France May ‘Close Loophole’ in Healthcare for Expats
French politicians have voted to close a healthcare loophole for third country nationals, including British citizens resident in France. Currently, if you are not working but can prove that you have €23K, private healthcare, and a long-stay visa, you will be eligible to apply for a French healthcare card, a carte vitale. However, under the new legislation, which could come into force as early as the New Year, you will have to make some kind of contribution, although the amount is yet to be decided.
The new rules will not affect pensioners resident in France, who are covered under a separate post-Brexit agreement. It will, however, affect you if you have not yet reached state pension age (66) and retired, even if you are currently living off a private pension.
The new legislation is designed to try to fill a hole in public finances. Its architect, French MP François Gernigon, told the press:
“Reciprocity does not mean fairness. In France, we have a health insurance system that is unique in the world, and is surely the best in the world. That is why we are in financial difficulty. We must not hide from this fact. It is certain that contributions from foreign nationals will not fill the social security gap, but they will at least contribute to it.”
If you do have a carte vitale, you may be aware that many people can now download a digital version, with rollout having just started in France. From 17th November, a new app allows patients to access their Ameli health account. There are some glitches: it is not yet clear whether this new app will be made available to foreign nationals. In the spring, the app was linked to France Identité, so if you do not appear on this system, you will not be able to use the app. However, you can still use your existing non-digital card, and you may find this more helpful, as not all pharmacies or GPs currently accept the digital version.
UK Experiences ‘Super flu’ Outbreak
An outbreak of ‘super flu’ is hitting the UK, with hospitals reporting rises in ICU admissions and critical incidents, and schools being closed due to illness. There have been calls for masks to once more be made mandatory. If you are travelling back to the UK for Christmas, it may be worth investigating the option of a flu jab, such as the one offered by Spain’s Health System (Sistema Nacional de Salud), before you travel.
Health Insurance for Expats: Industry Developments
The big news within health insurance is portability: insurance that can be carried across regions for expats who are on the move. Easy-to-search hospital networks are also increasingly requested by expats, as are premiums that may not be the cheapest but which may be more stable over time. Simplicity in upgrade plans is also a popular feature. Insurers report that clients are comparing local policies, which are easy to access, with global insurance that has a wider reach (for instance, medivac cover).
IPMI Health Insurance Landscape Report
International Private Medical Insurance Global (iPMI) has recently issued a report investigating the impact of tighter private insurance stipulations on expats, introduced by governments. Health authorities, and the governments of which they are a part, are increasingly concerned about an influx of expats placing strain on national healthcare systems as populations age and state healthcare starts to creak at the seams. This is, of course, the primary reason for the loophole closure mentioned in the first section relating to France.
An increasing number of countries are now insisting that expats entering the country have government-approved insurance, with people reporting visa and residency delays caused by holding policies with unrecognised providers. Changing insurance can be both time-consuming and costly.
Germany, for example, is demanding insurance that mirrors the cover provided by its own state system and has been rejecting standard travel insurance. In Gulf states, recognised health insurance is a mandatory part of residency applications. In other regions, such as parts of Asia, the type of insurance required depends on the reason for relocating rather than a standard protocol applicable to everyone. Coverage scope and duration are important, as is financial structure—high-deductible policies are unpopular in some countries, such as Spain—alongside provider network.
iPMI’s Christopher Knight told the press:
“Securing the right health insurance has shifted from an afterthought to a foundational pillar of a successful relocation plan. Too many applicants mistakenly believe their short-term travel insurance will suffice, only to face rejection at a critical stage. The message from governments is clear: if you plan to live in our country, you must prove you can cover your own healthcare from day one. Short-term travel insurance is almost never enough.”
The message is clear: if you are relocating, you need to sort out not only the right cover for you as early as possible, but also the right cover for the country into which you are planning to move. The health insurance landscape is now compliance-driven, most heavily enforced in Europe and the Schengen states.
The report itself can be found on iPMI’s website and provides a checklist.
It suggests that if you are planning to relocate, you follow this protocol:
- Verify Official Requirements: Always check the specific country’s official immigration website for the exact insurance requirements tied to your visa category.
- Select Comprehensive Coverage: Opt for a true expat health insurance plan designed for long-term residency, not a limited short-term travel policy.
- Ensure Full-Term Validity: Confirm your policy covers the entire visa period, as many nations require proof of up to 12 months of uninterrupted coverage upfront.
- Scrutinize Policy Details: Avoid plans with high deductibles or copays, which are explicitly rejected in countries like Spain.
Successfully meeting these requirements not only secures a visa but also provides expatriates with a critical financial safety net in their new home.