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December 20, 2007

Important healthcare change for Inactive expatriates affiliated to the CMU prior to the 23rd November 2007

After many months of discussion between the French Ministry of Health and the British embassy the rumoured amendments to the changes brought into place in September 2007 have finally been officially confirmed by the French authorities and the British Embassy via the following statements:
http://www.securite-sociale.fr/comprendre/europe/europe/cmu_inactifs.htm
http://www.fco.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&c=Page&cid=1064572873553#SSHC
What does this change from the last official statement in September 2007?
·         Inactive EU citizens already living in France and already registered and accessing healthcare via the CMU before 23 November 2007 will now be allowed to continue to do so.
·         After 5 years of "regular, uninterrupted residence" in France, an EU citizen qualifies as a permanent French resident and will therefore have access to healthcare via the CMU.
·         The position remains that all inactive EU citizens under retirement age living in France now or in future who are not entitled to healthcare reimbursement (through the E106 or E109 forms) or to access to the French health system will be required to have their own personal health insurance until they reach UK state pension age (and therefore qualify for entitlement to the E121 form), or until they qualify as a French resident (after 5 years of "regular, uninterrupted residence"). And also as previously, people already over retirement age who are holders of an E121 which is registered with the French authorities will remain unaffected.
·         The situation also remains unchanged for Inactive newcomers to France, in that those without cover from and E121 or E106/E109 will be required to have their own personal health insurance until they reach UK state pension age (and therefore qualify for entitlement to the E121 form), or until they qualify as a French resident (after 5 years of "regular, uninterrupted residence").
·         Those who are currently being covered by an E106 will also be required have their own personal health insurance until they reach UK state pension age (and therefore qualify for entitlement to the E121 form), or until they qualify as a French resident (after 5 years of "regular, uninterrupted residence"). Although the British Embassy does state the following on its website "We welcome and appreciate the French government's decision, following our representations, to allow inactive EU citizens living in France who already have access to healthcare via the CMU to continue to do so. This is good news which will bring relief to many British people living in France.
However, we are aware that there are also British expatriates in France who are holders of E106 forms and therefore not in the CMU system. The Embassy has been in intensive discussions with the French Health Ministry about their situation. We have been told that this group will have the safeguard of essential immediate healthcare provision, and we hope that this information will be confirmed in the next few days."

·         There do however remain alternative options for those on very low incomes who fall ill as they may be able to apply for a benefit called the Aide Médicale d’Etat. And those who are facing a sudden life change – such as an illness which hinders them taking out private health insurance or possibly a marriage separation making it hard for them to pay for may be allowed to join the CMU although this would be strictly dealt with on a case by case basis.



And below is a translation of the Q & A factsheet on the Securite Sociale website, the French version of which can be found on the following link -
http://www.securite-sociale.fr/comprendre/europe/europe/q_r_cmu_inactifs.htm

In order to facilitate understanding of the circular, we are offering a list of likely questions and answers:

Q&A

Why are the rules being modified?


Like other EU countries, France is obliged to conform to the EU directive no. 2004/38/CE of April 29, 2004, which fixes rules relating to residence rights for EU citizens.

These rules have a direct bearing on CMU affiliation in France. This directive was transposed into French law by the July 24, 2006 law on immigration and integration, then by the March 5, 2007 decree. This transposition was also completed by the March 5, 2007 law on lodging rights in order to address the situation of those who have come to France to seek work. Finally, the November 23 Social Security Directorate circular no. DSS/DACI/2007/418 completes the transposition of the directive by clarifying certain points concerning access to the CMU. This takes effect from November 23, 2007.

How does this impact on right to the CMU?

By fixing new conditions to residence rights, the EU directive has direct consequences on access to certain kinds of social security in France. This is notably the case both for the basic CMU and the complementary CMU, to which access is based on a condition of stable and legal residence in France.

What are the new conditions which the EU directive fixes for residence rights?

Under the directive there are two conditions covering the legal right of EU citizens to live in France:

- having comprehensive health insurance, and
- having sufficient resources so as not to become an unreasonable burden on the finances of the host state.

In other words, an inactive EU citizen who comes to live in France cannot legally become a French resident if he or she does not already have health insurance.

What happens if an EU citizen doesn’t fulfil these criteria and becomes ill?

If these conditions are not, or no longer, fulfilled, this person is no longer living legally in France. If this person becomes ill and has been living in France for less than three months, they can benefit from the dispositif soins urgents (urgent healthcare measure). If they have been living in France for longer than this, they can benefit from Aide Médicale d'Etat (State Medical Aid), or AME, on certain conditions (in particular they must have a low income).

Who is affected?


EU citizens, EEA citizens and Swiss citizens, and their family members.

In particular, those concerned include inactive residents and jobseekers who have recently come to France, and who were not in the CMU on November 23. In future all people in these categories wanting to come and live in France will be concerned.

“Inactive” refers to people who do not work – workers gain healthcare rights through their work.

Can E106 holders join the CMU automatically when it expires?

No. These people, who have never benefited from the CMU, do not have an automatic right to join it.

Who is not affected?

Those who were in the CMU on November 23 can stay in it because at the time they joined it, the requirement for residents to be in France legally was considered to be fulfilled without conditions.

These people can stay in the CMU after their cases have been studied by their local CPAM.

What about students and retired people?

These people also come under the directive and must have health cover. In practice, students will either benefit from healthcare cover from their home country or, if they are under 28, from French student social security.

In the vast majority of cases retired people will benefit from healthcare cover from their original country if they get a state pension, and this pension has healthcare rights attached.

How long does an EU citizen have to be in France to obtain to automatic right to the CMU?

The 2004 directive states that after five years of legal and uninterrupted residence a permanent residence right is obtained. This right allows people to benefit from the CMU.

This right should be verified by the foreigners’ department (service des étrangers) of the prefecture of the department concerned.

Under what circumstances can inactive EU citizens gain access to the CMU before five years have elapsed?

If an inactive EU citizen no longer fulfils one of the conditions of legal residence (sufficient resources or health insurance) they do not automatically lose their right to live in France.

If certain circumstances are present – in particular, if the person is confronted by an unforeseeable change in life circumstances, the person and their family will be allowed to remain resident, and access to the CMU will be possible.

Examples of this are when the person is faced by unexpected circumstances making it problematic for them to access to health insurance for financial or health reasons such as separation from, or death of, a spouse; divorce; or being refused health insurance because of a serious existing illness which could not have been predicted when the person came to France.

For more information contact: CPAMS’ English-speaking helpline (the national umbrella body for the CPAMs) on 08 20 90 42 12 or CLEISS (the international social security helpline) on 01 45 26 33 41 – End of document.

Please keep in mind that
the majority of the statement released on the Securite Sociale website is intended for the CPAM offices, so it would be advisable to refrain from contacting them for a few day to make sure all of the information has been taken on board so that the advice you receive is based on the current information.
If this affects me what should I do now?
First of all if you have not already done so you should contact the English speaking CPAM service mentioned above or the DWP Overseas Medical Benefits line +44 191 218 1999 if you are currently being covered by an E106 to confirm exactly when your current cover expires.
You will then need to source a Private Healthcare policy to cover you from when you current cover expires until you reach UK state pension age (and therefore qualify for entitlement to the E121 form), or until they qualify as a French resident (after 5 years of "regular, uninterrupted residence").
If I need a Private Healthcare Policy what advice can you give?
Rebecca Gaywood of the Exeter Friendly Society who have been providing and underwriting private healthcare policies for eighty years gives the following words for consideration:
  • Make sure the Insurance provider you choose is fully regulated, if they are UK based this would be the FSA
  • Read all of the small print in the policy wording paying particular attention to standard rules, benefits and exclusions
  • Check any benefit limits/restrictions, especially when ‘full refund’ applies to benefits, also if there are any compulsory excesses and whether these excesses apply per claim or per year.
  • Some policies include ‘no claims discounts’ and so it is best to check how these affect your initial premium and premiums payable in the future as and when a claim is made.
  • Ensure any personal exclusions imposed are clear and concise so you know what you are covered for and what you are not covered for before making any claims.
  • It is always useful to check claims procedures and whether direct settlement to medical providers is available.
This information is only provided as a guide and, if you need assistance in this area you are strongly advised to seek the help of a specialist in this field as each individual case is different.
If you have a question, want to arrange for a free financial review or just want further information I can be contacted on +33 (0)325461631, via my website www.financialexpat.com or via e-mail steve@financialexpat.com  
Spectrum IFA Group company TSG Insurance Services Sarl is registered and licensed in France."
TSG Insurance Services S.A.R.L.
Siège Social: 34 Bd des Italiens, 75009 Paris
« Société de Courtage d'assurances » R.C.S. Paris B 447 609 108 (2003B04384)
Numéro d'immatriculation 07 025 332 -
www.orias.fr
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Financial Expats Market Update - 19th December 2007

As markets continue to react on an almost daily basis to the latest data and opinions on the extent of the sub-prime loans situation, what are some of the analysts' views for the medium to longer term as we head towards 2008?

Data from the Organisation for Economic Cooperation and Development (OECD) has indicated a moderate downturn in economic activity with a weakening outlook for the main seven economies. However, figures for major non-OECD member countries indicate the possibility of continued steady expansion in China, India and Brazil, although the outlook for Russia is reported to be weaker.

One complementary view is that emerging market equities could deliver double-digit returns in 2008, however, there is the cautionary comment that stock valuations will continue to increase. A key question appears to be how quickly emerging market stocks could move to a premium.

The positive sentiment towards the BRIC markets is supported by other comment that they will be the key driver of global economic growth in 2008. Growing consumer demand and schemes to improve infrastructure are seen as key elements of their continued expansion.

There is an expectation that Brazil will outperform China next year. While the Brazilian economy has endured a period of high interest rates, it is reported that rates will fall, which could benefit the stockmarket. In addition, strong export volume growth at more attractive margins is also expected to assist corporate performance.

Having increased by 12% in 2007, China's gross domestic product (GDP) is anticipated to grow by 8% to 10% next year. There is a similar expectation for GDP growth in India. Meanwhile, Russia's economy is expected grow by 8% in 2008, with higher oil prices compensating for weaker capital inflows.

Staying with oil, the price of a barrel of crude rose to USD91.45 per barrel following reports that Turkish troops had entered northern Iraq. A disruption in oil exports through Iraq's northern pipeline could send prices higher in the short term.

Longer term, there has been comment that supply and demand issues may well conspire to support an increase in the price of oil. While there have been recent discoveries of oil reserves in the Bay of Bengal and off Brazil, these are both reported to be deep and expensive to recover. In addition, demand for oil is likely to increase. For example, the Chinese domestic aviation market is growing at almost 30% per annum.

On the currency front, the yen has declined against the dollar and the euro following a move by the European Central Bank to add USD500 billion to the banking system. This has had the impact of encouraging investors to borrow in Japan to buy higher-yielding assets elsewhere. The yen fell to 113.33 against the dollar and 163.38 against the euro.

The information set out herein has been obtained from various public sources and is published by way of information only. The Spectrum IFA Group can accept no liability of any sort in relation thereto and readers should obtain their own verification of any statement before making any decision which may have any financial or other impact.

Neither the information nor the opinions herein constitute, or are they to be construed as, an offer or a solicitation of an offer to buy or sell investments.

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December 14, 2007

Healthcare latest from the British Embassy Paris

See below for the official response I have just received from the British embassy in Paris
Steve 

> Dear Sir /Madam
>
> French government's new decision on access to the French healthcare system
> for inactive citizens from other EU countries
>
> Following representations made to the French government, we can confirm that
> the French Health Ministry has modified its decision regarding access to the
> French healthcare system for inactive citizens from other EU countries
> already residing in France.
>
> According to the French Health Ministry's official revised statement and Q&A
> factsheet
> <http://www.securite-sociale.fr/comprendre/europe/europe/cmu_inactifs.htm>
> http://www.securite-sociale.fr/comprendre/europe/europe/cmu_inactifs.htm
>
> The position is:
>
>
> * Inactive EU citizens already living in France and already registered
> and accessing healthcare via the CMU before 23 November 2007 will now be
> allowed to continue to do so.
>
>
> * After 5 years of "regular, uninterrupted residence" in France, an EU
> citizen qualifies as a permanent French resident and will therefore have
> access to healthcare via the CMU.
>
> * The position remains that all inactive EU citizens under retirement
> age living in France now or in future who are not entitled to healthcare
> reimbursement (through the E106 or E109 forms) or to access to the French
> health system will be required to have their own personal health insurance
> until they reach UK state pension age (and therefore qualify for entitlement
> to the E121 form), or until they qualify as a French resident (after 5 years
> of "regular, uninterrupted residence").
> * We have ensured that the French authorities are fully aware of the
> specific circumstances of E106 holders already resident in France who do not
> have existing access to CMU and who may not be able to secure private health
> insurance for various reasons when their E106 expires. Following discussions
> to highlight the need for urgent clarification in cases where the E106 is
> due to expire imminently, we have been told that people will have the
> safeguard of essential immediate healthcare provision. We are expecting a
> response in the next few days from the Health Ministry to give further
> detail for people in these circumstances.
> * As previously, people already over retirement age who are holders of
> an E121 which is registered with the French authorities will remain
> unaffected.
>
> This information is based on what we have been told by the French
> authorities. We suggest people seek further information and advice on
> individual cases from one or more of the following:
>
> French Social Security website:
> <http://www.securite-sociale.fr/comprendre/europe/europe/cmu_inactifs.htm>
> http://www.securite-sociale.fr/comprendre/europe/europe/cmu_inactifs.htm
>
> CPAM - The French Health Service (English language service): +33 8 20 90 42
> 12 or to identify your local CPAM:
> http://www.ameli.fr/assures/votre-caisse/index.php
>
> CLEISS - (France's helpdesk for international mobility and social security):
>
>
> 11 rue de la tour des Dames
>
> 75436 Paris cedex 09Tel: +33 1 45 26 33 41
>
> www.cleiss.fr <http://www.cleiss.fr>
>
> For holders of E106 and E109 forms:
>
> DWP Overseas Medical Benefits helpline
>
> International Pension Centre
>
> Room Tc001
>
> Tyneview Park
>
> Whitley Road
>
> Newcastle upon Tyne
>
> NE98 1BA
>
> Tel: +44 (0) 191 218 1999 (Monday to Friday 8am - 5pm)
>
> www.dh.gov.uk/travellers <http://www.dh.gov.uk/travellers>
>
> or for press enquiries: Department of Health Press Office: +(44) 207 210
> 5221
>
>
>  _____ 
>
> Kind Regards,
>
> Public Enquiries
> Press and Communications
> British Embassy Paris
>
>

>
>
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>
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