# health insurance



## manuka

At last, after years of trying...( and missing the Brexit deadline) ....We have sold our house and will be moving to France on 22nd February! I have just asked for my S1 form- I receive a Uk state pension. I was told I need to get a mutuelle/ health insurance for the first months in France when I will not be covered. Would anyone have a recommendation for this. And..Does my husband also need this as well- he is an EU citizen?

Many thanks in advance.


----------



## Crabtree

Congrats.....Firstly do not confuse a mutuelle with "health insurance" .The french health system works in a different way to the NHS as you often have to pay up front and then you will get a refund from the french state equivalent to 70% of what you have paid out.Most people tend to take out a "mutuelle" AKA "top up" to pay for the rest.If you have a chronic health condition then the french state pays 100% eg diabetes.in resp[ect of the health insurance then you need that to really cover the period of time that it will take for you to be accepted into the french health system Try to find one that allows you to cancel once you have been accepted Google Schengen health insurance for a start.
In respect of your husband the same rules will apply to him as health care is not an EU responsibility it is down to each individual country Has he worked in the UK and getting a UK state or private pension? If the former he can get an S1 from the UK DWP If the latter then he cannot However anyone who gets a pension of any type does not make any contribution to french health care unless they are rich.
In respect of a mutuelle I have used Aviva france although I always say to people to perhaps look at using an English speaking agent initially for insurance so you understand what you are getting 
Best of luck


----------



## Bevdeforges

I'm wondering who used the term "mutuelle" for the insurance you'll need at first. In France, the term "mutuelle" is pretty much reserved for the "top up" insurance that pays for the part of your health care that the French sécu doesn't (vast oversimplification, but that's the idea).

What you'll need is a private insurance cover, ideally for the first six to twelve months of your stay. There is no automatic "carry over" for health insurance for an EU national - and even when there is some carry over, it is contingent on the EU national having been covered in their EU country of nationality just before the move to France. If your husband is covered by a UK pension, he should be entitled to an S1 also.

Oops, just saw Crabtree's message that explains this probably better than I have.

At the time that you register for your carte de séjour as the spouse of an EU national, both of you will have to show proof of health care coverage in order for your application to be accepted. Although it's not "necessary" to have your carte de séjour before you can apply for CPAM cover (with your S1), you'll most likely find the process runs considerably smoother if you hold off until you have the carte de séjour in hand. So, basically, you need health insurance cover for at least the time until you apply for CPAM cover - and then getting that can take a few months, depending on the backlog in your area. If you can find a private cover that can be cancelled on short notice, you'll save a bit of overlap.


----------



## manuka

Crabtree said:


> Congrats.....Firstly do not confuse a mutuelle with "health insurance" .The french health system works in a different way to the NHS as you often have to pay up front and then you will get a refund from the french state equivalent to 70% of what you have paid out.Most people tend to take out a "mutuelle" AKA "top up" to pay for the rest.If you have a chronic health condition then the french state pays 100% eg diabetes.in resp[ect of the health insurance then you need that to really cover the period of time that it will take for you to be accepted into the french health system Try to find one that allows you to cancel once you have been accepted Google Schengen health insurance for a start.
> In respect of your husband the same rules will apply to him as health care is not an EU responsibility it is down to each individual country Has he worked in the UK and getting a UK state or private pension? If the former he can get an S1 from the UK DWP If the latter then he cannot However anyone who gets a pension of any type does not make any contribution to french health care unless they are rich.
> In respect of a mutuelle I have used Aviva france although I always say to people to perhaps look at using an English speaking agent initially for insurance so you understand what you are getting
> Best of luck


Thankyou for the info and the clarification re mutuelle. I will google Schengen health insurance as you suggest.My husband is not UK state pension age and has worked for 17 years in the UK and paying his taxes . So. he should apply for S1 too?


----------



## manuka

Bevdeforges said:


> I'm wondering who used the term "mutuelle" for the insurance you'll need at first. In France, the term "mutuelle" is pretty much reserved for the "top up" insurance that pays for the part of your health care that the French sécu doesn't (vast oversimplification, but that's the idea).
> 
> What you'll need is a private insurance cover, ideally for the first six to twelve months of your stay. There is no automatic "carry over" for health insurance for an EU national - and even when there is some carry over, it is contingent on the EU national having been covered in their EU country of nationality just before the move to France. If your husband is covered by a UK pension, he should be entitled to an S1 also.
> 
> Oops, just saw Crabtree's message that explains this probably better than I have.
> 
> At the time that you register for your carte de séjour as the spouse of an EU national, both of you will have to show proof of health care coverage in order for your application to be accepted. Although it's not "necessary" to have your carte de séjour before you can apply for CPAM cover (with your S1), you'll most likely find the process runs considerably smoother if you hold off until you have the carte de séjour in hand. So, basically, you need health insurance cover for at least the time until you apply for CPAM cover - and then getting that can take a few months, depending on the backlog in your area. If you can find a private cover that can be cancelled on short notice, you'll save a bit of overlap.


Thank you Bev


----------



## papaia

Crabtree said:


> ... you will get a refund from the french state equivalent to 70% of what you have paid out....


As newbie as I am (for now), in France, I learned of something which is at least one critical exception to this rule: dental treatment (vs choices). For example pre-molars & molars are being covered by Amelie on 70% of the metal-metal only solution, which amounts to a few hundred euros, altogether. If you want something more durable and decent looking (and some dentists would not even do it otherwise), like a bridge céramo-céramique, you would be looking at a few thousand euros, so you'll be left with 2-3-4K€ (towards max end of spectrum if involving an implant or two) "out of pocket", after Amelie. I am not sure how much a mutuelle would pick up in such scenarios, but i am sure it is not that much, either. A trip to Hungary, Romania or Turkey may be the better "complementary" of Amelie, in regards to complex dental treatments.

Maybe there are other exceptions to the "70% Amelie rule of coverage", so I'll let the more experienced folks speak to such, for a more complete picture.


----------



## Bevdeforges

No, I'd say your understanding of the system on dental coverage is a bit off here. (And there have been recent changes to dental coverage along with the changes to eyeglass and hearing aid cover, which may differ, too.)

Basically, Amélie (actually CPAM or the Sécu) publishes a list of their "assumed" prices for various sorts of treatment and care and bases their reimbursement on that - sometimes at 70% and sometimes at a different rate, depending on the treatment or service. What your mutuelle then reimburses depends on the mutuelle you have chosen and the level of coverage specified in your mutuelle contract. Obviously, the more you pay per month for your mutuelle, the "better" the coverage, but in any event your contract should spell out the rates and limits on payments.

For dental stuff, the treatment may well have a maximum amount they'll reimburse. Example: if you need a crown for a tooth, you would normally first ask the mutuelle for a "devis" - i.e. to ask them how much they'll cover. Then, you can evaluate whether or not you're willing to pick up the difference yourself. I know I saw something that said that the Sécu will only cover a "metal" crown for a back molar - but my dentist put in a crown that was carefully matched to the color of the neighboring teeth. Not sure if it was a "metal" crown with an enamel covering, but whatever it was, the mutuelle paid their share with no difficulty while I picked up the rest.

Haven't had a filling in a long time now - probably because I've had most of my teeth filled - but for the last 15 or 20 years, my French dentist has used only the white colored ceramic filling material and he claims "no one" uses the old metal amalgam stuff any more. (He also claims that the ceramic filling stuff is stronger and more long lasting than the old metalic stuff anyhow.) Have never had a problem getting reimbursed by the mutuelle for fillings.

Anyhow, the 70% reimbursement mostly applies to the treatment services of a medical professional (doctor, dentist, ophthalmo, nurse, kiné, etc.). For "medical devices" (dental bridges, crowns, medical devices like braces, slings, specialized bandaging material) the rates of cover may vary (like for prescribed medications) and/or may be subject to a limit by the mutuelle.


----------



## manuka

"There is no automatic "carry over" for health insurance for an EU national - and even when there is some carry over, it is contingent on the EU national having been covered in their EU country of nationality just before the move to France. If your husband is covered by a UK pension, he should be entitled to an S1 also." So my husband has worked in the UK for 17 Years, which is when he left Poland. He has not reached UK pension age so does not qualify for a UK pension. What will he need to show when we go to the Marie to register our presence?

As far as we knew: "European citizens will be able to use their European Health Insurance Card (EHIC) in France to attain healthcare at the same cost as locals."


----------



## papaia

Bevdeforges said:


> No, I'd say your understanding of the system on dental coverage is a bit off here...
> ... Anyhow, the 70% reimbursement mostly applies to the treatment services of a medical professional (doctor, dentist, ophthalmo, nurse, kiné, etc.). For "medical devices" (dental bridges, crowns, medical devices like braces, slings, specialized bandaging material) the rates of cover may vary (like for prescribed medications) and/or may be subject to a limit by the mutuelle.


I don't think I [intended to] say anything contradictory. All I meant to underscore was the fact that the actual treatment (doctor and solution used, combined), at least for dental (other medical services may be in a similar situation) could come at a much higher out of pocket cost than the assumed 70% Ameli coverage for "any" (keyword) total. In fact there was a very interesting conversation the other day, on /r/vosfinances, where someone was able to bring up and sustain a strong point in favor of just saving € 4K/yr for a family, to use in case of over-Ameli costs of medical services, and never get mutuelle, as there is also a threshold beyond which Ameli picks up 100% (e.g. > 31 days of hospitalization).

I am the first to claim - again - lack of comprehensive knowledge in this area, at this time, but I promise to learn


----------



## Bevdeforges

You won't be going to the mairie to register your presence. You will be contacting the prefecture within the first 90 days that you are in France to apply for a carte de séjour as the spouse of an EU national. This is when you need to both have proof of health cover. 

If your husband is not yet drawing a pension I don't believe he is entitled to an S1. I have heard some say that an EHIC is acceptable for showing health care cover - at least in that first 90 day period - but I think he may need to apply to the health agency in his country of nationality for the EHIC card. Is the UK even able to issue EHIC's anymore - since they aren't actually part of the EU? I'm (obviously) not real concerned with the Brexit Withdrawal Agreement terms, but your husband's move to France is covered under the EU rules related to Freedom of Movement for EU nationals.

Take a look at the Service Public material on obtaining a carte de séjour for the "close family member" of an EU national here: Carte de séjour en tant que membre de famille d'un Européen Under the Pièces à fournir the last item reads:

Justificatif du droit au séjour de l'Européen que vous rejoignez en France (par exemple : contrat de travail, preuves de ressources, *assurance maladie,* carte d'étudiant)
There may be more information available on the website of the prefecture for the departement you are moving to.


----------



## Crabtree

Manuka-Your husband is entitled to a state pension and therefore an S1 when he reaches UK state retirement age However according to EU rules it is the country in which a person last worked that is responsible for their health care in retirement so if he works in France (as he can do as an EU citizen) then France will assume responsibility for his retirement health care but if he does work then he will automatically be enrolled in the health system 
One tip -when you apply at CPAM describe yourself as "retraitee" and your husband as "inactif"


----------



## manuka

Thank you. But I think inactive would not be accurate. My husband has proof of self employment, tax records etc in UK for 17 years and will be continuing self employment in France.


----------



## Bevdeforges

To claim "self-employment" your husband will need to set up a business entity in France, depending on the type of work he is doing. France tends to be much more formal about this stuff than the UK is. But if he can start out with a "micro-entreprise" (auto-entrepreneur), that can be easily accomplished - and once that is done, it takes only a short time to register with the appropriate cotisation agency as long as he falls within the limits for the type of work he does. That gives him his health insurance cover, which is, I believe, extendable to you until you reach the UK retirement age and qualify for that S1 and pension. I'm not sure that you qualify as a "retraitée" until you are actually drawing a pension, so you're the one who will probably start out as "inactif."


----------



## Crabtree

The OP states that she is getting the UK state pension and has applied for an S1
If the husband is going to continue working in France then any pension payable will be collated by the French making contact with all the countries he has worked If France is his last working country they will be responsible for his health care in retirement and also supply him with a CEAM for health cover in the EEA The OP will have to apply to the UK for a GHIC as they are responsible for her health care in retirement


----------



## Bevdeforges

OK, I'm just not clear from my latest re-skim of the thread whether the husband is planning to continue to work while in France. If not, it might be a wise idea for him to apply to the UK to start his pension before they make the move.


----------



## ARPC

In re to the question of how to find Heath cover for your first few month in France, my family and I had great luck with the company Geoblue for this. They’re not the cheapest option but they cover a lot and are very easy to use should the unfortunate need arise.


----------



## manuka

ARPC said:


> In re to the question of how to find Heath cover for your first few month in France, my family and I had great luck with the company Geoblue for this. They’re not the cheapest option but they cover a lot and are very easy to use should the unfortunate need arise.


Thank you ARPC that's what I am looking for....please help guys, with any other suggestions


----------



## Peasant

Bevdeforges said:


> For "medical devices" (dental bridges, crowns, medical devices like braces, slings, specialized bandaging material) the rates of cover may vary (like for prescribed medications) and/or may be subject to a limit by the mutuelle.


As a point of reference, I recently had a crown fitted (Cracked the tooth on a crusty bagel. How French.) and the total for the work (including ceramic crown) came to around €1200. My share, after CPAM and Mutuelle, came to around €550. If I'd gone for the metal crown there would have been no payment necessary.


----------



## bhamham

manuka said:


> Thank you ARPC that's what I am looking for....please help guys, with any other suggestions


Based on a document published in WA CdS for British citizens in France.

*Health Insurance Options (PHI)

Looking for private health insurance for a visa prior to moving to France?*
We believe acceptable PHI policies must cover expenses from the first Euro and include comprehensive coverage of: Hospitalization, medical consultation and Pharmacy. Basic travel and Emergency plans are not likely to be acceptable. -- If a company/agent insists you must have a Numéro Sécu (social security number), they have misunderstood your needs are are offering a mutuelle/Complémentaire santé. In such cases you need to explain you need what is often called global or ex-pat insurance.
*This list of insurance vendors is offered as a convenience only. We have no specific knowledge of, or connection with, any of these companies.* If you have more information on a company listed here, or if you have additional companies to add to this list, please provide that information in the comments for this post and we will update as necessary.
Here is a list of some companies and agents that may offer insurance to meet the requirements of some visas:
ACS https://www.acs-ami.com/.../foreign-resident-in-france.../
Allianz https://www.allianzcare.com/.../internati.../benefits-2.html
April https://fr.april-international.com/.../myhealth-france
AXA https://www.axaglobalhealthcare.com/.../internati.../france/
BUPA https://www.bupaglobal.com/en/campaigns/health-insurance
CIGNA Global https://www.cignaglobal.com/.../PersonalInformationLiteV4...
Pacific Prime https://www.pacificprime.com/.../france-health-insurance/
Pepite-Courtage https://www.pepite-courtage.com/en/
MAM ASSUR www.mamassur.com Email [email protected]
MOND assure https://www.mondassur.com/devis/goldimp
An "authorised introducer" is
SOFICAS www.soficas.fr [email protected]
mobile is 06 43 52 41 08
SOFICAS organises initial health insurance and the continuing mutuelle once set up. Competitive and all the initial summary is in English.


----------



## BackinFrance

I don't believe British citizens need 100% coverage, rather like other TCNs, coverage should be the equivalent of the French health system, which for most things is 70% of the listed French fee.


----------

