Under European legislation, pensioners from other EU member States, Iceland, Liechtenstein, or Norway who choose to retire to France can also transfer their health insurance entitlements to France. However, France will only cover care that is provided in France on behalf of the pension-paying State for individuals drawing a pension that is due pursuant to the legislation of an EU member State, Iceland, Liechtenstein, or Norway.
Applicable regulatory provisions:
To apply, you will first need to request the S1 portable document entitled “Registering for health care cover” (equivalent to the E 121 form) from the fund that is paying your retirement pension.
With this document, you will be able to register with the local health insurance fund (“caisse primaire d’assurance maladie”) where you reside in France without paying any new contributions, assuming that contributions are already being withheld by your pension payer if required under the applicable legislation.
To register with a French social protection institution, you will be required to submit a birth certificate showing your parents’ information as well as a passport or a national identity card.
The local health insurance fund with which you register will only cover care you receive in France. The health insurance benefits you receive will be French benefits paid under French legislation.
If any family members have come with you to France, each of them will need to be issued an individual S1 portable document.
These provisions only apply if you are drawing a pension from a basic statutory scheme.
Applicable regulatory provisions:
family members to coverage for all types of health care (medically necessary and scheduled care).
These States, which are listed in appendix IV of (EC) regulation No. 883/04, are the following: Austria, Belgium, Bulgaria, Cyprus, the Czech Republic, Germany, Greece, Hungary, Luxembourg, the Netherlands, Poland, Slovenia, Spain, Sweden, Iceland, Liechtenstein, and Switzerland.
Example: You are drawing a pension from the Belgian scheme only and have become a resident of France. You and the members of your family who have come with you are covered by the French health care system (“assurance maladie”) on the basis of the S1 portable document (equivalent to the E 121 form).
You and your family members can return to Belgium to receive medical care there, regardless of the reason for your stay, and you will be covered for all types of care in Belgium (medically necessary and scheduled care) pursuant to Belgian regulations.
As for the other member States which do not appear on the list in appendix IV (i.e. Croatia, Denmark, Estonia, Finland, Ireland, Italy, Latvia, Lithuania, Malta, Norway, Portugal, Romania, Slovakia , and the United Kingdom), only medically necessary care which is provided during a temporary stay in the State paying the pension will be directly covered by that State’s competent institution.
Example : You are drawing a pension from the Italian scheme only and have become a resident of France. You and your family members are covered by the French health insurance system (“Assurance maladie”) on the basis of the S1 portable document.
During a temporary stay in Italy, you and your family members will only be covered for care that becomes medically necessary during your stay pursuant to Italian regulations. If scheduled care is provided in Italy, the Italian social security scheme will not provide any coverage and you will have to pay for all medical expenses out-of-pocket.
Applicable regulatory provisions:
During a vacation in an EU member State that is neither France nor the State that is paying your pension, you and your family members are entitled to coverage for care that becomes medically necessary during your stay on the basis of a European health insurance card (EHIC) or provisional replacement certificate (PRC), pursuant to local regulations.
You will need to request these documents directly from the competent institution of the State that is paying your pension.
If you have paid for care upfront, do not sent your reimbursement claim to the local health insurance fund (“Caisse primaire d’assurance maladie”) where you reside in France and where you are registered (on the basis of the S1 portable document).
Rather, you are required to submit your reimbursement claim to the competent institution in the State that is paying your pension.
Applicable regulatory provisions:
The S2 portable document entitled “Entitlement to scheduled treatment” (equivalent to the E112 form) authorizes you to travel to an EU member State to receive medical care. It entitles you to coverage of your care pursuant to local regulations and at local reimbursement rates.
You will need to request this authorization from your French health insurance institution. When you do, your local health insurance fund (“caisse primaire d’assurance maladie”) will check that the care is included among the treatments permitted under its legislation and that it cannot be provided within a medically acceptable timeframe in France. It will then immediately submit its findings to the institution that is paying your pension.
The institution of the State that is paying your pension will notify your local health insurance fund (“caisse primaire d’assurance maladie”) of its decision. If it authorizes your care, it will issue you with an S2 portable document.
The institution that is paying your pension can only deny your request for authorization if the French fund has determined that the above-mentioned requirements are not met in France.
If there is no reply within the timeframe that has been set forth by its national legislation, the requested authorization is considered as having been granted by the competent institution.
In the event of a life-threatening emergency, the local health insurance fund (“Caisse primaire d’assurance maladie”) will issue the authorization on its own authority.