Desperate for help on medication in France!

[Composure]

Hi all, new to this forum so be gentle!

We are looking to move to France later this year but we have one issue which needs resolving and I am having difficulty finding the answers:

My 12 year old son has recently started growth hormone treatment here in the UK on the NHS. This is an expensive treatment for his stature and could last for a number of years (it is in the form of daily injections)

What I need to find out is if he can continue to get this treatment funded if we move to France. When we do, we will also retain a property in the UK.

Any help would be VERY appreciated!

[cooperlola]

Much depends on your status, as far as I know.  Are you working?  On E106s? Your family will benefit from the state system, so long as you belong to it, but which part of the system does depend upon what you're going to be doing over here.

Also, the treatments may be different, doctors will want to make their own judgements here and may not necessarily do things in the same way as your UK doctor would. I am not saying that they won't continue the same treatment - just something to be aware of.

Retaining a UK address is bogus, if you live here, you will have to join the state system here and so will your family, if your main residence is here - although you may "get away with" nipping back to get drugs and treatment you need - some do it.  But if the NHS ever figures that you are no longer resident in the UK, they will charge you for treatment - make no mistake.

[Composure]

Thanks for your reply, as far as status is concerned, I will retain my businesses in the UK and draw a wage from them in France but I may decide to have business interests in France too at some point. I guess my status is pretty flexible and can be 'tweeked' to however it needs to be!

[cooperlola]

From many points of view then setting up your business here - apart from, I believe being the legal way, but this is way beyond my expertise - would be the best way for your family.  Although they are very high, paying cotisations in France for your business, would give you the cover under the French state system (regime generale) which it sounds as though you would need for your son.  Then you'd need top-up insurance for the family to cover the difference between what the state pays, and what you get back from the state.  The cost of these is relatively reasonable, particularly if you're young!

I would seriously think about consulting a professional FRENCH accountant to get you the best deal in terms of costs, and to explain the business rules here.  There are a number of English speaking ones around, but I would avoid an English based accountant as there is a history (from things I read here) of people having been given poor advice, who subsequently find themselves falling foul of the laws here.

[Tony F Dordogne]

Composure, if you are resident in France, you will need to register here for taxation purposes, even though you will retain your business in the UK as it would come under world-wide income - and be assured, the French authorities do speak to each other about immigrants/ex-pats.  If you live in France, after a very short period of months, you have to comply with the French rules absolutely so you may not have too much room to manouvre.

My advice would be speak to the CPAM English helpline (often posted on here and you can search for it) to see what they would advise and pick where you want to live very carefully because you may have to travel many hundreds of kilometers to see your specialist.

[Will]

Although there is a lot that is good about the French health service, there are a couple of things you should know.

The less usual conditions and/or treatments, and something like growth hormone would probably be considered as such, depends on finding a practitioner with an understanding of the condition, or a willingness to learn about it, and then a primary medical insurer willing to fund the treatment. France doesn't have a national health service in the same way as Britain, it is funded through regional CPAMs (caisses primaires d'assurance maladies) for salaried or non-working people, and numerous other caisses affiliated to RSI (régime social des indépendents). Which of the latter you belong to depends on the nature of your business - this is an important consideration if you intend to run a business in France. So almost before you decide to register a business you need to find out which, if any, of the caisses you will have the option of joining may be willing to fund such treatment. And if you work in France for a UK business you must register either a subsidiary business or register as self-employed, as Tony says. If you have a registered business or are self-employed, paying the right cotisations, you should be able to get cover, as Cooperlola says. You certainly would if it had been diagnosed in France or was a long-standing problem, but because you say the treatment has only started recently, it just might be looked upon as 'health tourism' for want of a better term. The alternative is to retain your business and travel to UK to do any work. Then you can continue to pay NI contributions and get an E form to cover family (as long as your wife does not work and is a dependent) in France. But you would need to check with DWP in Newcastle that your son's treatment will continue to be funded through the NHS; as he will be non-resident that might be refused.

So there is still something akin to a post code lottery, though it is less obvious than in the NHS.

The CPAM help line is (from outside France) +33 8 20 90 42 12. But as a business you would come outside CPAM's scope, so they may or may not be able to give you a definitive answer.

Bear in mind too that unless your doctor and insurer agree that the condition can be regarded as an ALD (affliction long durée) which can be funded 100% (which given the nature of the condition may be difficult) then the French system will only fund up to 65% of medication, you will have to either pay the extra yourself or take out a top-up insurance.

Finally, remember that the French sécu is under a similar funding crisis to the NHS, despite the fact they do a good job of hiding this at the point of delivery. So expect cuts, rather than continuing to prescribe almost regardless of cost, in the near future.

Sorry this has turned out to be longer than intended, and if it looks a little bleak. I think I have got it right; it is pretty complicated so if I have overlooked or misunderstood anything I am sure somebody else can put you right.

 

 

[Composure]

Firstly, a big thank you for the replies to my post, they are extremely informative and very well received.....

My wife and I have made a few phone calls and it does seem like this could be a big stumbling block to us moving to France. Speaking to the Department of Health in the UK today, they informed us that once we leave the UK as a resident, the ability to claim on the NHS ceases regardless if we retain a business in the UK and continue to pay UK taxes. We also spoke to a lawyer who said the best course of action is to speak to a practioneer in France and to see if we could get funding (probably part) for the treatment but from everything I have read, this seems a slim possibility but one worth pursuing. We will also look at funding the treatment ourselves and will enquire with the specialist next week if we can do this through him privately.

[cooperlola]

At least you know what you might be letting yourself and your family in for.  Good luck, whatever happens, and whatever you decide.[:)]