Livvy48

Hi everybody, I have just joined and am looking to tap into your combined brainpower! My wife and I, both 70 and retired, are moving to France this year, as soon as we can sell our house in Lancashire, and will register as French residents. I have read extensively about the Healthcare system in France, but still would appreciate some input from people on the ground, as it were.
I have looked at the cost of Private Health insurance, and they are talking over £300 per month for each of us - out of the question on our combined annual gross of about £30k, made up of UK state pensions and private pensions.
It looks as though we need to complete an S1 form which will then entitle us to access to the French healthcare system. Am I correct so far?
I have also read about "top-up" insurance. Does anybody have experience of that?
I am assuming, perhaps optimistically, that UK and EU thrash out an agreement which provides the status quo for residents in place in March 2019.
Appreciate any feedback thanks

EuroTrash

Yes, you've understood correctly - except the S1 isn't a form for you to complete, it's a document that you ask DWP to issue. The S1 is the official document whereby DWP confirms that it will refund to France the cost of your healthcare. You need to give this to the French healthcare office so that they can record the details, put it on file and enter you into the healthcare system.

Most people take out top-up insurance because healthcare isn't free at the point of delivery. For most medical treatment the state reimburses around 70% of the cost and the rest you would pay out of your own pocket, if you don't have insurance to cover all or some of it.

If you decide to take out top up insurance, you need to spend a while getting your head around it. It seems complicated at first because you would assume that 100% insurance means that you are 100% covered, but it doesn't. What it means is that your insurance covers 100% of the state-recommended fee for that particular treatment. But many healthcare providers charge more than the state-recommended fee. So if you only have 100% topup, you'll still have to pay the difference between the actual fee and the state-recommended fee.

Eg you have a treatment for which the state recommended fee is 100€. However, the fee charged by your clinic is 150€. The state reimburses 70% of 100€, ie 70€. Your insurer tops the reimbursement up to the state recommended fee, ie another 30€. Leaves you 50€ to pay.

So you can take out 150% or 200% topup, but of course the premiums would be higher.

As regards Brexit, nothing is set in stone but I can't imagine anyone is going to start taking S1s off people who already hold them, so I think you'll be pretty safe on that. As far as I can see, the only precaution you need to take is to ensure that your income is above the threshold for "legal" residence, because you'll probably need to prove that in order to be given the right to remain in France after Brexit, and the 30k you mention is well above the threshold.

Hope the move goes smoothly

cyrian

Hi Livvy,
Can't add much to ET's reply other than the mutuelle top-up insurance is a menu type insurance. You can add on things like dental and optical cover or enhanced hospital services like better room; tv etc.
Be aware that if either of you eventually require residential care in France then it would be your family who would be responsible for paying the bill.
I would suggest that you consider renting in France rather than buying.
Renting is much more common in France than in the UK and (if you have children) you would avoid the issues with inheritance tax and succession.
Property is not an investment in France and can be a liability if you live out in the sticks.

HTH

Livvy48

Many thanks Eurotrash and Cyrian. Most helpful. You can read the articles on the various websites and still end up scratching your head because what you think is a straightforward situation is portrayed as much more difficult by the "experts". Your answers have given me more information in a few minutes than a bookfull of advice!
As far as the renting, Cyrian, it is certainly out intention in the first place to rent for at least 6 months, but the interest on the proceeds of our house sale will be funding this, and that capital will not generate enough interest to make that a long term option I think.
But I take your point about Inheritance issues, which I have researched as well - although I seem to recall reading that there may be a route around that?

EuroTrash

Have you thought about keeping a rental property in the UK, either your current house or a smaller place? The rent from it would probably cover your rent in France, and it would leave you a way back to the UK if you needed it.

I know it's depressing to talk about worst case scenarios, but the situation to be avoided is one or both partners getting to the stage where they need residential care, being unable to sell the French house (because houses don't tend to sell fast in France), being taken into care, running out of funds and ending up with a French court order on their children in the UK to pay the care costs. As Cyrian mentioned, under French law children are automatically responsible for their parents (and vice versa) - the French state will only contribute to the costs if, after studying the details of the children's financial situations, the judge decides they can't afford to contribute without causing hardship to their own housholds. It's not like the UK where if the parents can't afford to pay for themselves, the state takes over and the children don't have to pay a penny.

Livvy48

Eurotrash, yes we have considered that, and it may well be that we take that option, not with our existing house, but with a smaller property.
Christ, this is good stuff. I am learning so much. Thanks guys.

scot47

Anecdotes I have heard suggest that Health Care in France is as good, or better than, the NHS

EuroTrash

I think you're right. Although to be fair one would have to add that it varies from hospital to hospital in both countries - there are excellent NHS hospitals, and there are time when hospitals and consultants in France fall short.

Big difference though is that NHS care is free at the point of delivery for everyone who is covered by the NHS. For most of us who grew up in the UK taking it for granted that it's the state's job to look after us from cradle to grave, it can take a while to readjust to the notion that actually, perhaps it's not unreasonable to expect people to take responsibility for their own health, and it should be top priority - saying we can't afford to pay for our own healthcare, when we've been able to comfortably afford no end of other lifestyle luxuries, is skewed thinking.

scrubbedexpat056

In the issue of children being responsible for residential care costs, indeed any care costs, for elderly parents in France, what is the case if you don't have children. Does the responsibility revert to any other close relatives?

LowriderChevy

I have lived here for about 17 years now and have never found a more clear and understandable explanation of the system than posted above by EuroTrash and cyrian.
"As far as I can see, the only precaution you need to take is to ensure that your income is above the threshold for "legal" residence, because you'll probably need to prove that in order to be given the right to remain in France after Brexit, and the 30k you mention is well above the threshold."
I have heard mention of this threshold many times but have never learned what it actually is. Does anyone know? I'm hoping I won't be kicked out because of it.

EuroTrash

Yes it's here
https://www.service-public.fr/partic...sdroits/F12017
just click on "ressources suffisantes" and then whichever age band you fall into, and it tells you the income level required according to household composition.
This doesn't apply to workers or the self-employed.

EuroTrash

AFAIK it is only 'direct bloodline' (or officially adopted) children, or if there were children but they have predeceased the parents but left children of their own, then they, ie the grandkids, would be responsible. If there aren't any direct line relatives, then the state will fund the care, and recoup the costs as far as possible from the estate.

It's to do with inheritance, and as always with France it's also about droits et devoirs, rights and responsibilities. Direct line children are protected heirs but if during their parents' lifetime they renounce their right to inherit, ie they inherit absolutely nothing, then they also renounce their responsibilities. That said, renouncing your inheritance is a fairly unusual and tightly regulated procedure and the courts will look at it carefully to make sure there is no attempt to abuse either one of the parties, or the system.

Other relatives such as siblings, nieces etc don't have the same rights nor the same responsibilities, they are not protected heirs.

LowriderChevy

Many thanks for the link. It wasn't good news. It appears I've been living below the limit the whole time I have been in France. I'll just have to keep my head down and hope I'm not noticed.

EuroTrash

It does say those figures are the maximum they can insist on. Basically it's about being self-supporting, and since clearly you are, that will hopefully be good enough.