The Brexit deals and how they affect healthcare

Two Brexit deals were signed, with implications in the first case for Britons already living in France before the end of the transition period, and in the second, for those moving to or visiting France afterwards.

The first deal, the Withdrawal Agreement, provided the terms and guarantees for continued social security protection for Britons who had their residency established in France prior to December 31, 2020. Those fitting this category were eligible to apply online for a Withdrawal Agreement (WA) residency card.

The card allows them to maintain the same rights as EU citizens before Brexit with regard to health and social security. Close relatives including spouses, civil partners and dependent children joining them post-Brexit can also benefit, where the relationship pre-dated Brexit.

For WA beneficiaries, the card confers benefits including maintaining S1 healthcare coverage for UK state pensioners and the right to continue receiving uprated UK state pensions each year, as well as retaining the ability to export disability benefits abroad. It also confers the right to receive French benefits on an equal basis with French nationals.

Those benefiting fully, who could show that they had lived in France for five years or more or who were married to a French person, obtained ‘permanent stay’ cards. They must be renewed every ten years in a simple process; demonstrating proof of health coverage will not be required.

Other Britons living in France before 2021 obtained five-year cards and are in theory entitled to apply for a 10-year card once they can show five full years of living in France. As part of applying for these five-year cards applicants had to prove that they were already covered for healthcare in France, in most cases by belonging to the state system.

For most applicants, the attestation de droits issued by the local Cpam, certifying that the insured person is a registered beneficiary, was sufficient proof.

Five-year cards issued to those living in France before 2020 will be expiring in late 2025 to 2026 in most cases (depending when issued) unless renewed.

Children of UK nationals who are registered as permanent or five-year card residents under these rules are covered by the same social protections as the parent. This extends to healthcare.

Foreign (non-French) spouses of WA residents enjoy the same benefits, provided they were married before the end of the Brexit transition period.

Since January 1, 2022, all UK nationals residing in France under the terms laid out by the WA are required to own a WA residency card (people arriving post-Brexit as family members of WA Britons should apply as soon as possible). 

This new card must be marked accord de retrait du Royaume-Uni de l’UE and is different from the cartes de séjour that some Britons previously obtained as EU citizens – these cards are now invalid for them.

Britons moving to France since 2021 benefit from provisions of the second agreement, known as the future relationship deal or, officially, the EU-UK Trade and Cooperation Agreement. This covers, among other points, the situation of visitors and second-home owners.

This second set of measures has also put in place a structure for continuing coordination of reciprocal healthcare rights and exportable benefits.

The UK and EU agreed that the social security, including healthcare, aspects of this deal must be renegotiated every 15 years. As a result, the various provisions governing social security protection for foreign residents should, in principle, remain valid until at least 2035.

While it maintains some of the same rights as before in healthcare terms, notably the S1 for state pensioners and Ehics/Ghics for visitors it does not mean Britons can simply move over and apply to the local Cpam after arrival, without formalities, as they could as EU citizens. Visas prior to arrival are now needed.

Non-EU citizens moving to France may need to take medical 

Some non-EU citizens who move to France are called in for a medical. This does not concern people who are on temporary stays (usually up to six months) and there are also exemptions for holders of certain kinds of visa such as the passport talent (for certain highly-qualified or experienced individuals).

The medical is done at the premises of Ofii, a body concerned with integration of newcomers. In the case of a retirees’ visitor visa, for example, people are called in after applying to validate their visa online, which must be done in the first three months. 

We note, however, that as of 2025, the process has changed for Britons, who are now sent a form to fill in with their GP and are only called in if this raises specific concerns. 

The medical typically includes a lung X-ray and is part of a meeting at which newcomers’ visas are officially validated for residency purposes in the first year (Britons who are not called in will be sent a certificate in the post). We asked the Ofii office of Limoges whether health problems can invalidate the person’s right to stay. 

An official said it is just a required check for the validation process. Any problems that may be flagged up would not invalidate the person’s right to stay but they may be steered towards appropriate support, the official said. 

The checks are also intended to help limit the spread of diseases. The new process for Britons aims at reducing the number attending Ofii (which they did not have to do prior to Brexit).