HEALTH CARE

EHIC

All citizens of EU member states are entitled to health care in other member states as well as in the European Economic Area, which includes Iceland, Liechtenstein, Norway and Switzerland.

Until recently you required an Eform – such as an E1 11 or El28. Those who applied for these forms after July 2004, and who have subsequently remained resident at the address from which they applied, should already have been added to the national database and their new card – the EHIC – should by now have been issued.

The new EHIC is available through national social security systems. The card entitles you to ‘necessary’ health care in the public system if you become ill or injured, but may not provide the full cost of health care. Further, the card does not cover the cost of repatriation or ongoing or continuing care for chronic conditions other than those specified such as serious such as diabetes. The EHIC may also not cover someone who ‘decides’ to have treatment for a chronic condition in another member state. This, however, is currently a matter of legal interpretation. There have been cases, for instance, when a person who has been waiting for treatment ‘beyond a reasonable time’ has successfully recovered part of the cost of ‘necessary treatment’ in another EC country.

In theory, the question of reimbursement for medical costs will remain as before the introduction of the EHIC. In practice much of the former chaos remains. You may still have to pay for your treatment at the point of delivery and then claim a refund in the UK. And that refund may not necessarily cover the full cost of the treatment.

The card has courted controversy, not least because it is seen as another step towards federalism. Ultimately a common model of the card – featuring the EC logo – is to be applied. It will be a smartcard, which could contain medical records and, perhaps, iris recognition data. There are not, however, presently in existence technological systems that allow the interchange of this kind of information beyond national boundaries.

Paying for medical top-up insurance is highly recommended.

Medicines

Short-stay visitors (those who have not applied for a carte de séjour) should take an adequate supply of regularly-required medication with them. Each medicine should be labelled with both its generic and trade name, and dosages should be clearly indicated.

NHS doctors are encouraged to supply only limited quantities of medicines, so if you intend to be out of the UK for more than a month you will need certificate E1 12 to get further supplies in France. Enclose a covering letter from your doctor and write to:

Department of Health
Overseas Branch
Richmond House
79 Whitehall
London SW1A 2NL
(0207 210 4850)

Some pharmaceutical products are marketed in France with different brand names and others are formulated slightly differently. In some cases (particularly for patients suffering from a heart condition) it is best to arrange for an imported supply of medication. Doctors can give long-term prescriptions to UK pharmacists who can arrange for dispatch in sealed packaging together with the appropriate customs declaration. You should expect to pay around extra €3 per package in addition to normal prescription charges.

It is worth remembering that French pharmacists, like their English counterparts, offer good advice on simple medicines like pain killers, mosquito repellents or those offering relief from cold symptoms.

Mail delivery times between France and the UK are notoriously irregular. It may be wise to retain several days’ emergency supply of regularly-used medication.

Dental and Eye Care

French dentists and opticians are amongst the best qualified in Europe.

Replacing spectacles and contact lenses is straightforward if you have a copy of your prescription. Failing that, a phone call or email to the UK can quickly remedy the situation. A new eye test will be automatically carried out if the prescription is more than five years old (three years for those over 70 years of age).

There is a special ‘dial a dentist’ service for emergency home treatment, and for those staying in temporary accommodation. Charges are made and reclaimed in the same way as for other medical services.

Health Care for Residents

If you become resident in France you can choose to make voluntary contributions to the Securité Sociale which administers the French Health Service. If you are retired (and in receipt of the UK state pension) you are, theoretically, entitled to health care without making a contribution. Form E121 is required to prove this entitlement. Residents, whether retired or not, should seek a more permanent solution. Again, this will inevitably include top-up health insurance.

Choosing a Doctor

As in the UK you are theoretically entitled to choose your own medical practitioner. In practice this may also mean registering at a local health centre or clinic.

However, French doctors are more likely than their UK counterparts to be working independently. Some are similar to our GPs, but the majority offer an additional, specialist qualification. This specialist work is the most lucrative, so French practitioners make a concerted effort to promote this area of their work. Choosing a doctor is therefore not as straightforward as in the UK. Yellow pages may help, but personal recommendation is better.

Take family documentation to the Relations Internationales department of the Securité Sociale. This should include passports and marriage certificates, including translations.

The Relations Internationales department are unable to recommend any individual doctor or practice. They do, however, provide information about many aspects of health care, and they hold lists of practitioners, together with their specialisms.

Medical Insurance

The French private health scheme is called the Mutuelle. By joining you can reclaim any payment you have made for medical charges. In most cases you are claiming back from the Health Service the difference of approximately 25% of total treatment charges that you have had to find from your own pocket. In certain circumstances (such as disability) it is possible to claim a supplementary or top-up pension. Again the Relations Internationales department will be able to explain the rules to you.

The French Securite Sociale is a network of organisations that provide welfare benefits which are more extensive than their UK equivalents. Joining the scheme is expensive, so private medical insurance is well worth considering and this is often cheapest and simplest to arrange in the UK. However, insurers may question a claim made from France unless you make your intentions clear on the proposal form. It is also worth checking the wording of the policy for limitations and exclusions sometimes applied to extended illnesses and chronic medical problems.