The number of British people retiring to France from the UK remains high; it’s one of the most popular destinations for older expats due to its laidback lifestyle and good quality of life.
According to an Office of National Statistics report released in August 2017, an estimated 148,800 British citizens were living in France in 2016. The data also shows that around 46% are aged 55 and over, and the majority of those over 50 were neither working or looking for work, choosing the EU haven for their retirement years.
There are a lot of things to consider when retiring to France, and something that is incredibly important is ensuring that the right health insurance is in place.

French healthcare system

France is well known for its fantastic healthcare services. Since January 2016 it has offered a universal healthcare system called Protection Universelle Maladie (PUMA), which ensures continuity of healthcare for all those people who are legally resident in France. Many expats living long-term in France (over three months to qualify, and then resident for at least six months every year) can access this healthcare system for subsidised medical treatment.
Healthcare provision in France is not free, unlike the NHS. Usually up to around 70% of the cost of care is covered by the healthcare system (although in some serious circumstances this may be higher), and the rest is payable by the individual. Many residents chose to take out complementary ‘top up’ health insurance, which is different to private insurance, to cover medical costs either completely or just for larger costs, such as operations.

Retiring to France

For retiring to France, the first step is to get an S1 form, which enables expats to affiliate to the French healthcare system. The S1 form is for those receiving a pension from another country, ie the UK. Once in the healthcare system, expats can then apply for the green ‘carte vitale’, which requires various supporting documents and can take a little time to organise and receive. Expats should, therefore, have some kind of interim healthcare cover until this process is complete.
There are two separate processes here. As soon as a person is accepted into the healthcare system, they can use it, but would have to pay for medical costs upfront and then have them reimbursed quickly by the state. Once a ‘carte vitale’ is obtained, then this can be handed over in lieu of payment to avoid the upfront costs.
The PUMA system is still relatively new. Up until its introduction, early retirees had to wait for five years to be considered a permanent resident before they could affiliate with the French healthcare system. This meant that they were legally obliged to have private health insurance instead. Early retirees, ie before the UK’s legal retirement age, cannot apply for an S1 form so the usual residency rules apply, which is that a person must have lived in France for more than three months and reside there for six months of every year. Upon proving residency, an early retiree can then access the French healthcare system. Private health insurance would then be required for those first few months before residency is established.