French Healthcare - The Cost Of Care

Many of you will remember the feature in the UK press and the follow-up on BBC television about expats in Spain after the expiry of their form E106. It raised many questions and our lines were jammed with calls asking if it could happen in France. It appears that the Spanish situation may now be repeated in France.

To describe the event in Spain for those who are not in the picture, it had to do with the E106. This European Union ‘E’ form is issued to people who have worked and paid national insurance contributions for the two years before leaving the UK. It provides health cover in their new member state for themselves and their families for up to two years.

In Spain, when the E106 expired, these people had no alternative other than private insurance, which was not a realistic solution for many who were already ill with cancer, insulin dependant diabetes, a heart condition or the like, as treatment would be excluded.
In France there was an alternative called CMU. This was a way of bridging the gap between the expiry of the E106, for instance, and qualification for the E121. CMU (couverture maladie universelle – Law 99-641) is a means of paying a subscription for joining the French national health service and was available to all residents of France.

Now CMU will only be available to French nationals or residents who have worked in France and paid social security contributions. Those arriving in France from other EU member states are being refused state medical cover. There is evidence that cover is being withdrawn from those who already have it – they are being required to return their carte vitale. Holders of the E106 or E109 are not affected until the forms expire, nor are holders of the E121 while their entitlement is valid.

If you are already affiliated under the provisions of CMU you should wait until you receive a notice of cancellation. If you receive such a notice, you need medical insurance at once, to protect yourself against accidents and emergencies.

This event is not confined to France only as many member states do not have an alterative such as CMU. The legal background for those who are interested is below:

Court decision
On 23 March 2006 there was a judgement (affaire C-408/3) by the Cour de Justice des Communautés Européennes (CJCE) which is important as regards the right of citizens of member states to reside in another member state. The CJCE also reiterated the two conditions required for such residence.

Firstly, the aforementioned citizens’ right of residence, as granted by the Maasstricht Treaty, is a fundamental, personal and immediate right.

Secondly, only two conditions are required of these citizens in order that they can reside in a member state other than their own: they must have health cover and sufficient resources to support themselves without recourse to the social assistance of the host member state.

Extract from the Sarkozy law
(Art.L.121-1) Unless his presence constitutes a menace to public order, every citizen of the European Union and every national of another state party to the agreement for the European Economic Area or for the Swiss Confederation has the right to stay in France more than three months if he satisfies one of the following conditions:
1) If he exercises a professional activity in France.
2) If he has, for himself and members of his family, sufficient resources not to become a charge on the social assistance system, as well as having health insurance (assurance maladie). normal subscription to be paid under the provisions of CMU is far short of the actual cost to the French state, which exceeded €3,000 per capita in 2005 and is probably much more by now.

Exclusive Healthcare Tel: 0033 (0)8 70 44 91 75/ 0121 288 2363 www.exclusivehealthcare.com

---