How works the health insurance in France for British patients? 

How works the health insurance (Assurance maladie) in France for British patients? 

How does the healthcare and insurance system in France operate for British nationals? This question is becoming increasingly common on the other side of the Channel. According to an article in The Sun from April 2024, thousands of Britons are seeking surgery abroad due to long waiting lists for essential operations in the UK. Since the pandemic, the number of patients compelled to pay for treatment abroad has surged by a third. The British media is now referring to these individuals as "NHS exiles"! 

As reported by The Sun, France is renowned for its more affordable healthcare costs. For example, angioplasty costs £7,700 in France, whereas it is £10,000 in the United Kingdom. Consequently, many patients are seeking heart surgeries as well as hip and knee surgeries, or foot surgery, endometriosis treatment in France. 

Medical care in France for foreigners.

However, according to the british government, anyone residing in France must have health insurance coverage. State public healthcare in France (Assurance maladie) is not free; costs are shared between the government and patient contributions. Medical treatments and tests are partially funded by the government, with the patient covering the remainder. French state health insurance covers 70 to100% of necessary treatments, such as doctor visits and hospital stays. 

How does it work if you want to go to France for medical treatment as a UK citizen living in the UK, especially after Brexit and the introduction of new regulations?

The Centre français des liaisons européennes et internationales de sécurité sociale (Cleiss) serves as the intermediary between French Social security institutions and their foreign counterparts for implementing European regulations and bilateral or multilateral social security agreements. Cleiss provides information in English about new regulations following Brexit. Post-Brexit agreements include a social security protocol, with similar advice offered by the French government.

Therefore, if you are a UK citizen and wish to receive medical treatment abroad, you will need to follow these steps:

If your care is authorized by your UK health insurance provider (NHS) or commenced before the end of the transition period, you can complete your entire course of treatment in France.

You will need to apply for and obtain prior authorization from your UK health insurance provider (NHS). If your application is approved, you will be issued an S2 form, which must be submitted to the French authorities. Without this approval, you will be responsible for covering the full cost of your care out-of-pocket.

The trade and cooperation agreement, which applies from January 1st, 2021, allows for coverage of scheduled treatment on the basis of prior authorization. This will apply to applications submitted after the transition period ends on January 1st, 2021.

If you are a UK citizen "expat" living in France and need to get treatment in France. 

If your insurance coverage is British and your employer is also British, but you are living in France, as an expat and your situation has not changed, you continue to qualify for the same benefits under the same rules as before, based on the S1 portable document. The only change is that from October 1st, 2021, you need to obtain a residency permit (permis de séjour). 

If you are a UK citizen living in France and you have a UK pension. 

If your situation has not changed, the European Social Security coordination rules will continue to apply. This means that your healthcare expenses in France will still be covered by the French social security system on behalf of the United Kingdom. You must have the S1 portable document titled “Registering for health care cover.” If you do not have it, you need to apply for it through your UK retirement pension.

If you also start receiving a French pension and continue to live in France, the coordination rules stipulate that your health insurance will then be provided directly by the French system. Obtaining a residency permit (permis de séjour) has been mandatory since October 1st, 2021. 

Students studying in France.

If you began your studies in France before December 31, 2020, and continue studying beyond that date, the rules remain unchanged: you will need to show your European Health Insurance Card (CEAM or EHIC). However, a residency permit (permis de séjour) has been mandatory since October 1st, 2021, even for students.

If you became a student in France after the end of 2020, you fall under the Trade and Cooperation Agreement, which includes provisions on student healthcare coverage similar to the European social security coordination regulations. You can continue to use your EHIC. 

If you travel to France and need health care. EHIC.

UK citizens with a valid EHIC card can still use it. Since 2020, UK authorities have issued a new EHIC (EHIC CRA) for citizens with expired EHICs, ensuring their rights are maintained. Other citizens can request a Global Health Insurance Card (GHIC), which replaces the EHIC. 

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