Question: While visiting France recently my husband had an accident and needed hospital treatment. When the time came to leave, the hospital presented me with a bill – I showed them our GHIC cards, but they said it only covered 70 percent of the costs, so I was faced with a bill for over €1,000. Is this correct? Is it a post-Brexit change?
Health cover has changed since the UK left the EU, but despite some changes to the system, the overall principle is the same.
Healthcare in France is done on a reimbursement basis – so French people (and permanent residents in France) are presented with a bill after they have received medical care. They pay the bill and then present the health card that all residents are entitled to (known as a carte vitale) and the French state then reimburses a portion of the bill.
The reimbursement level varies depending on the type of treatment (eg cancer treatment is reimbursed at 100 percent, dermatological treatments at a lower rate) and the patient’s circumstances (pregnant women, children and injured war veterans get all treatment fully reimbursed) but in most cases the patient will be left with a portion of the bill to pay themselves.
This can range from just a few euro for a GP appointment to thousands of euro if you have had a lengthy hospital stay and/or complicated treatment. For this reason, most French residents have top-up insurance known as a mutuelle to cover these extra costs.
The system for visitors to France is basically the same, the difference being who reimburses the costs.
Travellers from within the EU are covered by the European Health Insurance Card (EHIC) in which EU governments basically agree to refund each other for healthcare their nationals receive while visiting other countries.
Brits used to benefit from EHIC but since Brexit, do not. However the UK government does provide a card known as GHIC (Global Health Insurance Card) which, if you are travelling to France, works in basically the same way as EHIC.
The crucial point, however, is that both GHIC and EHIC only reimburse a proportion of the cost – in most cases around 70 percent.
If you do not have either travel insurance or separate health insurance, the remaining cost will come out of your own pocket – and this can easily run into hundreds or thousands if you have a serious illness or accident.
GHIC and EHIC will also usually only cover emergency or unplanned treatment and don’t cover the cost of repatriation – for this reason it is strongly advised for people to have travel insurance when coming to France.
Non-EU nationals may also be asked at the border to provide proof of health cover while in France. In practice this is quite rare, but border guards are within their rights to ask for this, as well as proof of where you will be staying and whether you have the funds to support yourself while in France. EHIC or GHIC can be used as proof of health cover in these circumstances.
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