UK pensioners' healthcare ends March 29, 2019 - Cnam
Confusion surrounds how British pensioners living in France will continue to access healthcare rights after Brexit as Cnam, the national body in charge of local Cpams, told Connexion their rights end on March 29, 2019.
It comes after a reader who has lived in France for 15 years contacted us on receiving an official letter saying her rights stop at Brexit day next year.
However, in theory, if the draft UK/EU withdrawal agreement is confirmed then nothing should change for resident UK pensioners: the agreement says their rights to French healthcare paid for by the UK under the EU’s S1 scheme will continue as long as they stay in France. Matters are more uncertain with regard to the possibility of a ‘no deal’ when the draft agreement will be voided. However, the points on healthcare could be maintained via a separate agreement with the EU/and or France - or not.
Today Cnam, the body in charge of local Cpam state health insurance bodies, told Connexion: “The rights are today limited to the end of March and the British retirees will no longer be covered by French social security”.
The Cnam response was given to Connexion after we followed up the reader’s case. She had been told by her Cpam that her and her husband's rights were being limited to that date, as we report in September’s edition out this week. Her Cpam told her to “contact your British organisation for information on your cover after that”.
The Cnam spokesperson said this is not a “position of the Cnam” as such, simply “rules, that have to be applied”. They added Cnam is merely a state agency that carries out the decisions and missions given to it, and we should speak to the ‘competent authorities’.
Cnam also said that Cleiss, a centre of expertise on social security matters in Europe, may be able to advise about British retirees' rights - but a Cleiss legal expert told Connexion she was not able to comment, and its communication team said the best-informed authority would be the Direction de la Sécurité Sociale (DSS), the French government department in charge of social security. They said they will inform us if further information becomes available.
However, asked to confirm that the Maine-et-Loire Cpam’s comments to the reader do not apply if there is a deal, and to clarify the position if there is ‘no deal’, the head of the DSS's international section, François Brillanceau, said: “The issue of the UK leaving without a deal is a subject that has only emerged very recently and in consequence a reflection on this has only just started at the highest levels in France. Whatever choices are made will be communicated on a wide scale. That is all I can say for now.”
Connexion asked the UK’s Brexit Ministry if there are contingency plans for the UK to pay for British pensioners’ healthcare in France after a ‘no deal’ Brexit, and it referred us to the Health Ministry. The Health Ministry did not comment other than to say that it is preparing for all eventualities but is still confident a deal will be achieved.
Earlier this week the French Prime Minster's office confirmed he has asked his cabinet to work on contingency measures for a ‘no deal’ Brexit, including ‘facilitating residency of British people already living in France’.
In an interview for the August edition of The Connexion newspaper a senior official in the Interior Ministry said they plan to respect the residency rights of Britons living in France before Brexit, especially those who already have cartes de séjour, but also those who are after Brexit able to prove the same legal and continuous residency criteria with similar paperwork.
In Connexion’s analysis the following points follow from this:
- With regard to the situation if there is a ‘deal’ Cnam is probably working on the strict basis of what is known – as yet there is no final deal or transition period. If there is one, the situation should be resolved, barring any technical or communication complications that might ensue once Britons no longer have the status of EU citizens (ie. after March 29, 2019).
- Although the DSS did not confirm this to us, if there is no deal, then for those Britons who are able to confirm their legal residency rights, it seems to follow logically that they may join the French system under ‘Puma’ (Protection Universelle Maladie). As the website of the Cpams states: “Every person… living in France in a stable and legal manner has the right to their healthcare costs to be covered their whole life long – such is the principle of Protection Universelle Maladie”. This involves having to make an annual payment above a certain level of income (this is at present 8% of income above €9,933/year per person; in theory this is restricted to ‘capital’ income but Connexion was previously told by the DSS that it could take into account private pension income).
- Those with a carte de séjour after Brexit should – based on our previous Interior Ministry interview – therefore be able to apply for this. Those without any residency card may face the difficulty of lacking proof of legal residence until such time as they can obtain one, bearing in mind that delays are already being reported with obtaining carte de séjour appointments at prefectures. Those with a card might also have a period of uncertainty while a Puma application is processed.
- Those lacking healthcare because they have no card might be able to apply for Aide Médicale d’Etat, a form of stop-gap French healthcare cover for those who have no legal residency status.
- Those able to afford it could take out a comprehensive private healthcare policy (which, however, are costly and typically exclude serious pre-existing conditions).
- Finally, it is possible the UK would agree a bilateral deal with France on healthcare, but it would be just one item on a long list of matters the UK would have to deal with if it leaves with no deal and it is unknown how long it could take.
Loss of S1 cover has long been flagged as a potential concern with regard to the impacts of a Brexit on British pensioners. Among several similar articles, we reported in March 2016 that “S1 health forms are an EU scheme: Britain may therefore cease to pay for British pensioners’ French healthcare”. The S1 scheme is also available to the EEA countries (Iceland, Liechtenstein, Norway) and Switzerland (which participates in the EU single market via more than 100 bilateral treaties and follows many of the EU rules including on free movement of people).
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