Health care for US citizens spending a year in France

[Abra]

Forgive me if this has all been asked and answered elsewhere, but I've scoured the past year's posts without much success, as much of the information assumes citizenship in an EU country.

My husband and I are about to leave the US for a year in Uzès.  We won't be working, except for writing, and will bring US income with us.  We're going to use the 90 day visa option, as we'll be traveling to other EU countries frequently and they've made it a huge hassle to get a long stay visa from within the US.  We have US health insurance that will cover accidents and urgent care in France.  My husband will be going to Institute Gustave Roussy for participation in a cancer research study once a month.

Are we eligible to sign up for CPAM after the first 90 day period?   Is there supplemental insurance that a cancer patient would be eligible to buy?

All help and advice will be much appreciated!

[Anton Redman]

I suggest you have a look at

http://www.americansintoulouse.com/

I have 'put up and shut up' for medical care in France and found it much better value than the UK. Broadly we paid about Euros 26 for an unrushed visit to the doctor. The last time I translated for Isabel during a visit the very nice lady doctor insisted on checking my blood pressure so we had out monies worth from the visit. I think eligability for CPAM is governed by reciprocal agreement with the country where you are permenantly recident. Chronic Illness like cancer means you are exempt form the medical charges BUT you have to have paid Tax/ NIC/Community Charges to be in the system

 

[Sunday Driver]

If you have lived in France in a stable manner for more than three months, then you are entitled to apply for couverture maladie universelle (CMU) which is the basic French state health insurance.  As a non-EU citizen, you won't be able to take advantage of reciprocal arrangements for exemption from costs, so you will have to make contributions (think of them as being like insurance premiums).  These are based on 8% of your worldwide taxable income after allowances. 

You will be entitled to the same level of reimbursement of healthcare costs as any other French resident, one of which is the 100% allowance for approved long term illnesses such as cancer.  Your doctor will need to submit a formal application for this exemption and it is subject to approval by the medical commission of your CPAM.  For non-100% treatment, you will need to purchase a top-up insurance to cover the shortfall.

 

 

[Gardian]

Abra ..................

No advice on the health care bit - SD et al are much better qualified to advise.

However, welcome to the area. Believe me, it'll be better come Autumn when all the tourists (we were thus once!) have gone home.  Oct - April is the best time, in what is a lovely town out of season.

Also, pls tell your other half not to wear one of those daft hats that so many N Americans tend to sport  - it's good for the local economy, but bad for the bar prices!

Bon courage. 

[samdebretagne]

[quote user="Abra"]

We're going to use the 90 day visa option, as we'll be traveling to other EU countries frequently and they've made it a huge hassle to get a long stay visa from within the US.[/quote]

I just wanted to let you know that the laws regarding entry into France have changed - you are no longer allowed to stay here for three months, leave for a day or two, and then come back for another three months.  The new rule is that you can stay for three months, but then you must leave for three months before being allowed to re-enter the country, meaning that you are only allowed to be in France for six months total out of the year.  This rule was obviously made to stop allowing people to use the loop hole you mentioned above, and not go through the process of getting a visa.  That said, it is probably not very well-enforced.

[Abra]

Wow, Sam, do you have a reference for that?  This is the first time I've heard that, and I'd thought I'd made a thorough study of the options.

SD, thanks for that concise advise.  Do you know whether the supplemental insurance requires a physical exam?  Or would a guy with cancer be eligible?

[Sunday Driver]

No physicals required.  You'd probably even get a discount for having cancer as it's 100% covered by the state so there's no cost to the top-up insurer.

You can find all the details on the French Health Insurance [url=http://www.ameli.fr]website[/url].

 

[Owen]

Hello Abra,

Without a long term visa you are not going to be considered a permanent resident of France and therefore unlikely to be accepted for affiliation under CMU legislation.

Regards

Owen

[email protected]

[samdebretagne]

[quote user="Abra"]

Wow, Sam, do you have a reference for that?  This is the first time I've heard that, and I'd thought I'd made a thorough study of the options.[/quote]

I don't actually, but a friend of mine tried to get a long-stay visa just to be able to live and write here, and she was refused, and the Consulate in NYC told her to not even think about doing that because the laws had changed.  And I kind of agree with it - I mean, it's not really fair that the rest of us had to go through all the work to get visas and be here legally, but that there are so many Americans out there who are just ignoring the rules and taking the easy way out (no offense - this is a general statement, not targeted at you!).   I just think it's funny that immigration is such a hot topic in the US, but that once abroad, Americans have no trouble breaking the immigration laws of another country.

And I agree with Owen - the majority of the forum members come from the UK, so they often forget about things like needing a carte de séjour or a visa.  So while they may be considered residents after three months, it's not quite the same for non-EU citizens, who need to provide proof that they are here legally.

[Sunday Driver]

The previous information presupposes that the original poster will be legally resident here with the appropriate visa/permits.  If he is not, then clearly it won't apply.  Details of the required documentary proof for non-EU citizens is set out in the link provided.

 

[samdebretagne]

[quote user="Sunday Driver"]Details of the required documentary proof for non-EU citizens is set out in the link provided.

 

[/quote]

Can you post the exact link then, I've just spent 10 minutes going through the site and haven't found anything pertaining to foreigners living in France but not working. 

And as a side note, I've had three different carte vitales now, and each time, the CPAM has required proof of my carte de séjour before they would send it out to me, which is why I find it hard to believe they could get health insurance without having to show they were here legally.  I've also known Americans here on short-term contracts who were sent letters saying that their sécu coverage was up because their carte de séjour had expired, which is another reason that led me to believe that getting health care was linked to having a valid titre de séjour.

[Sunday Driver]

It's [url=http://www.ameli.fr/assures/droits-et-demarches/par-situation-personnelle/vous-avez-des-difficultes-financieres/c.m.u.-de-base-une-assurance-maladie-pour-tous/les-conditions-pour-en-beneficier-aff_deux-sevres.php]HERE[/url] under the section entitled  "Les conditions pour en bénéficier".

To be able to live in France, you must first be legally entitled to do so, by whatever regulation applicable to your personal situation.  If you are then legally resident, then you may apply for any French benefits that are available to you.

 

[samdebretagne]

Thanks for the link - the problem was that I was looking for regular sécu coverage, and not the CMU de base.  I also thought that you were disagreeing with me and saying that one didn't need to be in France legally to benefit from coverage, but I now see that is not the case.

[Sunday Driver]

CMU de base is the regular secu coverage.  If you are of modest means, then you can be exempt from paying contributions, otherwise you have to pay according to your income levels

 

 

[Sprogster]

Abra, non EU citizens can only legally spend a maximum of six months in any one year in France and indeed the EU, unless they obtain some form of long term visa. The French immigration authorities are increasingly able to monitor this, as they are now electronically scanning and logging vistor passports on arrival at their major airports .

As you are no doubt aware post 9/11, US immigration controls have tightened to the point of putting off tourists, as all  US visitors including EU citizens are now subject to finger printing on arrival and any over stay even if by an untinentional couple of days leads to an automatic ten year ban from the USA! (From this October full sets of prints of both hands will be taken).

Partly as a result, the French immigration authorities have become far less flexible in the application of their immigration controls on US citizens.

[Abra]

Thanks for all for the information, and to Sprogster for the analysis.  I've been to France several times without all this foo, but indeed that was pre-9/11.  I think I now know how to proceed, and I really appreciate all of your help and advice.

Let me just say that the requirement that I travel almost 1000 miles to the nearest Embassy to submit a visa application in person on the Monday and Wednesday afternoons on which they accept such applications but unfortunately have no appointments available before the end of August is onerous.

[samdebretagne]

[quote user="Abra"]

Let me just say that the requirement that I travel almost 1000 miles to the nearest Embassy to submit a visa application in person on the Monday and Wednesday afternoons on which they accept such applications but unfortunately have no appointments available before the end of August is onerous.

[/quote]

You better get used to it, it's only going to get worse once you're in France, LOL!!