2. Health Insurance Cover in France

1. 2.1. E106 Health Cover
   2.2. Health Cover for Self-Employed
   2.3. Health Cove for Cross-Border Workers
   2.4. E121 Health Cover for Retired Persons
   2.5. Health Cover for Early Retirees
   2.6. European Health Insurance Card (EHIC)
   2.7. Travelling Abroad from France

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2.4. E121 Health Cover for Retired Persons

We define a 'retired person' as someone of the age of retirement of the country of origin, with no professional activity, and in receipt of a State pension from their home EEA country.

We also include in this category for E121 purposes those persons under the age of retirement, but in receipt of long term incapacity benefit.

The early indications from the British Government are that the benefit will be exportable to France, although future claimants will be required to demonstrate a satisfactory national insurance record, and all claimants in France will be required to go through a periodic 'Work Capability Assessement' by a French doctor.

If you are relocating from within the EEA and you are retired and in receipt of a state pension, or you suffer from long term incapacity then, in order to register with the French health service, you will need to bring with you Form E121 from the social security authority in your home country. This form should be presented to your local French health authority, the Caisse Primaire d’Assurance Maladie.

This does not mean you will get free health care in France. It means that you will not need to pay into the French social security system in order to obtain health cover.

However, as the social security system only covers around 70% of basic health charges, like everyone else in France, you will need to take out voluntary ('top up') health insurance if you wish to cover those charges not met through the social security system.

You will also be responsible for paying some residual costs that are not picked up by either the social security, or most voluntary health insurance systems.

So do not assume an E121 picks up all your health costs. It does not, although most are covered.

That said, a person on long term incapacity benefit is likely to be entitled to receive full reimbursement of all the medical costs relating to their condition, provided it is classified as a affection de longue durée – (ALD) by the French Government.

Similarly, anyone who suffers from a long-term or major illness is likely to find that 100% of costs in relation to the treatment of this illness are covered by the French social security system, provided it is also on the list of affections de longue durée – (ALD).

The definition of just what is regarded as being 'dependant' includes all those in a married relationship or in a civil partnership. Thus, even though your spouse may have an independant source of income, they would be admitted as a dependant. Only in the case of those not married, or in a civil partnership, would it normally be necessary to prove financial dependancy.

The decision as to who is dependant is not made by the French authorities, but by your country of origin. Some local health authorities in France have been known to contest dependancy status, but the cases have been rare, and generally not upheld.

In the event that the holder of an E121 dies before their 'dependant' younger spouse reaches retirement age, then the surviving partner will continue to retain health cover through the E121 for 12 months.

If you have not reached retirement age by the end of this period, then you can make application to the French health authorities to be admitted to the State health insurance system, on grounds of 'accident of life' provisions, which also cover the dependant spouse in the event of divorce. You would be required to pay health contributions, but these would be related to income, and those on a low income are entitled to free cover.

On this basis, a dependant younger spouse of a retired person should always be able to obtain State health cover in France.

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