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Re: Latest Health care Entitlement discussion


makfai
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[quote user="londoneye"]

Makfai I have forwarded email to you.

I had anyway, upon receipt, requested clarification of the above section (as per my underlining).   No response received yet.

It is always better however to have more than one person asking, so lets see if we receive any clarification and if it says the same thing.

[/quote]

 

Thanks.  I wonder if anyone could do the same with the French Health ministry?

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[quote user="Will"][quote user="JJ"]

So is it a fact that the French Health Ministry are taliking to the British Embassy, but not their own Dept CPAM

[/quote]

Just to set the record straight, there is, strictly speaking, no such single department as CPAM. It is a string of regional organisations, basically one for each département (that's dépt in the geographical sense, not the governmental). All CPAMs are affiliated to CNAM (caisse nationale d'assurance maladie). There are also an even greater number of other caisses, some of which are insurance companies, who provide a similar service to the CPAMs but for the self-employed, for example, and these are gathering under the umbrella of the RSI.

The help line which did not appear to know the answer is run by just one of the CPAMs, the CPAM de la Manche, in St-Lô, 50.

So perhaps we can begin to see why the chain of communication is so tortuous and ineffective.

[/quote]

To add to Will's very important point, whilst the French Health Ministry may have given an indication to the British Embassy that the changes are not intended to deprive exisiting UK affilliates of their healthcare rights, they are unlikely to be in a position to issue instructions to the various organisms until such time that they have formalised a policy to handle the situation.  Such a process would not normally be concluded overnight, so we'll just have to wait.

 

 

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[quote user="Sunday Driver"]

 Such a process would not normally be concluded overnight, so we'll just have to wait.

[/quote]

SD, while I understand where you are coming from on this one, and please forgive what some may see as naivety, but one would have thought that the policy implications would have been dealt with prior to the decree being published unless that decree contained a date well in the future for it to 'become active'.  As there is no such future 'implementation' date it appears that it is in already so I don't think it is unreasonable to expect the French Health Ministry to be able to explain this law's rules of application.

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Will,

The English language helpline for CPAM was given to me by the  British Embassy, so, I assumed it was a national helpline, that is why I got so steamed up.

If that number is a CPAM in Manche, well I was unaware of that.

 

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I quite agree Makfai. The French ministry ought to be in a position to give an answer if they are asked a specific question. But it seems that not even they know how France should best regard what is, after all, a European ruling on residency qualifications. Our point was that once a decision has been made then it will, due to the very nature of the system, take some time for the full implications to filter down to the level of helpdesk offficials in individual CPAMs.

JJ, my understanding is that the helpline began in one departement, but was sufficiently successful that it extended its coverage to English speakers in all of France, and, naturally enough, is publicised and encouraged by the British Embassy. It is under the CPAM banner, but is still part of just one CPAM so its authority on a national level is unclear.

 

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Makfai

It's not really a case of inability to explain the rules of application.  They follow from the published law which is quite clear.

The issue is the government's current position in having to backpedal by introducing this exemption from the published law - they might well have to issue a further decree to cover this. This is what will be taking the time, politically as well as practically...

 

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[quote user="Puzzled"]

 

SD

Is the published law you mention the old (1971 I think) European legislation about all non active people having to provide their own health cover ?

If so, they haven't been following this for years , since they abolished the Carte de Sejour and its requirements and decided that the CMU was the way to go.

Now the French government have suddenly decided that they want to opt back in and  follow the old published law. [8-)] If they want to cherry pick what bits of EU legislation they want to follow and when, no wonder the whole thing is a mess.

[/quote]

I think you will find that the Carte de Sejour has not been abolished for some EU members. In November 2003 the CDS was no longer required for those people who were from countries in the EU on or prior to that date. The actual date was, I think as I can't quite remember, something like the 28th November because the following day other countries joined the EU mainly from the eastern block. People from those countries still required a CDS to be a French resident as do people from outside the EU.

As to France 'cherry picking' what parts of EU legislative they want to accept, well I think you will find they are past masters at it.

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[quote user="Sunday Driver"]

Makfai

It's not really a case of inability to explain the rules of application.  They follow from the published law which is quite clear.

The issue is the government's current position in having to backpedal by introducing this exemption from the published law - they might well have to issue a further decree to cover this. This is what will be taking the time, politically as well as practically...

[/quote]

Sorry SD but don't completely agree. They don't 'follow from the law' they usually come with it as part of the explanation as to how the law is to be 'interpreted'.  Maybe this time not enough thought has gone into the pre-publication interpretation.

However, don't want to take up your and other people's time on the reasons why we have heard nothing from the French as we are all after the same thing -  to get the answer.

Have just been speaking to the Tax Attaché at the French Embassy in London about unrelated matters and now need to speak to her colleague the 'Social' Attache...I don't think they mean the bloke who arranges the 'socials' - he is supposed to be the one who deal with Health/Social matters etc.  Although I am not talking about this particular issue, I may just try to slip this into the conversation!

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Puzzzled

It appears that there was a change in the code de sejour (article L121-1) in 2006 which introduced the 'self sufficiency' requirement, but for those of us who don't read the Journal Officiel with our morning breakfast, it would apprear that none of us picked it up.  Neither did the caisses, by the look of things.

It's only when the March 2007 decree was issued amending some further points about the scope of private insurances that the caisses appear to have reacted and the September renewals have provided a timely point for them to start refusing ongoing cover.  As mentioned previously, the regional nature of the CPAM network has not helped, resulting in the variance in these decisions.

I suspect it's the failure of the caisses to properly implement the regulations that's put the government in this position where it's having to formulate some kind of public statement.....[;-)]

 

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Hi, re: obligation to affiliate to French Social Security.

 I have been thinking about this one and have gone back to look at the wording used and have found this:


MM. Xavier Bertrand, ministre de la Santé et des Solidarités et Philippe Bas, ministre délégué aux Personnes handicapées
et à la Famille viennent de réaffirmer, le 24 janvier 2007, l'obligation d'affiliation à la Sécurité sociale pour toutes les personnes
qui travaillent et résident en France. Ils tiennent à démentir une nouvelle fois les allégations sans fondement selon lesquelles
des directives européennes auraient mis fin "au monopole de la Sécurité sociale".

Basically it says that on 24 January 2007, the minister for Health confirmed again that all persons working and residing in
France have an obligation to affiliate to French Social Security.

It seems to me that the key words are "personnes qui travaillent et résident en France".  It does not say, work or reside in France",
it specifically says "work and reside in France".

Remember that Mr Bertrand's statement was on foot of a small campaign by French workers to use EC legislation to argue that
they did not have to pay contributions to French healthcare, which some find too expensive and bad value for money.



The 2004 EC directives says that non-working EC nationals must have sufficient resources to support themselves and
not be a burden on the country's healthcare; hence, they are not entitled to French SS (unless they have some E form that
covers them from their country of origin)

Hence they cannot be obliged to affiliate to a system, to which they have no entitlement in the first place ?

Does this make any sense to anybody else ? it does look as if comments along the line that non-active EC nationals
 moving to France should never have been allowed to join the CMU in the first place, make sense in view of the 2004 EC directive.

To add to the confusion, a lady has posted to the Expatica.com forum, stating that she had been asked to return her Carte Vitale,
and has since received another letter from CPAM, asking for proof of residence.

I reproduce her post below (hope it's OK?)


We've read loads of posts on all the other expat and french info sites and, very gradually, it seems to be becoming clearer.
It looks as though we should be allowed to continue with CMU but it remains to be seen if we can get our local office to accept
that that is the case!

You asked me for the exact wording of the letter we got - it's as follows...

---------------------------------------------- -----------------------------------------------------------

Pour me permettre de donner suite a votre dossier, je vous remercie de bien vouloir me retourner la presente lettre, apres avoir fournis les
pieces ou renseignements ci-dessous:

- Conformement au nouveau decret du 21/03/2007 tout resident communautaire non actif se trouvant sur notre territoire et ne pouvant
beneficier ou continuer de beneficier des droits europeens sur presentation de formulaire tels que:
E106 ou E121 ne peut beneficier de la Securite Social mais doit contacter ane Assurance Privee. En consequence vous voudrez bien
nous retourner vos CARTES VITALES

------------------------------------------------- -------------------------------------------------------
A couple or days after this we received the normal letter with forms to renew our CMU but saying they needed further proof of permanent
residence such as regular gas or electric bills. We have now completed and handed in these forms....we await the next developments.....

Sadly, it does seem from what I've read that new arrivals in France may have to pay for private cover although I'm not sure how that equates
with the fact that it's supposedly illegal!

I can't get over the fact that an important change like this is still undefined when it comes into effect (I think) at the end of this month!!

=================================================================================================

I hope it's OK to quote the post and that I am not adding to the general confusion. I have asked the lady who posted the above,
to also post on those forums which are actively discussing this issue, as I think it could be of interest to other people.
Unfortunately, I don't know where she lives and from what I have read, it could make a difference ?

Dominique

(post edit by a mod to make it a little less wide)

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[quote user="makfai"]

Have just been speaking to the Tax Attaché at the French Embassy in London about unrelated matters and now need to speak to her colleague the 'Social' Attache...I don't think they mean the bloke who arranges the 'socials' - he is supposed to be the one who deal with Health/Social matters etc.  Although I am not talking about this particular issue, I may just try to slip this into the conversation!

[/quote]

NO NEWS IS........................NO NEWS!

M. Chevrier, the attaché, being out I did speak yesterday to the Assistant 'Social' attaché (Alexia) at the French Embassy about various matters unrelated to this issue and slipped in 'The E106 Question'.  She said they had still not received notification of policy in regard to what happens to existing E106 holders now resident France once their E106 expires but they had received a lot of queries about this and the changes in general .

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No-one seems to have pointed out that the right to join the French healthcare system and not to subscribe to private healthcare was introduced by a Socialist government. The present changes are  being made by 'the others' plus the fact that many more Europeans are in the E.U and therefore the burden is greater.
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I would hate to muddy the waters but I have just been reading on Total France forum there is now a definitive statement from the French Govt on http://www.securite-sociale.fr  This seeems to fly in the face of the Connextion release concerning a meeting on 12 September with French authorities. Apparantly the French governement are expecting a legal challenge, particularly as this would make us Brits as EU citizens worst off than  the Americans.
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Having read this link this is what understand it to say:

Those who are 'inactive' and are at present affiliated to the CMU will have six months 'grace' to find alternative healthcare provision.

I assume this means six months from 30th september 2007 but it does not actually state this.

Holders of e106/121 will have thier cover withdrawn immediately upon the expiry of the said 'e' form. I dont know where this leaves people whose 'e' forms run out this coming january.

Does anyone concur with my interpretation?

cheminot
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[quote user="cheminot"]Having read this link this is what understand it to say: Those who are 'inactive' and are at present affiliated to the CMU will have six months 'grace' to find alternative healthcare provision. I assume this means six months from 30th september 2007 but it does not actually state this. Holders of e106/121 will have thier cover withdrawn immediately upon the expiry of the said 'e' form. I dont know where this leaves people whose 'e' forms run out this coming january. Does anyone concur with my interpretation? cheminot[/quote]

Please have a look at the discussion at http://www.completefrance.com/cs/forums/5/1019339/ShowPost.aspx#1019339.  The email I have received from the French Embassy seems to be out of step!

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