What kind of healthcare expats will be entitled to once Britain exits the EU is the make or break issue for many, particularly retirees, in determining whether or not they will return to the UK.
Expats who work in France and pay social charges are entitled to the same access to healthcare as French citizens. 70% of their medical bills are paid by the state and they can buy a top up policy to cover the rest. Those on very low income can apply for the CMU complémentaire which covers all medical expenses and those with a chronic illness also receive free healthcare.
Retired expats, however, have their healthcare paid by the NHS and the question is: will this continue after Britain leaves the EU?
If Britain stays in the European Economic Area (EEA) – the ‘single market’ – it is likely that existing arrangements may continue. If, however, Britain ends up negotiating separate trade agreements with individual EU member states it could decide to continue paying expats’ healthcare through the NHS (via an equivalent of the S1 form) or it could decide to cut costs by ruling that expats have to pay for their own healthcare if they want to continue living abroad – unless the country they are living in decides to cover these costs.
Additionally, without an S1-style agreement, income from pensions (except government pensions) would no longer be exempt from social charges which vary according to income. If both exemption from social charges and NHS funding are lost, it may become cheaper for retirees to take out private health insurance which would exempt you from social charges.
But this is a worst case scenario. It is very likely that reciprocal agreements will be put in place for pensioners already settled in France. For one thing, with the existing pressures on the NHS, the British government is unlikely to welcome thousands of returning pensioners. Existing early retirees could also be entitled to continuing health cover within the French system through acquired rights.
And remember, if you have lived in France for five years then you can apply for French residency which gives you access to all the same rights and benefits as French citizens.
The EHIC card, (formally the E111 card), which gives those travelling to France the right to free medical help for injuries or emergencies, was negotiated between countries in the single market. If Britain remains in the single market, nothing should change.
Even if Britain leaves the EEA, it is likely that reciprocal agreements will be negotiated with France. France is the biggest tourist destination in the world and thousands of those visitors are Brits heading across the channel to gites and campsites. France is unlikely to want to deter them.