Reader question: can visitors to France have a top-up policy?

Q: We are frequent visitors to France and my husband has a long-term health issue. Is it possible to have a mutuelle insurance policy for the costs that are not covered by the Ehic (we are British and live in the UK)?

A: As a general rule this is not possible as these policies are designed for people insured in the French system. The Ehic system, which the UK still belongs to, allows reimbursement up to standard French healthcare rates for care that is deemed necessary during a trip, which can include care for pre-existing conditions.

This does not include the part of costs that is not reimbursed by the French state, called a ‘co-payment’ (the UK used to reimburse these but stopped doing so).

The main options to cover this cost are a general travel insurance policy including a suitable healthcare element, or a comprehensive healthcare policy. These could be obtained from a UK insurer or a French-based one serving international clients.

However, we advise with any of these, checking what is included and if any pre-existing conditions will be excluded. Some travel insurance policies are designed to be combined with an Ehic/Ghic and will ‘top up’ the part not covered by the French state.

Depending on the policy, it may also be possible for the insurer to pay out for your total costs incurred in the case of costly urgent care and take charge of recovering the ‘Ehic’ part.

International insurance group Allianz said it would suggest its comprehensive Care international healthcare plan. However, a medical questionnaire is involved and pre-existing conditions can be subject to surcharges or exclusion.

Agence AXA International, an English-speaking AXA agency in France, said the best option to ‘top up’ a Ghic for clients not moving permanently to France would be a Schengen multi-trip policy, which can be obtained via the agency from one of its partners and can be used for multiple entries to the area during the year while respecting the 90/180 days rule.

These do not require a medical but are designed for urgent care. A spokeswoman said this broadly means something that cannot wait for you to go back to your usual home. An annual multi-trip policy would be €328, regardless of age.

It can also offer, via European partners, policies aimed at those staying for up to three months or six months at a time.

An English-speaking AXA agent for the Jean-Marie Lecomte agency in Normandy said it offers cover via April International for UK residents, but it “can be complicated” for those with serious conditions.

The Connexion has previously identified two other agencies which said they had a ‘mutuelle’ equivalent for second-home owners on temporary long-stay visas for an extended (but not permanent) trip.

Generali France’s Agence Eaton in Arradon, Brittany, stated it had a form of top-up insurance for those in the UK system with an Ehic or Ghic and a long-stay visa. It said the price varied depending on personal factors.

Swiss Life France’s Bordeaux agency said it, too, offered insurance topping up the part of costs not reimbursed under the Ehic/Ghic if UK residents declare they are living in France for a fixed time on a long-term visa.