Key facts about expatriate health insurance for retirees:
Laws on health insurance for expat retirees are very clear these days, but unfortunately most expatriates aren’t very familiar with them. This puts them at serious risk of not being covered in the event of a problem abroad.
Many retirees do not report their foreign address to their local social security office because they still have an address in their country of origin and can easily go back and forth.
They rely on their home country’s health care system and sometimes travel insurance, as if they were only traveling for a few weeks. This can work for modest health expenses, since health insurance often covers emergency health care costs during travel. For basic care, it should be sufficient for proper reimbursement.
The concern is that, in most health care systems, you have to maintain an actual residence in the country of origin in order to be covered. That means that an expat who returns to their home country only once or twice a year is in an irregular situation. In such cases expenses abroad are not covered, for any reason.
This means that, if you are hospitalized, your health insurance company may ask more questions than usual for a consultation and deny coverage, in which case your travel insurance may not work either since it is only meant for short stays.
If you are a citizen of the European Economic Area or Switzerland and are moving outside of this area, you can join the CFE, even if you have never lived in France. It is generally be much less expensive to choose a combination of CFE + CFE complementary insurance than a first euro plan. It costs €200/month for a single person, or €357 for a couple.
In addition, because CFE contributions don’t change after age 60, the benefit of this rate will increase over time.
When it comes to managing reimbursements, complementary CFE insurance management generally takes a little longer than direct management, since even if the insurer is a CFE partner (meaning that you don’t have to send your requests for reimbursements to both organizations), the insurer still has to wait for the CFE’s payment before making its own. You’ll need to allow an extra 3 to 10 days.
To manage your budget wisely, remember that you don’t have to choose the most expensive or comprehensive plans.
For hospitalization, most plans cover 100% of the invoiced costs. However, you will need a minimum coverage limit of €200,000, or even €300,000 or €500,000 depending on the country. The most inexpensive plans may not provide a private room, but they will allow you to be treated wherever you want without worrying about the price.
For vision and dental care, compare the price of the coverage with the price of these expenses locally. These types of expenses may be much less expensive in your host country than they are in your home country, for the same quality. We often advise clients to save money by purchasing these types of coverage, but if you do want to purchase them you certainly can.
Lastly, it is essential to have a good coverage for medications and examinations, because in the case of chronic illness you will run into two problems:
- In most countries with a strong health care system, such as France, Canada, Germany, etc., treatment prices are controlled by the state, which generally pays for a portion of these long treatments. Elsewhere, the price of medication is unregulated, and can be 5 to 10× more expensive.
- Examination equipment such as MRI machines, scanners, etc. are mostly installed in the private sector, which means that they are also very expensive.
Aside from the concept of coverage described above, purchasing a CFE supplement is important for several reasons:
- The CFE is often difficult to reach.
- The CFE's rules for reimbursement may change at any time, but the insurer's rules won’t. Investing in a CFE supplement makes your coverage more secure in the long term.
- If you are in a country where the CFE provides third-party payment for hospitalization, it is impossible for an insured person to know which hospital they will be able to go to until they are actually hospitalized.
Investing in a CFE supplement makes your coverage more secure in the long term. For example, between 2016 and 2020, the CFE changed its rules for reimbursements and third party hospitalizations 4×. No complementary global health insurance has ever done this.
For more information on these three points, see our CFE page.
Regular medical treatment, long-term condition: how to be covered abroad?
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