Amariz | Expatriates

Legislation has recently come into force in France which affects expatriates living, or intending to live, in France who are under retirement age and who do not work.

If you moved to France after the 23rd November 2007, have been living there for less than 5 years and do not have a valid E106 or E121 from the British authorities, you will no longer be entitled to state healthcare in France and will have to take out private medical insurance.

If you find that you now require private health cover, please contact us for further information on Option 1 of the Opale health insurance plan, which reimburses medical expenses at 100% of the ‘tarif de convention’, or visit the ‘documents to download’ page of our website.

Unlike the NHS in the UK where treatment is free at the point of delivery, in France you have to pay the majority of healthcare providers up-front and then be reimbursed.
The French Social Security defines the cost of virtually every type of medical treatment using the ‘Tarif de Convention’ (official or conventional rate) and reimburses medical expenses at an average of 70% of this rate.

For example, the ‘Tarif de Convention’ for a consultation with a doctor is 22.00 Euros. If your nominated GP was ‘conventionné’, you would pay him the 22.00 Euro consultation fee directly and be reimbursed 15.40 Euros by the French Social Security. If you were covered under the top-up option of the OPALE plan, we would reimburse the remaining 6.60 Euros.

Some healthcare providers are ‘conventionné – honoraires libres’ and charge over and above the ‘Tarif de Convention’, so if you were charged 35.00 Euros for a consultation for example, the French Social Security would reimburse 15.40 Euros, and Level 1 of the top-up option of OPALE would reimburse 17.60 Euros (as the maximum supplementary reimbursement is 150% of the ‘Tarif de Convention’, i.e. 150% of 22.00 Euros).

It should be noted that treatment received from providers who are ‘non conventionné’ will not be reimbursed by the French Social Security and that if you do not have nominated GP and/or go to see another doctor without referral from your GP, they will only reimburse you on the basis of 50% of the ‘Tarif de Convention’.

You can choose to either pay for the remainder of the cost of treatment yourself or, like the majority of people in France, take out what is known as a 'top-up' policy (complémentaire or mutuelle) .

These policies are designed to:

reimburse part or all of the difference between the actual cost of treatment and the amount paid by the basic medical insurance scheme

provide cover for certain types of treatment not which are not reimbursed by the French Social Security (e.g. private rooms in the event of hospitalisation)

ensure that you receive an acceptable level of reimbursement for dental and optical treatment which are poorly indemnified under the basic medical insurance scheme.