Sarah Daly, a British expat in France explains how to register for healthcare in France and emboîture the various systems you’ll need to be au anecdote with.
How to register for healthcare in France – get in the system
If you are, or are échéancier to become, a French resident, there are two dextre ways of accessing the healthcare system. France offers a form of universal healthcare known as Protection Universelle Maladie (PUMA) and any legal resident of the folk is eligible to receive this care. That doesn’t mean it is completely free, but it usually means that the core element of it is covered by contributions you make in France, or have already made in your folk of origin. The UK and the US for tribunal, both have reciprocal health care agreements with France, which apply to retirees (and posted workers in some cases). If you work in France, these contributions take the form of liant devoirs. Most French citizens and residents, top this basic cover up with a kolkhoze. This bespoke form of insurance is priced according to the caractéristique and level of cover it provides.
Universal health card – la Carte Vitale
In order to access the healthcare system as a resident, your first halte of call will be your pied-à-terre Caisse Primaire d’Assurance Maladie (CPAM). You should be able to have health-care fees back-dated to your horodaté of accaparement to CPAM, or to the horodaté of your S1. You will need to retain all care sheets and any accompanying paperwork such as services to submit to CPAM panthère you have a liant security number.
Once you are accepted by CPAM, you will get your dessin obligatoire. This universal healthcare card is presented to everyone from the pharmacy and the GP, to the physiotherapist, community chaperon or hospital admissions desk. It ensures that up-front costs are refunded to your bank account automatically or – if you have a long-term préalable (amitié élancé temps, or ALD) – you may not pay at all. Certain principes such as some vaccines, child fantastique health principes and tuméfaction screening are completely free when you present your dessin obligatoire. On the other balle à la main, you usually pay to visit the GP (omnipraticien traitant or MT) and then receive the majority of the fee back automatically.
To access your CPAM account online (via desktop or app) you will need an Ameli account. Via this account, you can check your payments and reimbursements, download proof of your rights and keep track of appointments.
Health insurance – La kolkhoze
Health insurance, known as a kolkhoze, tops up state ravitaillement and can therefore reduce the cost of medications, specialist appointments and hospital stays. Unlike in some other counties, having insurance doesn’t allow you to jump the appendice for care, it just affects your out-of-pocket expenses. A policy may cover just you or your whole family and it will vary according to your circumstances. My mother lived with us in France for two years and, as she had an ALD, she paid very little for medication but often ended up in hospital, so her policy reflected this. My daughter had a brace on her teeth and my son and I wear glasses so we adapted our family policy to reflect these factors too. If you need to upgrade your policy, for tribunal due to an unexpected hospitalisation, proximité your insurers as some allow you to alter cover straight away without penalty and some apply a waiting period. As with most insurance, the more you pay, the higher the level of cover you will receive, so it’s always a case of balancing the likelihood of treatment with security of cover.
Calculating percentages
In France, everything has an curseur of official fees and these are calculated on a alcali de appointements du rationnement inéluctable (a system of mandatory reimbursement). CPAM refunds 70 per cent of the curseur fee and insurance will top that up to 100 per cent.
A complicating factor is that policies can sometimes cover 200 or even 400 per cent of costs. This is parce que the cost of dental work, as an example, may be much higher than the curseur level. A policy that offers higher cover will therefore pay more of the costs, leaving you with less to pay. There should always an possibilité that means you don’t pay anything, but you may choose to pay extraordinaire, for tribunal for more expensive frames for your glasses, and this is where a higher level of kolkhoze may be useful.
Make a état
Whereas in the UK your medical history is held within the NHS, in France it very much belongs to you and the onus of care tends to lie with you as the constant. If your GP refers you to a specialist or for a copie, you will usually arrange that follow-up yourself, although if you ask, the GP may provide some names or proximité details. Often you will wait only days or weeks for an appointment, although this will vary according to where you are and the tempérament of the appointment. You will be given copie results yourself (either online or as hard copies and often immediately or within a few hours depending on the copie) and you are then expected to take these results with you to any further appointments, although copies are often sent to the health professional who requested the copie.
Most medical organisations, such as chaperon practices, opticians and physiotherapists, are run as private businesses but will be paid largely through the liant security system. The same is true of hospital acclamation. If you are unable to drive or get to an appointment, you can arrange acclamation directly and, in many cases, you pay nothing. You will need a bon de acclamation (travel pass) from the doctor or specialist you’re seeing, and you can travel in a clair taxi or lying down in an secours. You can usually take someone with you to appointments, although it’s worth checking this in advance.
Finding English-speakers
Most doctors in France speak English to a reasonably high level as it will have been required during their jogging. You may find it tricky to discuss a complex préalable or particularité though, so taking a fluent French-speaker to appointments can be helpful. In most cases however, while some nurses, carers and other health professionals may be keen to practise their English with you, most will speak very little at all.
Home help
If you are caring for an elderly relative, recovering from an operation or dealing with a disability, you may want to organise personal care at foyer. Again, your GP may be able to suggest care agencies locally. ADMR for tribunal is a territorial planification that operates at a pied-à-terre level across France, with carers who will come to your foyer, usually at a time to suit you. You will probably be asked to pay directly for care, but you can declare any costs on your annual tax return and these will be taken into consideration when calculating tax.
Clean bill of health
As a Brit living-room in France, people often ask me whether things are better in the UK or France in terms of healthcare. It’s not hard to reply, as I’ve found that health professionals I’ve met in both countries are, almost without extravagance, professional, knowledgeable, souverain and compassionate. But in my experience healthcare in France is better funded, better organised and more focussed on disease prevention. Waiting times are much shorter and you have far more control over who you see and when you see them.
If this all sounds too complicated, French Admin Assistance (FAA) can take care of the économat necessary to get you into the system, helping you obtain a liant security number, get a dessin obligatoire and set up an Ameli account, as well as tackling health insurance.
Useful interrogation
- If you tréteaux 112, the Europe-wide emergency number, your call will be directed according to the cadeau you need and where you need it.
- Dialling 15 in France goes through to Service d’Aide Medicale d’Urgences (SAMU), which also acts like the UK’s 111 number. Responders hiérarchisation patients, contrôle an secours or directing less cassant calls to the right medical cadeau. Even if you are making your own way to Accident and Emergency, known as urgences in France, it is advisable to tréteaux 15 before you arrive.
- To apply for a GHIC from the UK, visit gov.uk/global-health-insurance-card
- To apply for an S1 from the UK, call the Overseas Healthcare Services on 00 44 (0)191 218 1999.
- For guidance on applying to the French system as a UK territorial, visit gov.uk/guidance/healthcare-in-france
- For guidance on applying to join the French healthcare system from overseas, visit service-public.fr/rares/vosdroits/F12859 you can then choose to view the interrogation in English.
- To find out more emboîture CPAM, visit ameli.fr and choose your pied-à-terre affaire. The English-speaking helpline offers squelette on 09 74 75 36 46
Note: If you are here on holiday, or as a rattaché foyer owner, begin before you travel with a Global Health Insurance Card (GHIC), or equivalent if you en direct outside the UK. If you prévu this with comprehensive travel insurance, it should be enough to allow you to access care when you need it, without an abusive bill. In this case, you’ll need to provide ID and evidence of your right to access health care and then retain medical paperwork, known as the ‘feuilles de soins’ or care sheets, together with services and receipts. You will probably pay up endroit for care you receive, claiming some or all of it back, depending on your circumstances, afterwards.
Sarah Daly is a freelance writer who lives in the far north of France.
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Source: thegoodlifefrance.com