SHARE
COPY LINK
Paywall free

BREXIT

Brexit: What will happen to your health cover in France (deal or no deal)

There is a lot of confusion over what Brexit means for the health cover of Britons living in France. Kalba Meadows who heads up Remain in France Together (RIFT) has taken a look at what would happen to our healthcare after Brexit, in both a deal and a no deal scenario.

Brexit: What will happen to your health cover in France (deal or no deal)
Photos: Depositphotos
Yesterday evening, many people found an unwelcome update from the UK government in their inbox, about healthcare for British citizens living in the EU if there is no deal.
 
It stated – rather blandly and as though it was of no great import – this: “If you have an S1 certificate, it will be valid until 29 March 2019. After this date, the certificate may not be valid, depending on decisions by member states.”
 
If you haven’t read it, you’ll find it here.
 
Unsurprisingly this has provoked something of a reaction today and has been picked up by many newspapers. And confusion reigns about post-Brexit healthcare in France for British residents, especially for those who are covered by the current reciprocal health care arrangement between the EU and the UK.
 
READ ALSO:

No-deal Brexit: British pensioners in EU to lose NHS healthcare cover

In this article we take a look at what would happen to our healthcare after Brexit, in both deal and no deal scenarios. 
 
First, though, a word about reciprocal healthcare. This is based on an agreement between the EU and the UK, and is covered by the EU regulation on the coordination of social security systems (Regulation EC N° 883/2004).
 
Contrary to popular belief, it isn’t based on bilateral agreements between the UK and other EU countries so when the UK leaves the EU it would no longer be a party to this regulation, which means that we – and EU citizens living in the UK – would no longer be covered by it.
 
IF THERE IS A RATIFIED WITHDRAWAL AGREEMENT 
 
If the UK leaves the EU under a ratified Withdrawal Agreement (a ‘deal’), those of us already resident in France can breathe something of a sigh of relief. This is what will happen.
 
Workers, self-employed and those who’ve retired after working in France
 
You’re already in the French health system, and France is your ‘competent state’, which means that it is responsible for funding your healthcare. You have, or can apply for, a CEAM – the European health card that covers emergency treatment in other EU countries.
 
Nothing will change for you if the UK leaves the EU under a Withdrawal Agreement. Your healthcare is unconnected with Brexit and is not affected by it.
 
France activates emergency plan for no-deal Brexit
 
UK state pensioners and cross border workers who hold an S1 form
 
Your S1 form means that the UK is your ‘competent state’ – responsible for funding your healthcare. You are affiliated to the French health system via CPAM and receive health care on the same basis as a French national, but the UK reimburses France for your health care costs. You have, or can apply for from the UK, an EHIC card that covers emergency treatment in other EU countries. 
 
Nothing will change for you if the UK leaves the EU under a Withdrawal Agreement. The draft Withdrawal Agreement continues the reciprocal health care / S1 scheme for British residents in the EU and EU nationals in the UK. This applies whether you currently hold an S1 form, or whether you’ve not yet retired but the UK will be your competent state when you do so.
 
Early retirees and others who are economically inactive and are currently covered by PUMa
 
PUMa (la Protection Universelle Maladie) is France’s universal health care scheme, open to all those who’ve been legally resident for at least 3 months. Those who don’t fit into either of the 2 categories above will have applied to join the PUMa scheme. It’s contributory, though not onerously so (see below) and for most people not at all, and is administered by CPAM (La Caisse primaire d'assurance maladie).
 
Nothing will change for you if the UK leaves the EU under a Withdrawal Agreement. You will continue to benefit from healthcare in the way you do now. If you later receive a UK state pension, the UK will become your competent state; you will then be covered by the provisions of the Withdrawal Agreement for reciprocal health cover and can request an S1 form. 
 
IF THE UK LEAVES THE EU WITH NO DEAL
 
If the UK leaves the EU without a deal things become rather more complicated, as there would be no Withdrawal Agreement and therefore no automatic continuing protection for Brits in France who are currently covered by reciprocal health care arrangements.
 
Workers, self-employed and those who’ve retired after working in France
 
Nothing will change for you if the UK leaves the EU with no deal. Your health care is unconnected with Brexit and is not affected by it.
 
What exactly is France's plan for a no-deal Brexit?
 
UK state pensioners and cross border workers who hold an S1 form
 
As the UK guidance makes clear, the S1 scheme will fall away by default on 30 March 2019, or on Brexit day if this is later. This means that the UK will no longer be your competent state and will not, unless it has entered into a bilateral agreement with France by that point, continue to fund your health care. We currently have no certainty about exactly how this situation would be handled, but this is what we do know:
 
In the preamble to France’s enabling legislation, it was stated that the forthcoming ordonnances could provide for the ‘mode and terms of contributions to be made by British citizens and their dependents towards certain benefits which would no longer be reimbursed by the UK social security scheme’.
 
This is a clear reference to the reciprocal health scheme, and we can expect the future access to the French health system for current S1 holders to be included in the ordonnance that is coming out soon and will cover our rights.
 
Everyone who has lived in France legally for at least 3 months has a right to join PUMa. The health administration for S1 holders is, like PUMa, administered by CPAM. It would be a simple administrative job to transfer current S1 holders into PUMa and it must be very likely that this is what would happen.
 
PUMa is, in theory, contributory. But contributions – 6.5% in 2019 – are ONLY due on capital income (rental income, income from investments etc) over €20,262 per person per year. Pension income is excluded. Few people therefore would pay to join PUMa.
 
Brexit: Brits in France must start preparing for the worst
 
If your healthcare was no longer funded by the UK, you could become liable to pay social charges on your pension(s), just as French people are, bit from which S1 holders are currently exempt. The base rate for this is 8.4%, with some reductions for those on lower incomes.
 
It’s important to reiterate that nobody living legally in France would be left without access to healthcare, even if there is no deal and even if the S1 scheme falls away. So if you are currently receiving treatment and are concerned about what might happen, please don’t panic.
 
Early retirees and others who are economically inactive and are currently covered by PUMa
 
Nothing will change for you immediately if the UK leaves the EU under a Withdrawal Agreement. You will continue to benefit from healthcare in the way you do now. If you later receive a UK state pension, your situation then would depend on whether a new bilateral agreement had been made between the UK and France and its terms. 
 
In the longer term, the UK government is pursuing the possibility of ongoing reciprocal health care arrangements with EU member states and is, according to a written answer to a recent Parliamentary question, ‘prioritising those that are the major pensioner, worker and tourist destinations’. 
 
We at British in Europe are pursuing all of this and will be talking with the relevant government departments in the UK, and with politicians, as soon as we can.
 
We are also closely watching the situation here in France and will bring you up to date on that as soon as possible once we’ve seen the ordonnance that covers our rights.
 
Kalba Meadows is a member of the steering committee of British in Europe and citizens’ rights coordinator of Remain in France Together.

Member comments

  1. Thank you for this article, and for the continued information flow on healthcare and other citizens’ rights.

Log in here to leave a comment.
Become a Member to leave a comment.
For members

VISAS

‘Be ready to wait’: Your tips for getting a French visa post-Brexit

Now that Britain is out of the EU, just how much harder is the process of moving to France from the UK after Brexit? British readers share their experiences of applying for visas as 'third country nationals’.

'Be ready to wait': Your tips for getting a French visa post-Brexit

Whether you’re moving to France to live, or you’re a second-home owner wanting to spend more than 90 days out of every 180 in France, if you’re British you will now need a visa.

You can find more on how to apply for a visa, and how to understand what type of visa you need, in our visa section HERE.

But how these systems work in practice is not always the same as the theory.

To learn more about the process of getting a visa as a UK national, The Local asked British readers for their experiences of going through the system.

The consensus among respondents was that the whole thing was bureaucratic, though there were notable differences in experiences that ranged from the “easy” to the “complicated” and “time-consuming”, while the advice for future applicants was, routinely, have all your paperwork ready – and be prepared for a lengthy wait at one of the UK’s TLS centres

Appointments

Like most visas, French visas for UK nationals must be applied for before you leave home. You can find a full explanation of the process here, but the basic outline is that you apply for the visa online, and then have an in-person appointment in the UK in order to present your paperwork. 

Sue Clarke told us: “As long as you get all your paperwork together correctly and in the right order, the time it takes to receive your passport back with the visa in it once TLS has sent it off is only a few days.

“TLS – the centre which works on behalf of the French Embassy to collate your application – is so very busy,” she added. “That part of the process took hours even when you have an appointment.”

READ ALSO EXPLAINED: What type of French visa do you need?

“The visa process itself was fairly well run, and a decision for the initial visa was quick,” wrote Ian Sheppard, who successfully applied for a visa in July 2022. 

“Although getting the follow up residence permit was a pain, [and] took longer than expected, and there was little to no communication with severely limited ways to get in touch about the application.”

Sheppard thought that, biometrics apart, the process could have taken place online, and wondered whether the follow-up residence permit application could be more closely linked to the initial visa application, “rather than effectively submitting the same application twice”.

Georgina Ann Jolliffe described the process as “stressful”. 

“A lot of the initial stage was unclear and I needed a lot of reassurance about the visa trumping the Schengen 90 days. (The Local helped on that one),” she wrote. 

“[The] lack of ready communication was very stressful. It could be slicker, however staff at Manchester TLS were excellent.”

Jacqueline Maudslay, meanwhile, described the process as “complicated”, saying: “The waiting times for the appointment with the handling agent (TLS in the UK) are long and difficult to book online. We applied for a long-stay visa and were given a short-stay visa, with no reasoning and no option of talking to anyone.  

“We had met every criteria for the long-stay visa. There needs to be a contact link with the French Consular website directly for discussing visa applications.”

Handling agent TLS’s website – the first port of call for applicants from the UK – was a target for criticism.

“The TLS system is probably the most user unfriendly system I have ever used,” wrote Susan Kirby. “It throws up errors for no legitimate reason and even changes data you have keyed in. Dates are in American format so you have to be very careful and it can be very difficult to edit.”

Bea Addison, who applied for a visa in September 2021 with a view to retiring in France, agreed that it was complicated and believes the French system is chaotic and badly organised compared to other countries. “Even staff in the French Embassy in London were not knowledgeable of the process and documentation,” she wrote.

“The renewal in France was applied for in July 2022 … we have received an attestation that we will be granted renewal visas, which expired in October 2022, but we have not yet received a date to attend the préfecture due to a backlog.

Second-home owners

Many of our survey respondents were not moving to France, but were instead second-home owners who did not want to be constrained by the 90-day rule.

They have the option of remaining residents of the UK and applying for a short-stay French visitor visa – which must be renewed every year.

Second-home owner Peter Green told us: “Our appointment with TLS was delayed by two and a half hours and the whole experience was chaotic.

“We now have to go through exactly the same process again to get a visa for 2023. With second-home owners there should be a fast track that just involves proving financial viability, nothing else has changed. The system needs to be fully computerised.”

Second-home owner Alan Cranston told us his application met with no problems, but came with “unwanted cost and effort”. 

“Our six-month visa was for our first stint at our house in France in the spring, and that then overlapped our second visit in the autumn which was under Schengen. How that is handled seems to be a muddle (we did not leave the country for a day at the end of the six months, as some advise),” he said. 

SHOW COMMENTS