Married couple Samuel and Olivia, both 37, are moving to the French Riviera to open a B&B, having spent over 10 years as City investment bankers. Samuel is planning to go back to London two weeks a month to work for his old firm. They are looking for private medical insurance to cover them in France and the UK. Both are in good health. What recommendations can you make?
Leslie Smith, Medibroker
Some British expats, particularly those in Europe, believe they can return to the UK for treatment. However, they may find that once they are resident abroad they lose their entitlement to free NHS treatment.
This is why we recommend that a couple like Samuel and Olivia would consider private medical insurance (PMI). A standard level of insurance would cover inpatient and day patient hospital treatment only, which would effectively cover the major medical costs, from a host of plan providers such as Goodhealth's Major Medical plan at £538, William Russell's Select Care at £569 and Bupa International's Lifeline Essential plan at £774 - all premiums quoted per person per year for the first year.
Should they prefer a higher level of cover they could consider looking at the comprehensive level, which also usually includes outpatient treatment, local GP visits, prescription medication and specialist visits. The premiums for this level would be £827 from Goodhealth Foundation with a £65 excess per claim; £858 from William Russell Premier Care with a £30 excess per claim; and £1,108 from Bupa International Lifeline Classic with no excess. Local GP visits are not included in the Bupa plan but it does include a degree of maternity cover.
Samuel and Olivia may decide to start a family in the Riviera, in which case they will need a fully comprehensive plan to include maternity cover. Goodhealth offers a Lifestyle Plus plan for £1,485 with a £65 excess per claim, William Russell has Premier Plus at £858 with a £30 excess per claim and Bupa International's Gold plan costs £1,366 with no excess.
All the plans mentioned can have increased excess/deductible to reduce premiums.
Andrew Apps, Goodhealth Worldwide
With a new business to worry about, for Samuel and Olivia being in good health and keeping costs to a minimum will be important.
In the short term (up to six months), while they are finding their feet, Samuel and Olivia may be able to rely on EU reciprocal arrangements such as those provided by the E111 (now the EHIC) but will nonetheless need to register with the Caisse Primaire Assurance Maladie (CPAM), which for many is now obligatory.
With the French spending twice as much on healthcare as their UK counterparts, waiting lists such as those endured by NHS patients for most procedures do not exist.
But while the cost of most serious illnesses and major surgery will be covered in full under CPAM, Samuel and Olivia will still be responsible for up to 30% of costs of other treatment, including dental care.
They should therefore consider a top-up policy, or "policies complementaires" and "mutuelles", to cover this balance.
Goodhealth's Première Healthcare Plan has been specifically designed for the English-speaking community living in France and covers the difference between the amount reimbursed by CPAM and the actual costs involved.
Samuel and Olivia may choose from two levels of cover, either the Première plan at !305 (£209) per person, which provides for inpatient treatment, or the more comprehensive Première Plus plan at !494 (£337) per person, which covers both inpatient and outpatient treatment including a family doctor and prescription drugs.
The option to include treatment received outside France costs just another !278 (£190) a year. This would be ideal for Samuel while he is working in the UK.
Ron Buchan, Allianz WorldWide Care
Samuel and Olivia require a solution which provides full health insurance coverage in the UK and France. It is possible for French residents to participate in the French social healthcare system if they pay tax.
However, even then, "top-up" insurance is needed to meet the full costs of treatment. Therefore it seems unlikely that membership of the French social health system will be an immediate, or medium-term, option.
It is also important to remember that many UK health insurance plans, even international plans, follow the UK health insurance model of excluding coverage for chronic conditions because of the availability of treatment for such conditions on the NHS.
Since this facility will not be available in France, it is important that chronic condition cover is included in any plan purchased. It is also important that any plan provides cover in other countries.
This will deal with any travel the clients may undertake and will also allow for treatment shopping.
Allianz Worldwide Care would therefore suggest that Samuel and Olivia choose an international plan which provides cover for chronic conditions and pre-existing conditions and provides direct settlement for inpatient treatment. This will require underwriting, but if the clients are in good health that is not an issue.
We would also recommend they purchase a plan which covers them for treatment throughout the world.
One of our standard international plans, Executive, plus our outpatient plan, Bronze, would be an ideal solution. The annual premium (excluding insurance premium tax) would be £1,264 per person.
By selecting an optional outpatient deductible, Samuel and Olivia can reduce their outpatient premium by up to 70%.
