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Healthcare situation for elderly new ex-pat?


Boudicca

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We are in the process of researching our return to France. I say return because my husband is French and we lived there for 11 years before coming to the UK.

We will be bringing my mother with us. We already live together and know there will be no issues from that alone. However I do worry about the implications of moving her to France. There are a number of concerns, but here we are on the healthcare thread so let’s go with this one here:

My husband will be in employment (to begin with) and then hopefully we’ll be running our own little business together and paying the relevant cotisations.

My mother is 77 years old and has her UK state pension and an earned pension. What will be her healthcare rights?

She has no major health problems at present - just the odd ache and pain (when she over does it!) but she isn't getting any younger and she's worried about what will happen if her health goes and she needs major or long term treatment.

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I'm not sure if there are any extra benefits for those her age. The standard French social security health cover gives you 70% refunds on the cost of treatment, medicines etc. The usual way to cover the remainder is to take out a 'top-up' insurance. If you have a recognised affectation de longue durée (long term illness -- ALD) then you get 100% cover from the state for costs directly related to it. There is a list of ALDs, including things like cancer and chroic heart conditions. You need your French family doctor (medecin traitant) to fill in an application if this ever becomes an issue.

A UK pensioner gets a form from the UK authorities that gives you the same rights as a French national. This was an E121 but nowadays is an S1 (If I remember rightly).

I expect one of our experts will be along soon with more info.

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When you talk about "top up insurance" I presume that is like the "mutuelle" we had via my husbands employer when we lived in France.

I wonder whether the average French OAP has this or whether they are just content with the 70%? To be honest I'm not sure what she has in the UK - whether she pays prescription charges and the dentist as we do. I’ve a feeling she does because she does have a sort of mini top up insurance where she can claim back a bit of what she pays - dentist, glasses etc...

So it doesn't sound like she'll be any worse off - and I do know the health care and dentists are excellent in France. I was ever so lucky that I needed a root filling whilst on holiday last year. I didn't time it that way on purpose but I had been putting it off in the UK!
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[quote user="Boudicca"]... I do know the health care and dentists are excellent in France. [/quote]

General health care may have a good reputation. but is still far from perfect. I know cases of botched operations, superbug infections in hospitals etc. How long the good reputation can last is a moot point. France, like everywhere else, is hit with demands for cost cutting, and even before the recent financial crisis, overspending on health had created a big problem for the government. So it would not be unreasonable to see France experience the sort of measures that the NHS has been familiar with for some years.

Dental and, in particular, optical treatment is, frankly, not that good overall. Dentists are very much luck of the draw. You obviously got a good one. As with optical care, many things tend to be a bit primitive, or very expensive, and sometimes both. Neither dental or optical fees attract much of a refund from the state system (apart from basic dentistry), or from the average top-ups (or mutuelles as you call them). You really need a top-of-the-range top-up if you expect to get much back for work like crowns or bridges, or if you want refunds for spectacles and lenses.

I'm not saying these are bad points about health in France, but they really need careful research if you are going to be relying on the sécu in the future. As far as I know, most elderly French do have topups if they are not eligible for state-funded mutuelles (and even if they are, they will only get refunds up to the basic tariff, and many dental and optical practitioners charge well above that basic level).

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I know when I left France 13 years ago they had already been saying for many years that the healthcare can’t be sustained at this rate. I think it’s probably going down as is the NHS but I think that France started higher up and will remain higher up than the UK. I read recently, can’t think where to quote, that it had come out top – I think it was of Europe, but not sure.

I’ve always been well served by the NHS. We are lucky to live in a “good” post-code from that point of view. However when I had my root filling in France last summer it was like something state of the art compared to here (just a small village dentist in the Alps). My NHS dentist had to finish it off with a crown here (couldn’t manage to get that done as an emergency) and he marvelled at the work. My mum had the same experience (different dentist) 20 years ago. Not only that but what I paid up front (and partly claimed back) was less than I would have had to pay on the NHS here.

Don’t get me wrong, I’m not saying its perfect – mistakes happen everywhere and we didn’t have a good experience when we had to take our daughter to A&E on a Saturday night in Lille a few years ago. I’m not slating the NHS either but I certainly don’t think we’ll be any worse off. I know my French in-laws always complain about the cost of healthcare but are amazed when we tell them we pay £7.50 (or there abouts) for EACH item on a prescription.

I will look into top ups for her though in particular for dental work which she does require from time to time. Then again her NHS dentist says he can’t do a lot of what she needs and sends her to a private specialist who then charges her £300+ for a “check up” to tell her the work will cost £5,000…

I think it will be swings and roundabouts…

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