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French Health Care Plan Guidelines - Expat Guidelines for France
France's health system offers one of the best health care services in the whole wide range of the globe, although under certain conditions there is a need for privately funded health care. Persons resident in France are required by statute to take out health care in France. Expatriates are now entitled to l'assurance maladie to gain entry into the world-famous health system after the introduction by the current administration in January 2016 of a new general health system called Protection maladie universelle (PUMA).
Persons not insured by the PUMA or wishing to upgrade their health cover must take out personal health cover in France. Bupa Global, the Bupa Global health insurer, declares who is entitled to receive health care in France and whether they need to take out health care in France for aliens.
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Effective January 1, 2016, Protection Maladie Universelle (PUMA) superseded the old Maladie Universelle (CMU) health insurer and now offers all inhabitants of France - even aliens - easy acces to health care in France. According to PUMA, lawful inhabitants of France who are permanently resident are eligible for state health cover in France if they have been living "stable and regular" in the territory for three successive month.
The health care reforms have facilitated the eligibility of employees and inhabitants of France, since unrestricted health care accessibility is now an automated and permanent right of all inhabitants, regardless of ages, backgrounds and proof of payment of France's health care contribution (cotisations sociales). Until now, health care coverage for foreign nationals in France was only available if a number of different working or life circumstances were fulfilled.
When their life or work situations change, they are asked to request state health cover in a different and more appropriate class, sometimes abandoning a period when they were not insured in France. This new PUMA system ensures that any lawful inhabitant of France can remain with his health insurer despite a change in his or her status or his or her position.
It also means that those who have obtained health cover in France through the old CMU system no longer have to request an annual renewal of their cover, which reduces actually the administration costs for the beneficiaries of state health insurances. The PUMA also balances the right of EU and non-EU nationals to request their CV (health care card) and take out health care in France after three month's stay in France.
Outside the EU, this right existed before 2016, while EU nationals had to await five years before applying for health care in France - a bill that was widely criticized for eroding the free movements of these people within the European Union. COMplémentaire CMU (CMU-C), a programme that offers free health cover in France for the low-income and unemployment sectors, will also remain complementary to the PUMA.
See below if you are entitled to the CMU-C. Health care reforms will mainly concern inhabitants who were not previously insured by occupational or company health insurances in France, present beneficiaries who had changes in their individual or professional circumstances and new inhabitants in France. Can anyone request the new health cover in France?
Under the new PUMA programme, expatriates who live in France can claim state health cover in France if they have spent less than five years in France, have no job, are below the pensionable 65 years of old and do not draw a benefit from a social security scheme in a Member State.
Non-EU nationals over the age of 28 without a wage and UK early retired people are also considered if they do not get a wage. It is possible to claim health cover in France once you have stayed for three permanent-month periods. In the event of approval, the authorities will consider whether you should contribute to the Union de Recouvrement des Cotisations de Sécurité Sociale et d'Allocations Familiales (URSSAF).
If your request is refused, you would have to take out health cover in France. In France, who is entitled to health cover? Usually all persons - also aliens - who want to stay in France for a long time must have a health care policy. Everyone resident in France and employed in France who pays into the system of compulsory health care is entitled to state health care in France, although there are some exemptions according to your circumstances.
See below if you can take out statutory health cover in France. Now that the health system has been converted to the new PUMA programme, all inhabitants who can prove a stabile and normal stay in France for at least three successive monthly periods are eligible for health cover in France. A " steady and frequent " stay means that your family or main residence is in France, where you must have spent three uninterrupted monthly periods and then at least six monthly periods (183 days) a year.
Employed or low-income people are also eligible for health coverage in France and can receive CMU-C grants. Workers working in France are eligible for health care coverage through the compulsory health insurances they contribute to the national system. The Régime Société des Indépendants (RSI) offers health coverage in France to micro-entrepreneurs (sole proprietors) and Société à Responsibilité Limitée (SARL) or small businesses with restricted liabilities.
As a rule, European Union (EU), European Economic Area (EEA - EU plus Iceland, Liechtenstein and Norway) and Swiss nationals and their family members residing (and not working) in France on a temporary basis can use their European Union Health Card (EHIC). If you are domiciled or stayed in France, however, your health insurer will apply.
Pensioners from the United Kingdom and the EEA who receive a pension from their country of origin and are mainly resident in France can claim under the scheme if they have a current E1 health card (formerly E121 and E106). Usually made out by the relevant health authorities, this document certifies the long-term dedication of the person concerned to the stay in France.
Everyone aged 16 and under is entitled to health care in France, regardless of his/her country of origin. As a rule, international undergraduates are not considered "French residents", which means that most undergraduates have to purchase the necessary student social security (Sécurité Sociale Etudiante) to cover health costs during their stay in France, unless they belong to the following categories:
As a rule, a student living in France for less than six monthly periods per year (183 days) is not entitled to receive health care. For those who are not entitled to state health cover in France, France offers a variety of affordability possibilities for privately funded health cover. To find out more about health coverage for foreign nationals in France, please consult the website of L'Assurance Maladie (AMELI), the health insurer of the Flemish State.
Getting started with health care in France is by joining the France system of compulsory health care or visiting your CPAM (Caisse Primaire d'Assurance Maladie). When you are in employment, your employers will usually enrol you in the compulsory health system and then regulate your health care arrangements, although it is your own personal duty to verify this.
Independent persons submit their applications via the Régime Société des Indépendants (RSI). CPAM assesses your health status, but it is the URSSAF that determines whether you must contribute to your health care cost; if you are earning below a certain level, you are entitled to free health care (under CMU-C).
As a rule, you will be asked to provide a CERFA certificate, a document proving your identification and your legality of stay (passport and visa), documents certifying your date of origin and date of wedding, a document proving that you have been living in France for three consecutive month (electricity bill, tenancy agreement), your RIB (bank account) and your statement of your earnings, as well as your statement of your medical certificate. You can also register a beneficiary or relative (e.g. spouse, law spouse or children) to your health plan in France.
You can call the CPAM hotline in English at 3646 (from France) or +33 811 70 3646 (from abroad) for further information; charges are levied. After you have authorised and enabled your health cover in France, you may need to make a regular application for your French health cover in France (carte vital, i. e. your French health cover card), as it is not always automatic.
It contains information that is necessary for the collection of health rights, but does not contain any health information. We recommend that you apply for a social security certificate or a provisional health care voucher, as it can sometimes take a long time to obtain a vital health care voucher. Your vital health pass must be presented at every health visit (doctor, hospitals, pharmacy) and you will usually be reimbursed directly to your current savings accounts within one workweek.
Everyone who works in France receives welfare payments (cotisations sociales), which are taken into account from his salary to pay for his national health care in France. Please consult CLEISS (Centre des liaisons Européennes et internationales des securité sociale) for the complete listing of health care premiums in France from 1 January 2016. When you are out of work or your incomes are below the state threshold and you do not have health care in France, you are entitled to a free, government-funded supplementary benefit known as CMU-complémentaire (CMU-C).
The income is calculated by the total income of your home in the last 12 month before the application for CMU-C. As soon as you are classified as entitled, all your health and dentistry expenses will be fully paid for and you will no longer be required to make any advance payment after the health care has been provided. The CMU-C can be requested by completing this application and sending it to your CPAM (Caisse Primaire d'Assurance Maladie).
Adults over the age of 16 who are insured by the French National Health Service must consult a general practitioner (médecin traitant) to obtain full coverage for their health care expenses. Otherwise, higher physician charges and lower refund percentages will be imposed.
Most of your physician expenses are paid by the national health system in France, usually in the order of 70% for visits to a physician, dental surgeon or consultant, about 80% of your cost of hospitalization in France and up to 100% of the medication you prescribe. Remaining physician expenses must be borne by the patients.
Cardholders of the Carte vital are not obliged to make advance payment, while those without a cardholder must make the corresponding payment at the place of surgery. Refunds from the Fédération Française will then be paid directly into your current savings accounts and usually last five to ten working days. Prosthodontic care is provided by the public health insurer in France, but has its own scales of premiums and refund percentages.
Generic dentistry will be refunded in the same way as other types of treatment that fall under the specialists heading, but your refund for intermediate dentistry will usually be lower due to the higher costs. In order to make up for the differences, which are not covered by health insurances, many people in France take out personal health insurances known as mutuals.
In the meantime, pupils can opt either for mutual health coverage from their parent or for their own personal health coverage in France. The majority of these insurers in France pay the remainder of 30% of your general health care expenses, which includes urgent medical care. Nursing home care charges depend on the nature of the coverage needed and a number of determinants such as the applicants' ages, although few individuals will ask for your health data before granting it.
As a rule, the base packs concentrate on providing care in hospitals and medical care, but may also contain restricted covers for dentistry. However, unlike health insurances in some other EU Member States, in France there is no quicker access to health care nor is there any link with doctors. Its sole purpose is to close the 30% deficit created by France's health state.
As a rule, state health insurances do not provide coverage for consultation with a psychologist, osteopath, chiropractor or certain professionals. When you need special care, especially for people with pre-existing conditions or chronically ill people, French health insurers can make more sure that you get the same care as at home. It is therefore important to begin to research and compare plans before you move in order to get the best personal health plan for your particular circumstances.
A lot of medical specialists are either self-employed or privately insured, but are covered by statutory health insurance. Usually the prices for their service are set by the state, but some pay an additional fee to be payed by the person if their mutual does not pay for it. For example, some polices relating to 100% coverage may appear deceptive at first sight.
Reimbursement refers only to governmental rates, such as the basic fee for a consult with a physician in France. Your personal health insurer in France can also provide full or full reimbursement for your prescription, according to the type of policies you have. Therefore, it is important to determine which insurer in France has the best health coverage in France to meet your health needs.
Several of the biggest health insurances in France or mutual are among others: Here are some technical English language health terminology to help you set up health coverage in France and visit a local physician or clinic in France. More can be found in our guidelines for specialist English language terminology, while this speech guidance can help your speaking skills on-line.
Ambulances in French: an Ambulance; J'ai bezoin d'une Ambulances (I need an ambulance). Please click here to go to the beginning of our French Health Care Guidelines.