What changes in healthcare for British people in France after Brexit?

It's the thing that nobody wants to think about, but we will all get sick at some point in our lives, so having health cover in place is vital. Here's how Brexit changes the situation for British people either living in or visiting France.

What changes in healthcare for British people in France after Brexit?
Photo: AFP

Since the UK exited the EU we have been in a transition period, which lasts until December 31st.

During tat period, most things stay the same including the right of British people in France – either living her or just visiting – to access healthcare if they need it.

After the transition period ends, however, some things will change and people may need to register within the French system.

As this can be a slow process at the best of times we would recommend that people who are not already registered use the next six months to do so – you can start the process immediately as it is not Brexit-dependent.

After the transition period

Once the transition period ends some of the processes will change, but here is the good news – the Withdrawal Agreement guarantees the rights of British people already in France to healthcare for the rest of their lives.

So if you are legally resident in France by December 31st, 2020 – your healthcare will be covered.

(Quick caveat here is that being legally resident is not quite the same as simply being in the country – find out more here).

However for some people the process they use to access healthcare will change.

What changes

Most people who are working in France will have already registered for a carte vitale – the magic card by which you get your healthcare costs covered.

In France you pay upfront for medical treatment and the state then reimburses all or part of the cost depending on the type of treatment you are having.

More on how the carte vitale works here.

The majority of British pensioners will also have a carte vitale, although in their case costs are reimbursed by the British state under the S1 scheme.

But many people have until now been relying on their European Health Insurance Card (EHIC or what used to be called the E111).

Once the transition period ends EHIC cards issued by the UK won't be valid unless a future agreement is made before December 31st. 

Importantly, however, UK issued EHIC cards for S1 holders can be used in the UK after the end of the transition period for those legally resident.

Everyone who is resident in France needs to register themselves in the French system. 

For people who are working – either an an employee or self-employed – it's fairly simple. If you are paying in to the French state through taxes you are entitled to healthcare.

For pensioners too the process is pretty straightforward (which is not the same as being speedy, this is French bureaucracy we are talking about) – apply for a carte vitale as an S1 holder.

For early retirees or otherwise economically inactive people the process is slightly more complicated, but after three months of residence you are entitled to healthcare with the PUMa scheme – find out what that involves here.

What about non residents

People visiting France either as tourists or on regular visits as second home owners have until now relied on the EHIC card if they need healthcare.

Currently UK issued EHIC cards will cease to work after the end of the transition period so – unless a separate deal is made – visiting France will become the same as visiting any other non EU country, ie you will have to arrange your own private travel insurance or health insurance to make sure you are covered in case of illness or accident.

Although the British government has stated it wants the EHIC card system or something similar to continue after Brexit, but this will have to be negotiated with Brussels (along with that trade deal and quite a few other things).

What about trips back to the UK if you are resident in France

The same applies if you are travelling the other way.

Unless France and the UK come to a separate bilateral agreement about covering the healthcare costs of non residents, the costs of French residents will not be covered in the UK after December 2020.

This might seem pretty unfair to Brits who over the years have worked in the UK and therefore contributed quite a lot to the NHS, but free-at-the-point-of-delivery heath services in the UK are only for permanent UK residents.

But there are exceptions.

Kalba Meadows who runs the France Rights citizens' rights group says S1 holders who are UK state pensioners will be able to access full healthcare on trips to the UK under Overseas Patients regulations.

France Rights' Meadows also points out that British residents in France who have a CEAM (Carte Européenne d'Assurance Maladie – the equivalent of an EHIC) issued by France (because France is their competent state) will be able to continue to use that card if they are in the UK or other EU countries for short visits. 

You can apply for this at your local CPAM office or through the online Ameli portal.

Check out The Local's Preparing for Brexit section for more detail and updates as we get them. If you have questions, please send them to us here and we will do our best to answer them.


Member comments

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


Brits in Europe won right to vote for life in UK but questions remain

After years of campaigns and promises British citizens living abroad finally won the lifelong right to vote in UK general elections in April 2022. But campaigners say more needs to be done to allow all those Britons abroad to be able cast their votes easily.

Brits in Europe won right to vote for life in UK but questions remain

What’s in the law?

The Elections Act 2022 introduced several changes to the current legislation on electoral participation. Among these, it removed the rule by which British citizens lose their voting rights in the UK if they have lived abroad for more than 15 years

The new rules also abolished the requirement to have been previously registered in the UK electoral roll to become an overseas voter. In addition, the registration in the electoral roll will now last up to three years instead of only one year.

It is estimated that these changes could increase the number of overseas voter registrations by some 3 million. But the way new measures will be applied in practice is still to be defined.

READ ALSO: ‘Mixed feelings’ – British citizens in Europe finally get right to vote for life

Defining the practicalities

Under the new law, Britons living abroad will have to register to vote in the last place they were registered in the UK. This means that people who have never lived in the UK will be ineligible to vote, regardless of how long they have been overseas, while those who left when they were children will be able to use a parent or guardian’s address.

But given that the UK does not require residents to register with local councils, how to prove previous UK residence? “Typical documents accepted as a proof of residence are Council tax or utilities bills, but not everyone will have them or will have kept them in an international move,” says Fiona Godfrey, co-founder of the British in Europe coalition.

Ballot papers are pictured in stacks in a count centre as part of the 2019 UK general election. (Photo by ANDY BUCHANAN / AFP)

Other questions concern how people will effectively cast their ballot. UK citizens overseas will be able to vote by post or by proxy or in person at their polling station if they are in the UK at the time of the election. However, few people are likely to travel to the UK for an election and in the past there have problems and delays with postal voting.

The Electoral Commission has recommended that overseas electors appoint a proxy to vote on their behalf. But who could that be for people who have been away from their constituency for a long time?

New secondary legislation will have to answer these questions, defining how to be included in the electoral roll and how to exercise the voting right in practice.

According to British in Europe, the government should present draft legislation in the first half of the year so that the parliament can adopt it before summer and registrations of overseas voters can start in the autumn.

British in Europe survey

British in Europe are currently running a survey to understand the difficulties UK citizens abroad may face in the registration and voting process, as well as their intention to participate in elections.

The survey asks for instance which documents people can access to prove their previous residence in the UK, what problems they had voting in the past, and if and how they plan to vote in the future.

“We need to get an up-to-date picture of British citizens living around the world and have information to make recommendations to the government, as it prepares secondary legislation,” Godfrey said. “If millions of people will exercise their voting rights, there will be consequences for council registration offices, post office and authorities that will manage the process, among other things” she argued.

The right to vote concerns only UK parliamentary elections and national referendums, not elections in the devolved administrations of Scotland, Wales and Northern Ireland, or at local level.

The survey is open to UK citizens living anywhere in the world and is available at this link.