With the French Government circular on health cover now published, what are the circumstances in which early retirees can join the French national health system? If you are relocating to France from within the European Economic Area to retire, then the use of Form E106 is available on the same terms from your home country, as was previously the case. This grants you up to 2.5 years of health cover in France. Once cover under Form E106 has expired then, hitherto, it has been possible to obtain continuing health cover in France under the Couverture Maladie Universelle (CMU). However, in November 2007 the French Government introduced new rules that deny access to the CMU for early retirees from the EEA who do not take up employment, or start a business. Accordingly, if you relocate to France under the age of retirement with the intention of living off your capital, and/or early retirement pension then, when cover under the E106 expires, you will need to take out private health insurance. This insurance will also need to cover trips back to your home country, as you will not be eligible for a European Health Insurance Card, which is only available to those in the State system.
At this stage the precise application of these rules is not entirely clear simply because, as we reported in a recent Newsflash, detailed technical guidance has yet to be issued to the local health authorities.
Under the new regulations there is provision for those who relocate to France and subsequently develop a serious medical condition, that makes it impossible for them to obtain private medical insurance, to make application to join the CMU. Although this would seem to exclude those who relocate with an existing medical condition, we are not so sure the rule will be so automatic. Some local health authorities with whom we have spoken advise us that it would depend on the circumstances. Thus, it may well be that someone who has suffered from a life-long serious medical illness, or disability, would be admitted to the CMU. Neither is the picture a uniform one across the country insofar as existing expats are concerned. Whilst some local health authorities have granted access to the CMU for some who arrived in France with a prior medical condition, others are taking a tougher line. Accordingly, if you are proposing to relocate to France, and feel you might qualify on medical grounds, then you would be well advised to make enquiries to the relevant local health authority (CPAM) before you relocate. At a minimum, you will need to prove a refusal of private health insurance in order to make application on this basis.
The same provision also applies to those who relocate to France and later suffer some other 'accident of life', such as death of spouse or divorce. Such persons are also entitled to make application to join the CMU. This provision is an interesting one because, on their own, neither divorce, nor death of a spouse would necessarily make it impossible to obtain private health insurance. The test of eligibility seems to be an 'economic' one. In these circumstances, the circular suggests that a successful applicant on a low income could then also become eligible for free national health cover under a related health scheme called the CMU Protection Complémentaire (CMU-C).
If you take employment, or start a business in France, which later ceases (either through termination of contract, or because the business does not succeed), then you will be able to make application to join the CMU. This is because the new regulations only exclude those who relocate without employment and remain 'inactive'. Once the cycle of inactivity is broken, and you become involuntarily unemployed, you would be entitled to make application to join the CMU. At this stage it is difficult to assess how the local health authorities are going to interpret this rule. However, the indications from the circular are that EU early retirees would then enjoy the same rights as French nationals, granting them an entitlement to join the CMU for an unlimited duration, with even less than one year in employment. You can read more in a recent article we published at A Strategy for Health Cover. It is also worth noting that if you run a business in France (during which you will have paid health and retirement contributions), you can retire at 60, and then receive health cover in your retirement, despite the fact that you may be below the age of retirement of your home country.
Once you have been resident in France for 5 years, you will be entitled to join the CMU, in accordance with a rule that applies throughout the European Union. Accordingly, if you arrive in France on a fully paid up E106, then the maximum period for which you will be required to take out private health insurance would normally be 3 years. In all cases, when you reach your official retirement age you will be entitled to free affiliation to the CMU, provided you are in receipt of state pension from your home EEA country. You can read more in our Guide to the French Health System