Medical coverage information in France for Canadian / Travel Insurance

You are Canadian and currently living in British columbia. You want to know if you are covered for medical expenses :

- during a short stay in France (tourism,business travel, short-term job)

- during a long-term stay in France (immigration, long-term job etc.)

- when sharing your time between France and British Columbia

- during studies in France

- when retiring in France

Note : Workers sent to France by their Canadian employer are not concerned by this guide. In this case, you should refer to your employer.

Disclaimer : This guide is provided for information only. French and BC medical coverages are defined by legal acts which can be modified at all times. The Consulate of France and the authors of this document are not liable for any omissions, errors or inaccuracies which may be found in this document.

For further information, please contact the different health agencies of both countries.

A short stay in France.

Am I covered by my BC Care card?

You are the holder of a BC Care Card. BC Medical Service Plan (MSP) will help to pay for medical services you receive in France, provided that the services are medically required and are normally covered by MSP.

However the MSP provides limited benefits :

• Reimbursement will not exceed the amount payable had the same services been performed in British columbia.

• The patient is required to pay for insured services and seek reimbursement later from MSP.

• Claims for medical care must be submitted within 90 days of the date of service and hospital claims must be submitted within 6 months of the date of discharge.

• Paramedical benefits such as chiropratic, optometry, physical therapy, massage therapy and podiatry are not covered.

• Payment of hospital charges outside Canada will not exceed $75.00 a day.

• Ambulance service fees are not covered.

• There is no reimbursement for the purchase of prescription drugs though the patient may be covered by Pharmacare in British Columbia.

If you intend to leave British columbia for medical or hospital assistance, the specialist looking after you should inform the MSP before you leave the province to receive prior approval for payment of insured services. As soon as MSP specifies the extent of its medical coverage, you shoud apply for an additional private insurance.

How long does my BC medical coverage work in France ?

If you are going to France for more than two months, you should inform MSP of the reasons of your stay (e.g vacation, work) and specify the dates of departure and expected return.

Under BC medical coverage, your eligibility for benefits is limited to 6 months. But if you are leaving on vacation or temporary employment, in some circumstances, benefits may be available for a period up to 12 months. Approval from the MSP for the extent is limited to once in five years.

Is an excess emergency medical insurance necessary ?

Applying for a private excess medical insurance when going to France is highly recommended for a stay of under 3 months and compulsory when your stay exceeds three months (except for people coming to work or study in France). This insurance has to be presented at the Consulate in order to be issued a visa. An excess medical insurance covers the costs that do not come under your BC medical coverage and all the repatriation fees.


A long-term stay in France

Does my BC medical coverage follow me ?

If you are no longer a BC resident you are not covered by the MSP any more.

Here are the first steps of the procedure :

• You must notify MSP of your date of departure and indicate the reason for cancellation. If you fail to do so, premiums are still charged.

• Your BC medical coverage works for the balance of the month you leave the province.

Am I eligible for a French medical coverage ?

To claim medical benefits from the French "Sécurité sociale" (social security), you have first to abide by the French immigration law. You must be granted one of the following status :

• Resident card

• Temporary "carte de séjour"

• If you are working, a temporary "carte de séjour" and a temporary work permit

• A temporary work permit of less than three months for the people who do not need a short-stay visa (Canadian people are concerned) under French immigration law

• A temporary work permit of up to three months for the people who need a short-stay visa under French immigration law.

You are eligible for the French social security when you are concerned by one of the cases described below :

• You are a salaried employee in France

• You have a liberal profession or you are working as an independent in France

•- If you are not concerned by these two cases, you are eligible to for the "Couverture maladie universelle" (CMU i.e Universal medical coverage) provided that you have been living continuously in France for at least three months before applying. The cover is:

    • free if your income is less than 626,75€ per month.
    • charged with an 8% premium based on the part of your income that exceeds 626,75€ per month

• The CMU provides the same coverage as the normal social security coverage. you also can benefit from a free additional insurance provided that your income does not exceed a certain amount. This amount varies according to the number of people that are covered by your insurance.

Plafon des ressources du foyer au1er juillet 2009 :

Number of people covered by the CMU maximum income for a free additional insurance
a single person 626,75€ /month
two people 940,16€ /month
three people 1 128,16€ /month
four people 1 316,16€ /month
additional person + 250,70€ /month

What is the procedure to get a French medical coverage ?

You are covered by the French Social Security once you have gone though this procedure:

• Upon arrival, you have to register to the Caisse primaire d’assurace maladie (CPAM). You can find the address in the phone book or ask your mairie (city hall).

• Premiums will then be charged to you (except if you have the CMU for free) : you are eligible for medical benefits if you pay a specific premium during the month preceding the date of the medical services. This monthly premium must be at least equal to the premium that would be paid on 60 hours paid at the SMIC rate (the French minimal revenue). The SMIC rate in 2010 is about 8,86 € an hour (1 343,77 € / Month).

If your salary (especially during the first months of your arrival) is not as high, you are entitled to get a medical coverage if you were paid the equivalent of 120 hours at a SMIC rate during the last three months preceding the medical services.

•- You are not concerned by this last condition in two cases :

    • You are covered by the CMU
    • it is the first time you have come to France to take a job and you fall ill immediately. In this case, the 60-hour condition is being suspended for 3 months.

Who is covered by my French medical coverage ?

Apart from the insured, the French Social security also covers the following people :

The spouse :

• married spouse

• attached spouse (concubin) on presentation of a "certificat de concubinage" (concubinage certificate) delivered by the Mairie or on a declaration on honour

• PACS partners

• homosexual partner on the proof that they have been living together for at least one year and that the insured financially support his/her partner.

The children on support (until the age of 18)

Note : The people on support must abide by the French immigration legislation to be eligible for a French medical coverage.


Sharing your time between France and British Columbia

Am I covered by my BC Care card ?

If you routinely spend time in France, be sure that your BC medical coverage is following you. There are a few conditions :

• You should keep your residence in British Columbia

• You must be physically present in Canada at least 6 months in a calendar year

• In some circumstances residents may be eligible to receive benefits for up to 12 months while outside the province. Approval from MSP is limited to once in five years.

However, the MSP provides limited benefits in France :

• Reimbursement will not exceed the amount payable had the same services been performed in British columbia.

• The patient is required to pay for insured services and seek reimbursement later from MSP.

• Claims for medical care must be submitted within 90 days of the date of service and hospital claims must be submitted within 6 months of the date of discharge.

• Paramedical benefits such as chiropratic, optometry, physical therapy, massage therapy and podiatry are not covered.

• Payment of hospital charges outside Canada will not exceed $75.00 a day.

• Ambulance service fees are not covered

• There is no reimbursement for the purchase of prescription drugs though the patient may be covered by Pharmacare in British Columbia

For planned medical assistance in France, prior agreement from the MSP is needed before you leave the country. It is highly recommended to apply for an additional private insurance to cover the costs not covered by MSP.

Am I eligible for a French medical coverage?

You can get the French Social security if you follow the conditions hereafter :

• You are employed in France or you receive a French pension

• You are a legal resident according to the French immigration legislation

• your main residence is in France

In this case please read the section concerning a long-term stay in France.


Studies in France

Am I covered by my BC Care card ?

If you leave British Colombia to attend school or university in France, you may remain eligible for benefits provided that you are in full-time attendance at an accredited educational facility, and are enrolled in a program that leads to a degree or a certificate recognized in Canada.

BC medical coverage may be available for up to 60 months (i.e 5 years) plus one month for going back home.

However, the MSP provides limited benefits in France :

• Reimbursement will not exceed the amount payable had the same services been performed in British columbia.

• The patient is required to pay for insured services and seek reimbursement later from MSP.

• Claims for medical care must be submitted within 90 days of the date of service and hospital claims must be submitted within 6 months of the date of discharge.

• Paramedical benefits such as chiropratic, optometry, physical therapy, massage therapy and podiatry are not covered.

• Payment of hospital charges outside Canada will not exceed $75.00 a day.

• Ambulance service fees are not covered

• There is no reimbursement for the purchase of prescription drugs though the patient may be covered by Pharmacare in British Columbia.

To avoid problems caused by these limits when receiving medical services in France (and in the European Union for occasional travels), it is advised to apply to the French Social security.

Am I eligible for a French medical coverage ?

Under a bilateral agreement between France and Canada, Canadian students are eligible for a French medical coverage in the same conditions as French students.

The applicant to a student medical coverage must abide by the two following conditions :

• The insured must be between 18 and 28 years old

• The insured must be enrolled in an educational facility accredited by the French Ministry of Education

The student must apply to one of the two medical plans that provide a student coverage : the MNEF and SMEREP (or regional plans affiliated to the SMEREP). It is also recommended to apply for an additional insurance which is also provided by each of these two plans.


Retiring in France

If you are the holder of a Care card, you must notify MSP of your date of departure and specify the reason for cancellation. If you fail to do so, premiums will continue to be charged. After your departure, benefits from MSP are provided fot the balance of the month you leave the province .

Your eligibility to the French "Sécurité sociale" (Social security) depends on whether you benefit from a French pension or not.

If you are benefiting from a French pension :

Since you are benefiting from pension from the French pension plan, you are eligible for the French social security. Upon arrival and on presenting your pension title, you must apply to the French Social security. If you were a salaried employee, you must apply to your local Caisse primaire d’assurance maladie (CPAM). You can find the address in a phone book or ask the Mairie (city hall) of your town. If you were working as a "profession libérale" (liberal profession) or simply on your own, you must apply to one of the medical plans that administer medical coverages for non-salaried employees.

For more information, please contact :

- le régime social des indépendants (RSI)

264 avenue du président Wilson

93457 La Plaine Saint Denis Cedex

FRANCE

http://www.le-rsi.fr/

or

- Caisse Nationale Assurance Maladie Travailleurs Salariés (C.N.A.M.T.S)

50 avenue du Professeur André Lemierre

75986 Paris Cedex 20

FRANCE

http://www.ameli.fr/index.php or click here

If you are not benefiting from a French pension:

You are not automatically eligible for a French medical coverage if you do not receive a French pension.

However, under certains conditions, you are eligible for the "Couverture maladie universelle" (CMU i.e Universal medical coverage) provided you have been living in France continuously for at least three months before applying.

The cover is :

• free if your income is less than 626,75€ per month.

• charged with an 8% premium based on the part of your income that exceeds 626,75€ per month.

The CMU provides the same coverage as the normal social security coverage. you also can benefit from a free additional insurance provided that your income does not exceed a certain amount. This amount varies according to the number of people that are covered by your insurance.

Plafon des ressources du foyer au1er juillet 2009 :

Number of people covered by the CMU maximum income for a free additional insurance
a single person 626,75€ /month
two people 940,16€ /month
three people 1 128,16€ /month
four people 1 316,16€ /month
additional person + 250,70€ /month

Note : If you once paid premiums to the French "Sécurité sociale" for at least three months, you are then eligible for the social security.

If you receive a pension from a country other than France and Canada, check if there is an agreement between France and this country which may make you be automatically eligible for the social security.

All the people supported by the insured must comply with the French immigration law to be eligible for a French medical coverage.

Dernière modification : 23/02/2012

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