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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
(Photo by 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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PROPERTY

New French State aid to help older people make home improvements

A new accessibility scheme recently announced by the French government gives grants for home improvements such as installing a stair lift or widening a doorframe to allow wheelchair access - here is how you could benefit.

New French State aid to help older people make home improvements

According to a recent survey in France, the vast majority of retired people expressed a desire to stay in their homes long-term, rather than entering a care facility.

While there are several schemes by the French government to provide assistance for renovating homes in order to make them more accessible for elderly people, the newly announced “MaPrimeAdapt” seeks to streamline the process.

When was it announced?

MaPrimeAdapt was part of President Emmanuel Macron’s re-election campaign, with plans for it first announced by the president last November.

Most recently, the government aid was earmarked to receive funding in the upcoming 2023 budget, which also hopes to increase the number of nursing home employees, as well as boost public funding for care centres.

The budget is set to allocate €35 million to the National Housing Agency (ANAH) in 2023. In response, the ministry of housing said to Capital France that one of their top priorities is “a single aid for the adaptation of housing to ageing” that would replace several existing government subsidies.

What is the goal of Ma Prime Adapt?

Similar to Ma Prime Renov, this programme hopes to provide additional funding for home refurbishment.

But while Ma Prime Renov focuses on environmentally friendly home adaptations, Ma Prime Adapt aims to make it simpler for older people or those with disabilities to refurbish their homes in order to maintain their autonomy and avoid falls.  

The French government also aims to reduce the number of fatal or disabling falls of people aged 65 by at least 20 percent by 2024, and by 2032, the goal is for at least 680,000 homes to be adapted, particularly those of low-income older people.

Who can benefit?

According to reporting by Le Monde, this aid is not solely reserved for people who already have decreased mobility. 

Instead, it is intended for older people generally. When applying, the applicant must be able to demonstrate that they are an independent retiree and need (this could be based on income, age, health, etc) to adapt their housing in order to make it more accessible.

The amount of assistance offered will be means-tested based on financial status.

What types of work would qualify?

Some examples of work that might qualify for assistance might be:

  • adapting the bathroom (for example, adding grab bars or enlarging the door)
  • replacing the bathtub with a shower
  • installing a bathtub with a door
  • installing a stair lift
  • adding access ramps to the home

The benefit is not limited to those options – any project that aims to increase home accessibility for a senior could qualify, as long as it is not simply aesthetic-focused.

Can it be combined with Ma Prime Renov?

They have different criteria, but Ma Prime Renov and Ma Prime Adapt can be combined in order to provide maximum support to elderly people wishing to adapt and stay in their homes.

How can I apply?

In order to apply, you will be required to meet the conditions stated above, in addition to being able to demonstrate that the housing in question is at least 15 years old and that the amount of work being done would cost at least €1,500.

Keep in mind that the renovation will need to be carried out by a recognised building company or contractor – specifically one with the label “RGE.”

You will be able  toapply for the Ma Prime Adapt aid via France’s National Housing Agency (ANAH). A dedicated website will be created to facilitate the process, with a launch date TBC. 

On the site, you will submit an application form that includes the estimates of the work planned. According to Le Monde, €5,600 will be the maximum amount of aid to be offered, and the cost of work will be capped at €8,000. However, this information has not yet been published by the National Housing Agency. 

What have the other available schemes been?

Currently, retirees in France can apply for the “Habiter facile” scheme from the ANAH (Agence Nationale de l’Habitat), which also helps to finance work that promotes the ability of elderly people to remain in their homes.

“Bien vieillir chez soi” is a similar aid scheme which is offered by the CNAV (social security).

The elderly and disabled can also benefit from tax credits on accessibility or home adaptation work. 

These will likely be replaced by Ma Prime Adapt, which will combine all benefits into one package.

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