New residents - what to do about healthcare

[Rob G]

We're moving to Normandy (76) at the end of this month. I'd be grateful if someone could explain in clear and concise fashion what we need to do about healthcare, on two levels:

1. What do we have to do to get registered in the French system, get social security numbers etc.?
2. What should we do about complementary health insurance? Initially, I will not be working but will be seeking employment in France. Presumably we will need to find a suitable insurer/policy as quickly as possible - does anyone have any recommendations?

Will the fact that I am not working, and therefore not making social security contributions, cause any complications?

For info, there are four of us - myself, my wife and two children aged 8 and 11.

Finally, I've read that the E111 is being replaced by the International Health Card. I assume that, like the E111, this is just for visitors to other coutries and so will not be relevant to us?

Thanks,

Rob

[Bobdude]

Hi Rob,

The first thing to do is to phone the Dept. of Work and Pensions in Newcastle. They will issue you with an E106 (if you have been working and paying stamps in the UK) If you wife has also been paying stamps she will be entitled to her own E106. You will need to give them the exact date you are leaving the UK, and they will send the forms direct to your French address. Once you have them you will need to take them to your nearest CPAM office, along with all your documents such as birth and marriage certificates, proof of address, bank account details and passports. Once you have done this you will be sent your Carte Vitales - these have to be presented at any healthcare establishment or pharmacy. You will get reimbursed by CPAM for about 65% of what you pay, unless you have some long term health problems, which sometimes attract 100% cover. To cover the part not reimbursed by CPAM it is advisable to take out private cover, or join a Mutuelle. I can't recommend any particular one - there are loads to choose from.

Your E106 will cover you for up to 2 years normally. After that you should integrate into the French system, through contributions via your employment for example.

Hope that is reasonably clear. Your E111 from the UK will no longer be valid once your are permanently in France, but you can obtain a French E111 from CPAM.

[Will]

Although I would agree totally with the comments in the reply you have been given above, I should point out that it assumes you are a UK citizen of below state retirement age and not in receipt of invalidity benefits or similar - otherwise different provisions will apply.

Should you become employed before the expiry of your E form then your status wil change, the E forms will no longer apply, and you will automatically fully join the French system. You will probably not notice any real difference, other than the high charges, as your healthcare will then be funded through the French system rather than a reciprocal European arrangment.

As far as the top up insurance is concerned this is another complicated subject. Although there seems to be little difference between providers, there is a vast range of available policies. It's down to you to choose the most appropriate for your needs - the differences are in things like optical and dental cover, or specialist treatment, i.e. things which in practical terms attract only a very small percentage of state funding. Best to talk to a few local agents for the major insurance companies, or a truly independent broker if you can find such a thing.

[Teamedup]

Re top ups, please do not assume that if it says 100% it means that you are covered completely. A half decent policy will cover many things for at least 300% and even then, you may have to fork out towards some of your care.

[Rob G]

Thanks very much for these comments, all of which are useful. A couple more questions:

- What does "300% cover" actually mean? How can anything be covered more than 100%?

- In the UK, dental care, optical care and prescriptions are free for children for as long as they are infull time education. Is there any such provision in France?

Thanks,

Rob

[Will]

300% cover - There is a set scale of fees, which relates to '100% cover'. Taking figures at a guess, rather than using real figures which I don't have to hand, a certain dental job - say a crown or a bridge - has a 'conventioné' rate of 100€. That means that if a dentist actually charges 100€ you will be refunded, assuming a rate of 65% (again I don't have actual rates to hand), e.g. 65€ by the state and your top up insurance, if it pays 100% of dental costs, will refund the other 35€. In practice few dentists will charge 100€for the job, most will charge 300€ - 400€ or more so to get a full refund you will need a topup insurance that pays 300% or 400% or greater.

You may decide that your teeth are perfectly healthy and you are prepared to pay the extra yourself in the unlikely event that work is needed, so will take a 100% policy. On the other hand, you may feel that dental work is likely to be necessary so it's worth paying the extra for a 400% policy. You also need to have some idea of what dentists, opticians and other specialist  in your area actually charge.

It is confusing and complicated, but I hope that goes some way towards explaining things.

I will leave it to those who have children in France to answer your other question but I think the answer is likely to be in the negative - you need to rely on your topup insurance to make up the shortfall for all the family.

[peterw]

I want to employ someone under the cheque de emploi system. They are from the UK but obviously would not have a french social security number. I have been told that i need to quote their French social security number under the Cheque de emploi system. Can anyone advise what how they do this? The complicating factor here is that the person concerned has not been living in the EU for the past 6 years so has no way of getting an E form from the UK.

Any advice would be greatly appreciated

[derf]

Whether they are from the UK or not E forms don't come into it, if they are resident in France then they need to affiliate into the French system and obtain a SS number through CPAM or CMU.

[peterw]

Thanks Les,

What you have advised, means going to register with the French Health system which is just ONE PART of there SS system. I would have thought that this would only cover the Health aspect and not his pension, unemployment, sickness etc etc which is all part of the french social security system. So is it possible that there are other registrations that need to be done as well? Or is it simply a matter of just registering with CPAM/CMU as you say

[Benjamin]

Will the C

I've only just read your second posting on 08/11/05 and am very interested as I am just about to buy top up insurance. I've got several quotes from various providers and no one, including my own bank (CA), have pointed this out to me.

Taking your example of the dental work, presumably CPAM will reimburse 65% (estimated rate) of the total cost but the top up provider will only repay 35% of 100 euros: or am I wrong?

Is the incidence of the rate conventione being less than the actual price charged for treatment in just a few cases/half/or in lots of cases?

If, for instance, I have a planned corrective operation for a hernia am I liable to find that my 100% top up insurance will leave me still paying part of the cost of this operation or is it only for things like dental work that this is liable to happen? Conversely, if I'm rushed into hospital say, for emergency treatment for a heart attack could I still find myself paying for part of the cost of 10 days in intensive care?

 

Benjamin

 

[Benjamin]

Will the C isn't responding. Can anyone else help please?

 

Benjamin

[Teamedup]

What you need to do is balance what you are prepared to pay out each year as opposed to what you get.

I would give them some examples:

 

my surgeon wants 300 euros depassement d'honoraires, how much would you give me back on that.

Would you pay for a private room in hospital.

How much forfait journalier would you give me, hospitals make a charge to the individual for they stay, I imagine it is to cover meals etc.

 

I need glasses exactly how much will you give me towards frames.

Exactly how much would you give me towards lenses.

 

My GP charges over and above the SS limit, would you reimburse me any of this extra charge.

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Percentages per se mean little. We now get about 300% for our specs, where as we used to get something like and I haven't got in front of me so it likely won't be exact 20% of the PMSS.  We now get a lot less than we used to. Quite a few of our things are reimbursed at 300% and yet if our GP asks for more than the 20 euros, we only get a reimbursement up to the 19 euros everyone gets back these days.

 

It is complicated. At least one can normally change a policy quite quickly. However, shop carefully, changing a company may be far different and often companies don't give cover for the first three months anyway.

 

 

[Benjamin]

Thanks for your guidance Teamedup.

As you say, it sure is a minefield.

 

Benjamin