New expats denied vital healthcover

Early retirees who recently moved to France are being refused private health insurance

1 April 2010

Early retirees who recently moved to France are being refused private health insurance – a requirement to continue living in the country – despite not having serious or expensive health conditions.

The problem follows legal changes that force non-working expats below state retirement age who came to France after November 23, 2007, to take private health insurance until they are eligible for a state pension, or have lived in France for five years.

On arrival, most British early retirees access the French health service via a European E106 form which allows healthcare for up to two-and-a-half years with Britain footing the bill.

After it expires, most Britons who are not of state retirement age, or working, should take out private health insurance.

Currently 1,700 Britons have E106 forms in France and many in the first wave of those forced to find private health insurance are being turned down.

Insurance broker Tony Mason of Bordeaux-based firm Soficas says he knows of at least 25 people turned down for policies by firms including international insurance giant Swiss Life.

“I’ve written to the health minister and the British ambassador to tell them we’re going to have serious problems,” he said.

Insurers have no obligation to give reasons for a refusal but Mr Mason said many of those affected were on ongoing medication or had been in hospital in the last five years, though they did not have serious illness or conditions that required expensive treatment.

“I have asked insurers: ‘is it not better for a person to have a known condition that is under control than for them to potentially have something unknown?’ However they have company doctors who go through the medical questionnaires and decide on each case.” Insurers ask if applicants have been refused by other firms, and a “yes” can result in another refusal.

Adding to the uncertainty is the fact that insurance firms disagree about the type of policy that correctly replaces French state cover.

While the government says expats with expired E106s should get private cover ‘comparable’ to that of the French state, there are no clear definitions of adequate policies and no ‘government-approved’ label.

Social Security Directorate official Jean-Claude Fillon said people must “weigh up the risk in taking a low-cost policy, of not fulfiling the conditions for legal residence.”

This raises the possible future problem that expats seeking to join the French health service after living here for five years, may be rejected because their private insurance was deemed inadequate to fulfil legal residency criteria. Mr

Fillon said that private insurance must not exclude whole “healthcare, product or procedure categories” though “little differences in terms of the conditions for reimbursement or the reimbursement levels” would be tolerated, as would some “minor, insignificant exclusions.”

Ian McKie, 64, from Mayenne, said he was “left in the lurch” after his E106 ran out. He was refused insurance, probably because of a stroke he had three years ago. “The stroke is no grounds for refusal. I’m fit. I do not want to go back to the UK. It is worrying.” Mr McKie was advised by France’s English-speaking health helpline (08 11 36 36 46) to apply for cover to his local Cpam (state health body), explaining that private insurance had been refused.

One reader from Lot-et-Garonne has type two diabetes, a common, often relatively mild form of the illness that develops in middle-age.

He said: “My condition is well-managed. My Cpam said ‘no’ straight away – I should go back to UK if I can’t get insured.”

However when he protested, they told him to fill out an application form to join the French system, but with no guarantee of acceptance.

Route to appeal

While early-retirees whose E106s have expired usually need private insurance, rules laid down after the 2007 health changes allow for exceptions. They state people can join the state system (usually through paid subscription) if they suffer an accident de la vie, defined as “unforeseeable circumstances making access to health cover problematic for financial or health reasons.”

“Refusal of insurance in the case of a serious illness, not foreseeable at the time of becoming resident in France” was one example given. However it is unclear if it could include those who have only minor health problems and/or conditions they knew about before coming to France.

Further clarification from the government was not available.

In some cases Cpams have now allowed those refused back into the state system, however there is a lack of consistency in how the rules are applied.

“Each Cpam does what it likes,” said insurance broker Tony Mason. “Some will just say ‘Are you 65? Are you working? Have you been here five years - no? We can’t help.”

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