Photo courtesy of vitasamb2001, www.freedigitalphotos.net
By Gillian Brotherwood, co-founder of Settling Here
Historically, all people had to take medical insurance in the country in which they were employed. However in 2002, a bilateral agreement between the European Union and Switzerland, gave Frontaliers the right to choose which national healthcare system they wished to take and pay into. France, under pressure from Frontaliers, accepted to allow Frontaliers to choose between the French healthcare system, the CMU, or take out a private health insurance. The decision was given initially for a 7 year timeframe. This was extended by a year in 2009 and then again until June 2014.
The majority of Frontaliers (95%) choose the private healthcare option, this is for a variety of reasons, including cost, choice, and availability of services. Private Frontalier healthcare insurance contracts offer a variety of options for people, allowing individuals to choose cover depending on their budget and health care requirements.
It was confirmed last October that from 1st June 2014 all Frontaliers will no longer have the option of choosing a private insurance over the CMU. What this means is that Frontaliers will either have to pay into the French healthcare programme: the CMU or the Swiss healthcare programme: LAMal.
The Swiss care option will be available to people currently signed up to it, new workers in Switzerland who will be living in France (new Frontaliers who will have up to 3 months to decide if they do not wish to take LAMal), people who return to Switzerland to live, and finally those whose personal circumstances have changed i.e. retire or taken new employment after having been unemployed and receiving benefit for a period of 3 months prior to taking up a new job in Switzerland.
The role out of this change will happen between 1st June 2014 and 1st June 2015. Initially the contributions to the healthcare will be 6% of the RFR (revenue fiscal de reference) less a fixed credit, increasing to 8% on January 2016. The fixed credit, which is set on the 1st of October annually, is currently 9,534 euro. This is the amount subtracted from the RFR before calculating the CMU contributions of 6%. All people working in Switzerland and living in France will pay the same percentage (6 then 8%) regardless of the number of people in the family working or number of children in the family.
Frontaliers will no longer have the choice to access healthcare facilities in Switzerland under the CMU with two exceptions. A medical emergency (the CMU cover medical emergencies in any European country including Switzerland. This cover is accessed through the EHIC (European Health Insurance Card)). The French Minister for Health indicated in a press release January 20th last that ongoing treatment in Switzerland would be covered. But it should be noted that the details on how, and to what percentage, it would be covered have yet to be announced.
This is a very emotive subject. Many people are concerned about the cost and also the lack of medical facilities available in the Pays de Gex. The cost may not be as much as one imagines and it is worth doing the maths. Some people i.e. one partner working with 2 children may be financially be better off under the CMU system. With regards to facilities available, there are many specialists and hospitals within a one hour drive so it will be an opportunity to discover what is available in France, which does have the reputation of having one of the best healthcare systems in the world. Private healthcare insurers will offer top-up or complimentary cover, this of course on top of the 6%, if Frontaliers choose to buy it.
On a final note, although it has been confirmed by the French Government that these changes will take place, the specifics and details as to how it will all happen have not been announced. One thing is certain, with tens of thousands of Frontaliers moving to the CMU from the end of May, the French CMU office is going to be very busy. Watch this space!
Bio
Gillian Brotherwood set up Settling Here with Aislinn Delmotte, to provide practical help and advice to individuals, couples and families relocating to the Pays de Gex, a region where some of the customs are similar to those in neighbouring Switzerland, but where many aspects of living are entirely different.
Settling Here aims to bridge the gap between France and Switzerland and provide information which is specific not only to France but to the Pays de Gex region too. Each week Settling Here run information sessions, bringing along regional experts to discuss certain topics which include, for example: what to do in an emergency situation; insurance requirements in France; driving laws: and cross-border issues.
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