Lifestyle and Leisure
The French health service
If you contribute to Sécurité Sociale in France you and your family will be entitled to excellent subsidised and, in certain cases, free medical and dental treatment
The French health service is one of the best in the world – though heavily subsidised. Benefits include general and specialist care, hospitalisation, laboratory services, medicines, dental care, maternity care, appliances and transportation. Those who don't automatically qualify for healthcare under the national health system can contribute voluntarily or take out private health insurance. "Generally, all Frenh residents must register with the country's health service", says Peter Owen of Expat Health Direct.
"However, there are exceptions and it can be both practical and possible to have full private insurance provided you plan sufficiently ahead. "The actual registration is fairly straightforward provided you have done your homework beforehand. Most people do not do it thoroughly enough and, therefore, face bureaucratic obstacles."
Sécurité Sociale has introduced an electronic credit-card-style card (carte a puce), called the Carte Vitale, which contains your social security number and covers all members of a family. The card is valid for three years. A new version of the card, which will carry a photograph of the holder and will be linked to a computerised system containing all your medical records, will come into effect in 2006. Under the French national health system, health treatment is assigned a basic monetary value (tariff de convention), of which Sécurité Sociale pays a proportion. The amount paid depends on your social security status, the kind of treatment received and whether the practitioner has an agreement with the Sécurité Sociale department.
Under the current system, when you visit a medical practitioner whose fees are wholly or partly refundable by social security, simply present your Carte Vitale and reimbursement will automatically be put in motion, although you must still pay your doctor and wait to be reimbursed. It is important to note that to obtain a residence permit in France, the carte de sejour, all foreigners must be able to prove that they have health insurance, covering partial or total reimbursement of their medical expenses. You may have a French property that you only visit for short periods, in which case, as a non-resident you will not be registered with the French health service. "If you are in France for only a few months of the year there are a few options", says Owen. "The new E111 (issued since the Summer of 2004) now covers 'necessary' as opposed to 'immediately necessary or emergency treatment. This will still not cover all your costs but it is better than nothing. It is only available for EU/EEA/Swiss residents visiting other EU/EEA states and Switzerland on temporary visits. "Travel insurance is another option but it will only be for emergency medical expenses and claims related to any pre-existing conditions are unlikely to be met. "If you have both a UK travel insurance and E111 then many insurers will waive the excess on any medical claims if E111 is used to pay part of the bill", concludes Owen.
French health service experience
When Sandie Marshall of the Granny Network and her husband Mark needed medical attention in France they were astonished at the level of care they received and were glad they had their Cartes Vitale and E111 forms to hand. Sandie tells her story. "When we arrived in 2000 I made sure one of the first things I did was to make sure that Mark and I both had our Cartes Vitale, which reimburse approximately 65 per cent of medical charges, and had also taken out a top-up medical insurance, which reimburses the remaining 35 per cent. "In July 2000 Mark was suffering from an agonising headache for two days, and I took him to La Roche sur Yon hospital. "Ten minutes after speaking to the receptionist we were seen by an eye specialist, who found some conjunctivitis, but unsatisfied that he had found the root cause of the problem the doctor decided to seek another opinion – and, he walked us through the hospital himself to introduce us to the ear, nose and throat specialist. "This doctor carried out many tests and came to the conclusion that Mark had shingles in the head. "But, he didn't stop there. He advised Mark that he should have a brain scan to make sure, and at 3pm that afternoon Mark had his X-ray sheet showing his brain – with nothing untoward, thank goodness. "So, clutching an armful of prescriptions, we paid the hospital bill, which after presenting our E111 came to the equivalent of £27 for all that treatment and time. "Unfortunately, we were to have another hospital experience in October 2003. Mark had been complaining for several days of a burning sensation from his throat to his stomach. I dialled 15 – for the emergency doctor service – and four of them arrived. "Mark was having a heart attack, and as they had arrived in a four-seater vehicle, they called 18 – the number for the pompiers, the foremaen who act as ambulance and paramedics in France. "Mark had intensive care for three days, with his own direct phone line, then he was moved to a private room with an ensuite bathroom and TV. The cost for call outs and treatment? Twelve euros – for the TV!"