What are the rules on accessing the UK health service if you live in France?
If you're British and live in France you will previously have been registered with the National Health Service, but once you move abroad things change - here's what this means for accessing UK healthcare both on a regular basis and if you have an accident or fall sick while on a visit back to the UK.
The NHS is described by the British government as a "residence-based health service" which means that if you don't live in the UK you're not automatically entitled to NHS care, even if you are a British citizen and even if you still pay tax in the UK.
However funding, access and care rules can vary depending on your circumstances.
Moving to France
Once you have lived in France for more than three months you are entitled to register in the French health system and get a carte vitale - here's how to go about getting the card and registering with a French GP.
This will take care of your regular healthcare needs, GP appointments, screening, planned procedures etc.
Healthcare in France is a state system, but unlike the NHS it's not free at the point of delivery, instead it operates on a reimbursement system.
READ ALSO How France's healthcare system works
Pensioners
If you are a pensioner, student or posted worker, it's likely that the UK will continue to pay for your healthcare through the S1 system.
However, being covered by S1 doesn't mean that you remain registered with the NHS - S1 only affects who pays for your care.
So, in France, you register for a carte vitale health card in the same way as everyone else, you pay upfront for your medical treatment and then the doctor swipes the health card - at this point, if you are an S1 holder, the UK government reimburses the cost, for everyone else the French government pays the cost. But for you as a patient, the system is the same.
Full details HERE on how to request an S1.
If you are not working, studying or seeking work in France but have not yet reached pension age you could fall into a 'grey area' in terms of who pays for your healthcare - in this case you can register in the French system through PUMa - full details on that HERE.
Can I stay registered with my UK GP?
No, you need to have a local address to be registered with an NHS GP. In practice, many people don't get around to telling their GP that they have moved and so stay registered for months or even years, but technically you should notify your GP so that you can be removed from the NHS register.
Even if you do remain registered with a UK GP, they won't be able to issue prescriptions for you in France as most UK GPs are not licensed to practice outside the UK - therefore are not covered by insurance.
If you are on regular medication it may be possible for your GP to issue you with an advance stock of medication to cover you while you get settled in France, but many prescriptions are limited to a maximum of three months.
What about travelling outside France?
Once you're registered in the French system you will be able to get a European health insurance card known as a CEAM (Carte européenne d'assurance maladie) which covers medical care while on trips in Europe. It's basically the same as the EHIC you might have had while you were registered in the UK but it's not issued automatically, you have to request it.
The easiest way to do this is through your Ameli account - head to 'Mes informations' than click the 'commander une carte européene d'assurance maladie' in the box next to the CEAM. It will be sent by post to your French address.
If travelling outside of Europe - ie a holiday in the US - you need to ensure that you have travel insurance with full medical cover in case of any mishaps while abroad.
What about trips back to the UK?
Although your day-to-day healthcare will be covered by the French system, there's still the possibility or falling sick or having an accident while on a trip back to the UK.
If you are an S1 holder you can show this to provide proof that you are entitled to NHS treatment, and if you are covered by the Brexit Withdrawal Agreement you can show your UK-issued EHIC or GHIC to provide proof of your entitlement to NHS care.
However if you don't have either of these, the CEAM covers all trips in the EU and European Economic Area, as well as Switzerland and the UK, so if you are charged for medical care while in the UK - because you do not have a UK address - then you will be able to claim the costs back once your return in France.
This also means that any French nationals who are with you on your trip - such as a French spouse or partner - have their care costs covered too through CEAM.
In practice, most UK nationals who need to use the NHS while on trips back to the UK report that no-one ever thinks to ask whether they are UK residents.
It's true that some Brits living in France keep their registration with a UK GP and make regular trips back to get prescriptions, while this can happen in practice it does involve lying or at least being economical with the truth about where you live.
Overall it's better to get registered with a French GP so that they can get to know you and have a full overview of your care as well as any ongoing medical conditions and prescriptions. Most Brits are pretty happy with French healthcare, which consistently ranks among the best in the world.
Emergency care
There are certain types of NHS care that are not charged for, such as A&E treatment or treatment from paramedics, but if you need to be admitted to hospital you may have to pay.
NHS hospitals won't turn you away if you cannot prove residency, but they may present you with a bill when you leave if you cannot prove either residency or health cover in a European country.
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The NHS is described by the British government as a "residence-based health service" which means that if you don't live in the UK you're not automatically entitled to NHS care, even if you are a British citizen and even if you still pay tax in the UK.
However funding, access and care rules can vary depending on your circumstances.
Moving to France
Once you have lived in France for more than three months you are entitled to register in the French health system and get a carte vitale - here's how to go about getting the card and registering with a French GP.
This will take care of your regular healthcare needs, GP appointments, screening, planned procedures etc.
Healthcare in France is a state system, but unlike the NHS it's not free at the point of delivery, instead it operates on a reimbursement system.
READ ALSO How France's healthcare system works
Pensioners
If you are a pensioner, student or posted worker, it's likely that the UK will continue to pay for your healthcare through the S1 system.
However, being covered by S1 doesn't mean that you remain registered with the NHS - S1 only affects who pays for your care.
So, in France, you register for a carte vitale health card in the same way as everyone else, you pay upfront for your medical treatment and then the doctor swipes the health card - at this point, if you are an S1 holder, the UK government reimburses the cost, for everyone else the French government pays the cost. But for you as a patient, the system is the same.
Full details HERE on how to request an S1.
If you are not working, studying or seeking work in France but have not yet reached pension age you could fall into a 'grey area' in terms of who pays for your healthcare - in this case you can register in the French system through PUMa - full details on that HERE.
Can I stay registered with my UK GP?
No, you need to have a local address to be registered with an NHS GP. In practice, many people don't get around to telling their GP that they have moved and so stay registered for months or even years, but technically you should notify your GP so that you can be removed from the NHS register.
Even if you do remain registered with a UK GP, they won't be able to issue prescriptions for you in France as most UK GPs are not licensed to practice outside the UK - therefore are not covered by insurance.
If you are on regular medication it may be possible for your GP to issue you with an advance stock of medication to cover you while you get settled in France, but many prescriptions are limited to a maximum of three months.
What about travelling outside France?
Once you're registered in the French system you will be able to get a European health insurance card known as a CEAM (Carte européenne d'assurance maladie) which covers medical care while on trips in Europe. It's basically the same as the EHIC you might have had while you were registered in the UK but it's not issued automatically, you have to request it.
The easiest way to do this is through your Ameli account - head to 'Mes informations' than click the 'commander une carte européene d'assurance maladie' in the box next to the CEAM. It will be sent by post to your French address.
If travelling outside of Europe - ie a holiday in the US - you need to ensure that you have travel insurance with full medical cover in case of any mishaps while abroad.
What about trips back to the UK?
Although your day-to-day healthcare will be covered by the French system, there's still the possibility or falling sick or having an accident while on a trip back to the UK.
If you are an S1 holder you can show this to provide proof that you are entitled to NHS treatment, and if you are covered by the Brexit Withdrawal Agreement you can show your UK-issued EHIC or GHIC to provide proof of your entitlement to NHS care.
However if you don't have either of these, the CEAM covers all trips in the EU and European Economic Area, as well as Switzerland and the UK, so if you are charged for medical care while in the UK - because you do not have a UK address - then you will be able to claim the costs back once your return in France.
This also means that any French nationals who are with you on your trip - such as a French spouse or partner - have their care costs covered too through CEAM.
In practice, most UK nationals who need to use the NHS while on trips back to the UK report that no-one ever thinks to ask whether they are UK residents.
It's true that some Brits living in France keep their registration with a UK GP and make regular trips back to get prescriptions, while this can happen in practice it does involve lying or at least being economical with the truth about where you live.
Overall it's better to get registered with a French GP so that they can get to know you and have a full overview of your care as well as any ongoing medical conditions and prescriptions. Most Brits are pretty happy with French healthcare, which consistently ranks among the best in the world.
Emergency care
There are certain types of NHS care that are not charged for, such as A&E treatment or treatment from paramedics, but if you need to be admitted to hospital you may have to pay.
NHS hospitals won't turn you away if you cannot prove residency, but they may present you with a bill when you leave if you cannot prove either residency or health cover in a European country.
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