Non-UK residents lose NHS benefits

A two-page article recently appeared in a UK national newspaper that caught me with a jolt.
The subject was that a large number of Britons, out of nearly one million who have emigrated to Spain, have found themselves plunged overnight into a healthcare nightmare.
One example given was a person who became very ill with cancer; his E106 expired and he could not get treatment either in Spain or in England. He had to pay himself and it took his life savings.
This is not an isolated case, out of 200 people in one settlement, 60 had the same problem. There were more examples and the conclusion was that thousands of Britons living in Spain could find themselves in the same situation.
Does the same problem apply to people coming to live in France?
Already there are indications that it does.
At Exclusive Healthcare we receive about 100 calls a day to our helpline and the number of people who could have trouble is increasing as France tightens up on its healthcare budget. Fortunately, most of the people contacting us have just lost, or are about to lose their cover, and ask us what they should do.
However, a mother in France called us a few days ago. Her young daughter had broken her wrist and she had to pay the bills for treatment.
She wrote “I am desperately trying to sort out my family’s health cover.”
Her E106 had expired and cannot be renewed.
This chain of events prompted me to carry out preliminary research in the UK, which confirmed my fear that what has happened in Spain is part of a general picture. If you have become resident in another member state you cannot return to the UK for treatment although if you fall ill during a visit you should be given treatment if you have an EHIC (France a CEAM).
However, if your E106, for instance, has expired your CEAM will probably
be invalid.
I asked how you could become entitled to treatment in the UK and were told that it was only possible if you had a UK address and re-established residence in the UK as cover under the NHS is by virtue of residence alone and paying UK tax is not relevant.
Our informant said that some people tried to get round the problem by giving a relation’s address while arranging their own accommodation but there still remained the problem of registering with a doctor.
This had become increasingly difficult during the last two years as doctors are now responsible for managing their own revenue.
The position varied from one area to another and if you could not find a doctor in your area you should go to the nearest Primary Care Trust, which would try to find a doctor who would accept you. Many people living in France believe that they can go back to the UK for treatment and the doctor they had previously been registered with could help them. We were told that it is fraudulent to do so and if it was discovered the appropriate measures to recover the costs would be taken.
I then considered the situation in France and of course it is much better than it is in Spain and in some other EU member states. Here we have what I call the Fallback Option when all else fails.
This is Couverture Maladie Universelle (CMU) of which most people are aware these days. France is in the lead once again with its healthcare system.
The CMU Law No 99-641 provides that, subject to proving ‘stable and regular residence’ for not less than 90 days, proof of identity and observing the regulations regarding residency, you can make an application to CPAM under the terms of the law.
Moreover, you are covered on the day you lodge your application and if further documents are required you have two months to supply them.
Sadly, it is said that a great many immigrants have failed to declare their true means or submitted a tax declaration at the earliest possible opportunity and this has made the French authorities wary. We have a stream of callers who tell us that they realise it is their own fault that they have been refused immediate cover because they have not bothered to get into the tax system until the point of their E106 expiring.
In fact, there is nothing difficult about arranging your affairs so that you do not have problems as long as you start the process without delay. Here are some ground rules:

1. If you decide to become resident in France you are subject to French law, systems and regulations from the outset. That you have a UK Passport makes no difference; it is valid in all member states and you have the same rights and obligations as a citizen of the member state in which you are resident whether it be the UK or France.

2. This means that you must declare tax according to French regulations although if your income or part of it is taxed compulsorily in the UK, under the double taxation convention, you will not pay twice. If you have arrived in France and cannot yet make a declaration for tax (usually done each May) you should go to your nearest tax office and register your presence and address. Ask for an acknowledgment as even if you have an E121 you may need it.

3. If you have come here with the intention of working, research the rules and follow them.

Article written exclusively for The Connexion by Larry Fulton, Exclusive Healthcare. www.exclusivehealthcare.com