Healthcare Part 1 – the EU countries

I received a very interesting question recently, one that I thought I might address on this blog as I’m sure many will be interested in the answer: it deals with medical coverage in countries abroad.

The writer says that “A subject which I need to address is a medical one as I am diabetic and require medication which at the moment I get from the N H S. Could you please tell me where I can find out which countries I could live in and still get NHS-funded treatment without returning to the UK every 3 weeks?”

I am assuming that this person means funding by the British National Health Service and this being the case, the quick answer is “none”. Once you leave the UK to reside elsewhere permanently you are no longer permitted to use the NHS. In future, because of spiralling costs, this is going to be far more strictly regulated than it is at present.

HOWEVER, the EU countries and Switzerland have national health systems that provide free or low cost health care for those contributing to their social security systems plus dependants. The system also caters for pensioners and this includes those from other EU countries.

If, as a EU member country resident, you are visiting the country, you will be able to access emergency care on showing your EHIC (European Health Insurance Card). For details of the EHIC please see below. UK nationals over 60 and for some people who qualify for invalid benefits will need the appropriate form (E121 or E106) to access free health care.

Comparisons, they say, are odious, but I recommend that even within the EU you look very carefully into the level of medical care compared to the NHS before you move. Don’t sign buy a property abroad and later find that there isn’t a doctor or hospital within miles for instance. There are many English-speaking and foreign doctors in resort areas and major cities of many countries but not necessarily so in the more rural areas. Find out if there are expats living nearby and try to find out what they think of the local medical facilities – or maybe your estate agent can help here?

I am going to outline very briefly a number of options on offer in a few of the more popular countries chosen by Brits for emigration:

Greece’s public health system (IKA) is more or less indicative of EU medical offerings and provides free or low cost health care for those who contribute to Greek social security, plus their families and retirees (including those from other EU countries). Members are charged 25 per cent of the actual cost of prescriptions, although there are higher charges for non-essential medicines plus substantial contributions for many services, including spectacles, dentures and other treatment.

Pensioners who intend to take up residence in Greece and who are entitled to free medical treatment in the United Kingdom also enjoy this facility in Greece. They should take the form E121, which is issued by their local Department of Health Office in the United Kingdom before relocation, to their local IKA office.

A person who was unemployed in the UK and coming to look for work in Greece is entitled to free medical treatment in Greece if he/she produces form E119 to their local IKA office. This should also be obtained before leaving the UK - it is issued by their local Department of Health Office in the U.K. In both the above cases IKA will exchange the form for a medical booklet.

But here is the worrisome factor: Novo Nordisk, a Danish company and the world's leading supplier of insulin for diabetics is withdrawing its state-of-the-art medication from Greece.

A spokesman for the Danish pharmaceutical company said it was because the price cut by the Greek Government would force its business in Greece to run at a loss – and it is already owed so much money by them.

Spain
As with the UK, Spain has a national health system which provides services as detailed above for Greece.

France
If you live AND work in France you will need to affiliate as a resident and in this case you should make provision to contribute financially. As a retiree you can affiliate to the system using an E121 form via the Caisse Primaire Assurance Maladie (CPAM). You can get this form from the Dept. for Work and Pensions (DWP) in Newcastle upon Tyne (take a look at www.dwp.gov.uk) As long as you are in receipt of the state pension in the UK this form will be valid.

Once you get to France you should take this form, along with proof of residence in France and a form of identity, to your local CPAM office. Most towns in France have this office but if in doubt, ask at your local mairie. Once you are affiliated to the system you will be issued with a Carte Vitale (green card) which you have to take with you when you visit the doctor or hospital.

For those under retirement age, it is not possible to affiliate to the French system unless you have an E106 form, again available from the DWP. This is relevant for those who are not planning to work in France and is valid for up to 2 years, after which it is wise to take out private health insurance until you reach state retirement age or you are there for 5 years, after which you will be able to affiliate to the system.

Many French citizens "top up" their state benefit so that they can have full use of the system as, unlike in the UK, in France treatment (whether private or public) is not free at the point of delivery. Even if you subscribe to the Sécurité sociale, on seeing a doctor or specialist (specialiste) you first pay the full bill (tarif) and are then reimbursed at a later date (about 10 days). Generally speaking, Sécurité sociale refunds 70 per cent of the cost of a visit to a médecin traitant (a GP or family doctor) and most specialistes.

Next week I will outline a couple of non-EU countries and tell you how they work.

Kim

The Overseas Guides Company
http://www.Emigrationguide.com