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Health Insurance for Expats in France

Submitted: October 2013

Private health insurance is good to have, as it may cover some expenses which are not fully covered by social insurance. An international health insurance policy would certainly be suitable, but a French policy (complémentaire santé)can be an easier and cheaper option.

The French tend to rely on non-profit insurers (mutuelles) when it comes to health insurance. Unlike for-profit insurers, non-profit insurers will not ask you to fill in a medical questionnaire. In other words, premiums will not depend on your health. Your age, however, may be factored in.

Under a national collective bargaining agreement signed on 11 January 2013, private health insurance will be made mandatory for all employees from 1 January 2016. The cost will be equally shared by employees and employers.

Do you need to have private health insurance?

France’s healthcare system is based on co-payment. Consequently, social insurance tends not to fully reimburse healthcare expenditures (subject to a few exceptions). Here is an example for a basic GP consultation:

Example

Cost of a GP consultation: €23 (to be paid upfront by the patient)

Social security refund: €23*0.7 – 1 = €15.1

Remaining out-of pocket costs (without private insurance): €7.9

Private insurer refund: €23*0.3 = €6.9

Remaining out of pocket costs (with private insurance): €1 (statutory excess)

The point of social insurance is not to fully refund you, but to keep out-of-pocket costs anchored, even if something really bad happens. Hence, the need to be protected against sky-high medical costs is only residual – unless you need to return overseas.

A non-profit health insurance policy is definitely good if you need peace of mind or if you have an ugly medical history. Nevertheless, a private international cover might be helpful if you intend to leave France later on.

International cover

You should check the geographical coverage of your existing insurance policy, if you have any. A French health insurance policy is unlikely to work outside France unless you specifically applied for an international cover. Many non-profit insurers offer international health insurance for expatriates.

If you rely a foreign policy but you haven’t been sold it as an international insurance cover specifically designed for expats, your policy is unlikely to work in France. In that case, you should let your insurer know that you are moving to France, and switch to an international cover. Your insurer is likely to charge you extra for this, but do bear in mind that the very fact of being insured in several countries carries an extra burden as well.

A good international cover would insure you against:

  • medical costs in France
  • medical costs in your home country (or another relevant foreign country), and
  • medical evacuation costs (without adequate insurance, these can cost thousands of euros).

State support towards health insurance

If you are on a low-income, the Government may help you with private health insurance costs.

If your income is below €8,593 per year, you may apply for 100% coverage from social insurance (CMU-C). If you qualify, there is nothing to pay at user-point: the French Government meets all of your healthcare costs.

If your income is below €11,600 per year, you may apply for a health insurance voucher (ACS). These vouchers can be credited against any health insurance premiums that you would have to pay. What you will get is designed to be slightly below what you pay for a typical health insurance premium. ACS benefits are set as follows:

Age

Benefit (EUR)

Up to 15

100

16 – 49

200

50 – 59

350

60 and over

500

Finally, private health insurance premiums are often tax-deductible. Pursuant to article 83 1° quater of the French Tax Code, employee private health insurance premiums are tax-deductible for so long as they are made mandatory by the employer or by a collective bargaining agreement. If you are self-employed, you would need to take out private health insurance under a Madelin scheme.

 

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