting views on offer however I do realise that no one has an absolute answer on these questions at this moment.

My own position is that I have been past retirement age for 6 years with NI contributions for 49 years in the UK.  My wife is only 50 this year and dependent upon me.  Our income is in the region of €1,350 per month, if that is relevant, and so am reluctant to take out top up insurance unless absolutely necessary. I have recently received my Carte Vitale but my wife has not received hers as yet.  I am told that EEC Directives state that both I and my spouse have 100% health cover because of me being retired and with full UK NI contributions and yet the authorities seem not to agree.  It is agreed that as I have had heart problems that I am covered 100% in that sphere.

Can someone please guide me to a web site where I may glean some accurate information regarding what I can rightfully expect.  In fact any advice would be welcomed.

David - Vendee

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What you have is the same as a French person has ie in general terms 70% of your costs refunded.In order to receive a full refund you require a top up assurance.It is your choice as to whether you wish to take the risk that you will never have a serious medical condition which will result in you paying the additional 30% .

Some conditions are refunded at 100% but I personally would not take the risk

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[quote user="runningdog"]

I am told that EEC Directives state that both I and my spouse have 100% health cover because of me being retired and with full UK NI contributions and yet the authorities seem not to agree.  It is agreed that as I have had heart problems that I am covered 100% in that sphere.

[/quote]

David ..........

To try to unravel this.  Firstly, you presumably have an E121 and (as SW17 has asked) your wife is presumably named as a beneficiaire?

Your heart problems may well entitle you (and you only) to 100% health cover for medication and treatment related to that condition and that condition only. If you already have a form called a Protocole d'Examen Speciale, produced by your French GP and approved by the Securite Sociale, then that will specify your ALD (loads of stuff searchable on here re that subject) and it will be reflected on your Carte Vitale and SS record.  If you haven't got that signoff, then you'd better get talking to your GP pdq - it'll take a couple of months to process.

Being fully retired and with full UK NI contributions does not entitle you, nor your wife to 100% health cover, except as above.

As to top-up insurance, any other condition that you may have or may suffer from in the future, will only attract up to 70% reimbursement of drug costs and fees and you may well feel that you should  take out such insurance (however financially painful).  Anything from a broken limb to something infinitely more serious could be very expensive.

I've generalised, but the above is broadly accurate.  Others may well fine-tune the comments.

  

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Many thanks to you all.  You have clarified several points including my needing a 'protocol'  from the doctor to claim my 100% and the expats web site.  It's a real bonus to know that I shall not pay any tax here in France and that would probably pay the cost of top up insurance if I decide to take any out.

I have a problem with insurance - psychologically that is - in that insurance companies are there to make money out of people and, to accomplish this, they play upon the fears and insecurities of their clientele.  We have been quoted at €150 per month which I feel is excessive considering that in the four months we have been here we have spent less that €150 including the initial blood tests for both of us, an eye test for my wife and the odd prescription drugs an, we have recieved the bulk of it returned to our bank.  In 72 years I have never had a broken bone or serious illness in my life apart from my heart which has 100% cover.  My wife is similarly healthy except for thyroid problems for which the prescription charges are €1.40 per month.  The jury is still out on this one because €150 per month buys a lot of healthcare which in all probability we shall not need.

Many thanks - David

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I think Tony has a point.  A friend of mine was taken ill over here a year ago whilst on holiday.  She spend 10 days in hospital. Although covered by an EHIC the difference between what the state paid and the hospital's actual cost was quite different from what one would have expected, as they often charge rather more than what the state agrees.  She had to pay 2500 € just for the balance as she had no travel insurance!  There was no surgery involved here, just tests and monitoring. Beware, if you decide to go down this route and keep a big sinking fund, just in case you get caught out.
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I always think that you pay for insurance not because you want to make a claim but because you want to sleep easy at night.

I agree with Tony on this one; I had an emergency and spent 10 days in Nantes hospital some years ago. Boy was I glad I had insurance.

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I think perhaps you should shop around regarding a top up but unless you really believe that both you and your wife are just going to die in your sleep I think you are taking a very big risk. For example one of you may become ill with something ongoing but after several years pass away, perhaps leaving the other in dire financial straits.......

Sorry to paint such a gloomy picture but I suspect in the future that rules about accessing the NHS are going to tighten up, it wouldn't pay to count on being able to return to the UK and access NHS health care straight away.

Think long and hard about this......

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David,

I have lived in France for some years and we have top up insurance.

I am 58 and like you I have never been ill, nor been in hospital..........until that is, I 'tombeed en panne' last year with an hernia  [:(]

Surgery cost about 7000 Euros;  consultations cost 50E a go as well.  That was for a small procedure and 3 nights. Think of the cost of something serious.

Total cost to me without Top Up:  approx 2200 Euros

Cost to me with top up :  12 Euros for the tv in my room.  [:)]

You might take the risk, but the fact is you actually cannot afford to cover the risk yourself.

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Hello David,

Some of my clients have decided not to take out any top up insurance and in all probability they have made the correct decision or at least a more informed decision than most. Most French people would be horrified to hear that you had no top up but there again they are a nation of hypochondriacs.

The point about peace of mind is a good one. Particularly in the case of hospitalisation. It is impossible to forecast what you may have to pay yourself. Almost everyone one has to pay the "hotel" charges and you will always have to pay for a private room. But over and above these certain charges it is impossible to forecast what extra you would have to pay. And what of when you come out of hospital? Convalescence/rehabilitation establishments are only covered 80% by the "Sécu". Say you need physiotherapy and or nursing at home which is only covered 60%. It mounts up. Taking out a policy covering simply hospitalisation and out-patient treatment relating to a hospital stay may be reasonably affordable and give peace of mind.

I am not an insurance broker. But you do need to shop around. For a start in your circumstances some insurers will base the premium on the age of the younger partner. Also you could be quoted very different premiums from 2 insurers offering more or less equal cover. This is because providers use different criteria in assessing premiums; for example where you live.

Regards

Owen

[email protected]

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We have a top up; paid pro rata [:D]something like 1500 euros a year last year.  Didn't know about health care in France, didn't know nothing so chose a company with an English speaking helpline.

This year, premium down to 850 euros for the same cover, with a French company.

Our aim is to keep paying the premiums and hope we NEVER have to claim off it.  That would be great; peace of mind and NO illness.

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David ..........

Presumably you've got the message?  It's loud & clear.

Sure, it's hard coming to terms with paying an Insurance Company for what you've been accustomed to getting free in the UK, but that's the way it works here.  There are offsets, as have been explained.

Shop around, make your choice and just do it: but don't take too long about it, or ............

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Hi Guardian & All

Many thanks for advice and, yes, I got the message loud and clear.  This is not just about money.  It is about faith, not in religion or anything like that, but in myself and the way I think.  The only time that I patronised the NHS was over me heart problem, I don't do doctors.

I am basically against insurance other than for legal reasons.  As far as I am concerned insurance is about 'in case' something happens which in all probability won't.  If you're a worrier get it, I'm not!  As for being on a low income I don't think that I am.  I have ample money for what I want out of life and I am infinitely better off than the vast majority of the world's population.  To me money is not a problem but that is not to say that I give it away without good reason.  That does not mean that I am a miser, I enjoy 'goodies', a nice home and techno gadgets etc and would prefer to spend disposable assets on these than insuring against, what I consider, a minor possibility.

Believe me, the one thing that I can claim is peace of mind and I sleep very well at night.   However the jury is still out and I do take your advice to heart.- - - - - David

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[quote user="runningdog"]

Hi Guardian & All

Many thanks for advice and, yes, I got the message loud and clear.  This is not just about money.  It is about faith, not in religion or anything like that, but in myself and the way I think.  The only time that I patronised the NHS was over me heart problem, I don't do doctors. I[/quote]

Fair enough - nor do I, but you never know what is going to happen; which is why my OH and I have hospitalisation cover. At a cost of just over 19€ each a month it is fine for a hospital stay and also analyses and technical stuff such as x-rays and blood-tests which are always demanded when you develop a medical problem - as my OH has just gone and done - out of the blue.

Sue

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Perhaps having mainly good health so far is somehow blinding the Op to some of the potential pitfalls of not having insurance ?

How does your wife feel about it running dog ?

My husband didn't plan on breaking his ankle, but he did, it took a second and a difference in level of an inch, I actually tripped over in my kitchen and broke my shoulder, I wasn't planning on that either.....stuff happens.....

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Gemonimo - Yes, I do have house insurance but simply because the notaire t5old me that it was a legal obligation in France.

Russethouse - My wife is undecided but leans towards having health top-up insurance.  Earlier you said, 'Only 4 months' and that is true but my decision will not be based upon the 4 months in France but my record of 71 years in the UK and my need [or lack of it] for health care there.

Incidentally we have just been talking to a friend here in France who came here five years ago with her builder husband to renovate a traditional house.  During the first week here he fell off a ladder and cracked his head causing a blood clot.  He lived for 4 1/2 years here in France with no top up insurance and never had to pay anything.  Everything that is life threatening and long term is 100% free.  It appears that a lot depends upon the medecin.

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 Everything that is life threatening and long term is 100% free.  It appears that a lot depends upon the medecin.

If this is the case I wonder why the couple (Ken & Dorothy, I think their names were) were so worried that Kens cancer treatment could have been jeapordised when their E106's ran out in January ? I'm not saying you are wrong but I think you may be wise to check this out with Coops or FHI.

It also raises a more political/moral issue, you have the opportunity of insurance and you don't take it, but later become ill with a life threatening illness, someone is going to have to pick up the tab - isn't this just the sort of thing that annoys those people who wish there were not so many retired Brits in France? Sorry if that sounds harsh.

Why not shop around a bit more and then make a decision?

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