BRITISH early retirees who move to France may have to take out private health insurance from the moment they arrive - after the UK government announced today that it would stop paying their healthcare costs.
The UK Department of Health says the changes will come into effect "probably from April 2014" and follow a consultation this summer aimed at finding ways to save the National Health Service money.
The new measures announced today also mean that British expatriates living in France who travel to the UK for healthcare will be routinely billed for their treatment under new measures aimed at saving money and stopping "health tourism".
Under the current system, the S1 form makes it possible for expatriates to use the French health system with Britain paying France to cover costs for up to two-and-a-half years, dependent on the individual’s National Insurance payments. There are no plans to stop S1 forms for state pensioners.
An estimated £305million a year is spent in the UK on healthcare for visitors from the European Economic Area, non-permanent residents and British expats living within Europe.
The Department of Health says paying for early retirees' French health cover is not a legal obligation under EU law.
"As these payments exceed our obligations under the EU agreement, and most other states do not make them, we intend to investigate ending them as soon as is practicable; probably from April 2014," it said.
However one legal group which responded to the consultation argued that scrapping S1s for early retirees "may deny British citizens who move to another member state the benefits of migration".
The move means anyone who is not a state pensioner and does not immediately enter employment in France (and thereby become registered with the French state health insurance system) or become self-employed will have a gap in health coverage and will need private cover to be certain of getting their money back.
Early retirees do not have a right to join the French health reimbursements scheme until they have been resident in France for five years. Before this a claim is assessed on a case-by-case basis, in theory requiring people to prove some unforeseen misfortune prevents them being properly covered privately. Though France is under EU pressure to allow all residents to join, it has yet to agree.
The UK's Department of Health also plans to introduce a new records system to stop non-residents having free A&E treatment, surgery, antenatal, dental or optical care on the NHS. It could be implemented by 2015.
The department says: "Currently many, but not all, expatriates are chargeable for healthcare when returning to the UK to visit ... Current rules are poorly understood and difficult to enforce.
"We need to improve the system so that we are better at identifying those EEA nationals who are not ordinarily resident in the UK and who do not have other rights of equal access to our healthcare system."
Details of how the charging would be implemented are not clear at this stage and the Department of Health said no one would be turned away in an emergency. GP consultations will remain free to all and hospital treatment that becomes necessary during a stay (as opposed to deliberate "health tourism") should still be covered under the EHIC scheme for those in the French state system (or for British pensioners in France, who have British-issued EHIC forms). A more detailed plan is due to be published in March.
The government acknowledges that implementing the new rules will be "hugely challenging and will require us to moderate and refine our proposals over the coming months".
Health minister Lord Howe said in a statement: "Having a universal health service free at the point of use rightly makes us the envy of the world, but we must make sure the system is fair to the hardworking British taxpayers who fund it.
"Current rules already state that, while services should not be withheld, an overseas visitor identified as chargeable and wishing to receive maternity or antenatal care must pay for any services they receive.
"We know that some people are abusing the system by coming into the country early enough to have one or more antenatal appointments before giving birth on the NHS - without the intention to pay."
Due to France's position since 2007 on early-retirees from other EU states – who may be obliged to have private health insurance until they have been in France for five years – most early-retirees have been relying on a period of S1 cover.
The European Commission considers that France may be in infringement of its free movement rules if it continues to apply this policy, however for the time being the matter is not fully resolved, meaning S1s have remained a key part of people’s plans for moving to and living in France.
The Connexion publishes a helpguide to the French healthcare system, including changes coming in in 2014. It can be downloaded here for €7.50. All printed versions have now been sold.
The January edition of The Connexion, which is now on sale across France, carries a two-page feature on private health insurance for residents of France. An edition can be downloaded here for €3.50.
• Connexion believes that changes like the UK's plan to stop temporary S1s - which people in France were unaware of during the period on which the plan was consulted on - might be avoided if British expats had dedicated MPs in the British parliament, as France has for its expats in other countries. A petition to the UK government can be found here: Expat MPs