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HEALTH

Reader question: Can I move into a French care home as a foreigner?

Many people move to France to enjoy their retirement, but what happens if you become ill and can no longer live independently?

A nurse serving drinks to elderly residents at a care home in France while they play bingo
A nurse serving drinks to elderly residents at a care home in France while they play bingo. Photo: Romain Lafabregue / AFP

Reader question: What happens if someone moves to France and then needs to go into a care home because of old age or infirmity? Who pays? Does it make a difference if you worked in France and paid into the French system, or if you moved here after retirement?

It’s a common question for both people who moved to France at a younger age and worked here, or those who retired here from other countries, but as a foreigner in France what rights do you have to access old-age care? And will you have to pay for it?

Let’s start with some positive news – there are no specific rules restricting foreign nationals going into a French care home or accessing any assistance they require – provided they have the legal right of residence in France and places are available.

There’s more good news, too – there are thousands of care homes, private and public, in France offering a range of services for older people.

You may have heard the term Ehpad – it is an acronym for établissements d’hébergement pour personnes âgées dépendantes. There are also Ehpa homes, which are établissements d’hébergement pour personnes âgées.

Most care homes for older people are Ehpads, catering for residents aged 60 or over who require some form of routine medical assistance that means they are unable to look after themselves fully. All are state registered and guarantee standards of hygiene, safety and comfort.

There are also options for those in need of more intensive medical care and those with dementia.

Importantly, in-home care is also available along with a series of specialised benefits which enable people to live in their own homes – where they may feel most comfortable – for as long as possible.

Sheltered accommodation provides a half-way solution for older people who are able to still live mostly independently but need some practical daily support. These are available in some towns but not all areas.

Cost

Costs for residential care homes depend on a number of factors – but are routinely divided into three parts:

Accommodation
AKA board, lodging and leisure – inducing meals, utilities, cleaning and laundry services.

In public-sector Ehpads, which care for those who are eligible for means-tested state aid, the rate is fixed by the local council. In private homes, however, this portion of the bill can be set by individual homes – though there is a limit on the size of annual increases. Expect to pay somewhere in the region of €50 to over €100 per day for this.

Medical care
The social security system (Cpam) covers medical costs, hence the importance of being legally resident in France, and registered with the French state health system.

READ ALSO How to get a carte vitale in France and why you need one

Dependency care
This is day-to-day non-medical care, such as help with washing and getting around, so includes any special equipment a person may require according to their needs.

Costs vary according to the level of daily assistance required, based on a six-level classification system – which includes everyone from bed-ridden patients who need constant care down to those still able to look after themselves.

On average, you would expect to pay in the region of €2,000 per month to stay in an Ehpad in France. But prices vary based on location, level of care, and level of service.

Who pays?

If you’re legally resident in France and registered within the health system (with a carte vitale) then costs of medical care are covered by Assurance maladie, leaving you with only the accommodation and dependency costs.

But here it gets complicated and depends on your financial situation.

There are a range of means-tested benefits available to cover these costs, but not all are available to people who have never worked in France, although if you receive a state pension from your home country, you may be entitled to financial support from them as well.

To qualify for these you will obviously need to show financial information and people with substantial savings are unlikely to benefit. However an important point is that the value of your home is not included in the means test, so you will not be expected to sell your home to cover care costs.

Remember, under French law children and grandchildren of those in care have an obligation towards needy parents and grandparents to help with their essential needs and the council can request they contribute, again depending on their financial situation.

Those who need help paying the bills should be able to show that they have been habitually resident in a given département for at least three months. Non-EU citizens (including Britons) must hold a carte de séjour.

Brits

Certain benefits that cover care costs are not available to non-EU citizens who have never worked in France.

However Brits who moved to France before December 31st 2020 – and are therefore covered by the Brexit Withdrawal Agreement – are treated in this regard in the same way as EU citizens. You can prove this using the Withdrawal Agreement carte de séjour.

Find out more

A lot of useful information on care for older people in France is available on a dedicated government website here – which explains the different benefits and payments available, along with the rights and responsibilities of older people and their families, and can help you identify the care you need, or find nearby residences.

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For members

TRAVEL NEWS

Paxlovid, tests and isolation: Covid care for tourists in France

With travel opening up, many people are planning trips to France over the next few months, but the Covid pandemic has not gone away. Here are your questions answered on testing, isolation and medical treatment if you do fall sick while on holiday.

Paxlovid, tests and isolation: Covid care for tourists in France

Travel rules

Covid-related travel rules have mostly been relaxed now but you will still need to show proof of being fully vaccinated at the French border. If you are not vaccinated you will need to show a negative Covid test – find the full breakdown of the rules HERE.

Testing

Once in France if you develop symptoms or you have been in contact with someone who has tested positive you will need to get a Covid test.

The good news is that testing is widely available in France, both for residents and tourists.

The easiest way to get a test is head to a pharmacy, most of which offer the rapid-result antigen test on a walk-in basis Tests are available to everyone who wants one, there is no need to fulfill any set criteria.

For full details on how to get a test, and some handy French vocab, click HERE.

The difference for tourists is that you will have to pay for your test, while residents get their costs reimbursed by the French state health system.

In the pharmacy you may be asked for your carte vitale – this is the health card that residents use to claim refunds. As a tourist you won’t have the card – you can still get the test, you will just need to pay for it. Costs vary between pharmacies but are capped at €22 for an antigen test or €54 for a PCR test.

Isolation

If your test is positive you are legally required to isolate, but how long your isolation period is depends on the your vaccination stats – full details HERE.

Treatment

For most fully-vaccinated people without underlying health conditions the symptoms of Covid are fairly mild, but if you do become ill, here’s how to access medical help while in France.

Pharmacy – one of the first things you will notice about France is that pharmacies are everywhere, just look out for the green cross. As well as selling over-the-counter medication, pharmacies all have at least one fully-qualified pharmacist on the staff who can offer medical advice. 

Take advantage of pharmacists – they train for at least six years so they’re very knowledgeable and they’re easy to access by simply walking into the shop. In tourist areas it’s likely that they will speak English. Pharmacists can also signpost you to a nearby doctor if you need extra help.

Doctors – if you need to see a doctor, look out for a médecin généraliste (a GP or family doctor). There is no need to be registered with a doctor, simply call up and ask for an appointment if you need one. If you have a smartphone you can use the medical app Doctolib to find a généraliste in your area who speaks English. You will need to pay for your consultation – €25 is the standard charge and you pay the doctor directly using either cash or a debit card.

You may be able to claim back the cost later on your own health/travel insurance depending on the policy.

Ambulance – if you are very sick or have difficulty breathing you should call an ambulance – the number is 15. All non-residents are entitled to emergency treatment in France, whether or not you have insurance, but if you are admitted or have treatment you may need to pay later.

READ ALSO Emergency in France: Who to call and what to say

Paxlovid – several readers have asked whether the Covid treatment drug Paxlovid is available in France. It was licenced for use in February 2022 and is available on prescription from pharmacies, mainly for people with underlying health conditions or an impaired immune system. You can get a prescription from a medical practitioner.

The drug is reimbursed for French residents, but as a tourist you will have to pay.

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