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HEALTH

Reader question: Can I move into a French care home as a foreigner?

Many people move to France to enjoy their retirement, but what happens if you become ill and can no longer live independently?

Published: 11 October 2021 15:41 CEST
A nurse serving drinks to elderly residents at a care home in France while they play bingo
(Photo by ROMAIN LAFABREGUE / AFP)

Reader question: What happens if someone moves to France and then needs to go into a care home because of old age or infirmity? Who pays? Does it make a difference if you worked in France and paid into the French system, or if you moved here after retirement?

It’s a common question for both people who moved to France at a younger age and worked here, or those who retired here from other countries, but as a foreigner in France what rights do you have to access old-age care? And will you have to pay for it?

Let’s start with some positive news – there are no specific rules restricting foreign nationals going into a French care home or accessing any assistance they require – provided they have the legal right of residence in France and places are available.

There’s more good news, too – there are thousands of care homes, private and public, in France offering a range of services for older people.

You may have heard the term Ehpad – it is an acronym for établissements d’hébergement pour personnes âgées dépendantes. There are also Ehpa homes, which are établissements d’hébergement pour personnes âgées.

Most care homes for older people are Ehpads, catering for residents aged 60 or over who require some form of routine medical assistance that means they are unable to look after themselves fully. All are state registered and guarantee standards of hygiene, safety and comfort.

There are also options for those in need of more intensive medical care and those with dementia.

Importantly, in-home care is also available along with a series of specialised benefits which enable people to live in their own homes – where they may feel most comfortable – for as long as possible.

Sheltered accommodation provides a half-way solution for older people who are able to still live mostly independently but need some practical daily support. These are available in some towns but not all areas.

Cost

Costs for residential care homes depend on a number of factors – but are routinely divided into three parts:

Accommodation
AKA board, lodging and leisure – inducing meals, utilities, cleaning and laundry services.

In public-sector Ehpads, which care for those who are eligible for means-tested state aid, the rate is fixed by the local council. In private homes, however, this portion of the bill can be set by individual homes – though there is a limit on the size of annual increases. Expect to pay somewhere in the region of €50 to over €100 per day for this.

Medical care
The social security system (Cpam) covers medical costs, hence the importance of being legally resident in France, and registered with the French state health system.

READ ALSO How to get a carte vitale in France and why you need one

Dependency care
This is day-to-day non-medical care, such as help with washing and getting around, so includes any special equipment a person may require according to their needs.

Costs vary according to the level of daily assistance required, based on a six-level classification system – which includes everyone from bed-ridden patients who need constant care down to those still able to look after themselves.

On average, you would expect to pay in the region of €2,000 per month to stay in an Ehpad in France. But prices vary based on location, level of care, and level of service.

Who pays?

If you’re legally resident in France and registered within the health system (with a carte vitale) then costs of medical care are covered by Assurance maladie, leaving you with only the accommodation and dependency costs.

But here it gets complicated and depends on your financial situation.

There are a range of means-tested benefits available to cover these costs, but not all are available to people who have never worked in France, although if you receive a state pension from your home country, you may be entitled to financial support from them as well.

To qualify for these you will obviously need to show financial information and people with substantial savings are unlikely to benefit. However an important point is that the value of your home is not included in the means test, so you will not be expected to sell your home to cover care costs.

Remember, under French law children and grandchildren of those in care have an obligation towards needy parents and grandparents to help with their essential needs and the council can request they contribute, again depending on their financial situation.

Those who need help paying the bills should be able to show that they have been habitually resident in a given département for at least three months. Non-EU citizens (including Britons) must hold a carte de séjour.

Brits

Certain benefits that cover care costs are not available to non-EU citizens who have never worked in France.

However Brits who moved to France before December 31st 2020 – and are therefore covered by the Brexit Withdrawal Agreement – are treated in this regard in the same way as EU citizens. You can prove this using the Withdrawal Agreement carte de séjour.

Find out more

A lot of useful information on care for older people in France is available on a dedicated government website here – which explains the different benefits and payments available, along with the rights and responsibilities of older people and their families, and can help you identify the care you need, or find nearby residences.

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For members

PROPERTY

French property: What is buying ‘en tontine’?

If you're buying property in France, you might be thinking about buying 'en tontine' - this has advantages especially when it comes to France's strict inheritance laws, but can also have tax implications.

Published: 25 March 2024 11:17 CET
French property: What is buying 'en tontine'?

What is it?

The ‘clause de tontine’ sometimes also known as a ‘clause d’accroissement’ is a clause that is inserted into the property deeds when you are buying a house or apartment.

It can only be inserted during the purchase, and cannot be added later.

It’s basically a ‘group purchase’. It’s most commonly used by unmarried couples who are buying together but it can be used by larger groups too – for example a group of friends buying a holiday home together.

You will have to ask a notaire to draw up the tontine clause during the property purchase and it can only be used if 

  • the parties are equally involved in the financing of the purchase
  • the parties involved have a roughly equal life expectancy (for this reason tontine clauses may be rejected if there is a significant difference in age between the purchasers)

What’s the point of it?

The main reason that people use it is to sidestep France’s strict inheritance laws, which assign that a certain portion of every estate must go to children, at the expense of a partner. 

READ ALSO How France’s strict inheritance laws work

For this reason it is particularly used by couples who have children from previous relationships.

On a property with a tontine clause in effect, when one owner dies their share of the property passes in its entirely to the other member/members of the tontine.

This cuts out children from inheritance, but means that a surviving partner is not evicted from their home in favour of the children of the deceased. 

It also has the advantage of making the intentions of the deceased clear, to avoid arguments among heirs after their death.

It should be noted, however, that the tontine clause only takes in the property that it covers – other assets may be subject to French inheritance law so it’s therefore probably wise to arrange a will, to ensure your wishes for your estate are met.

The surviving party can ask a notaire to update the property deeds to show that they are the sole owner, if they want. Be aware there will be a fee, which could reach four figures for the privilege – and it doesn’t actually involve any change to the property title.

Drawbacks

The advantages of the system are clear, especially for blended families, but there are some potential drawbacks too, which mean that anyone considering buying in this way would be well advised to take proper legal advice before they start.

Inheritance tax – while a tontine will help you to avoid restrictions on inheritance, it does not exempt you from inheritance tax. French inheritance tax is structured according to your relationship to the deceased, and people who are neither married nor related to the deceased pay an eye-watering inheritance tax rate of 60 percent.

The only exception to this top rate of inheritance tax is if the property is your main residence and it is valued at under €76,000 – in that case, tax is paid at a rate of 5.8 percent.

Married couples and family members pay a much lower rate or not tax, but if you’re not married to your tontine co-purchaser, be careful that you’re not lining yourself up for a massive tax bill in future years.

Wealth tax – depending on the value of the property, it could tip you over into the ‘wealth tax’ category when you inherit. France’s wealth tax is a real estate based tax and is levied on anyone who has real estate assets (property and land) worth €1.3 million or more.

The calculation includes property held en tontine.

Tax savings – you might hear tontines being advised as a way to limit your French tax liability.

While this used to be true, changes to tax laws means there are no no significant tax advantages to buying this way – the same is true for buying a property via an SCI, which used to represent a tax saving until the law was tightened up.

Disinheriting family members – One side effect of the tontine clause on mixed families is to effectively disinherit any children of the first person to die.

Because the property passed to the survivor, under French law, only their direct descendants – rather than any family by marriage – are entitled to automatic inheritance.

That means that the children of the surviving partner will be entitled to the statutory share of the entire asset (between 25 and 30 percent depending on the number of children), but the children of the first person to die will be entitled to nothing. Obviously you can choose to leave them something in your will, but you can only leave them some or all of the estate which is not automatically given to the children on the survivor.

Divorce/dispute – if the members of the tontine split up or (in the case of friends) fall out, then they can either sell the whole property or agree to buy each other out.

However, if one party refuses to sell, then you have very limited legal options – unlike a standard property purchase a tontine is not regarded as joint ownership, so one partner cannot be forced to sell as part of a divorce procedings, for example.

Basically the tontine can only be ended or changed with the agreement of all parties – so if you can’t agree between yourselves then you may be stuck with it.

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