European Health Insurance Card
This article was written by Jo Cleere and will be of interest for any Eropeans visiting another EU country. Note, this does not cover emergency evacuation from mountains, which must be insured seperately.
EHIC (card that replaces the E111)
The European Health Insurance Card entitles you to reduced costs (the equivalent of being a French citizen) if you are unfortunate enough to have to use a hospital in an EU country while on holiday there. Without this card (or insurance policy) you will have to pay the full costs. Just having a British passport is not enough, at least it isn't in my experience.
You can apply online for the card, which is free, at: www.ehic.org.uk.
Other useful info on the NHS website: http://www.nhs.uk/healthcareabroad/Pages/Healthcareabroad.aspx. Specifically about France: http://www.nhs.uk/healthcarefrance/Pages/healthcarefrance.aspx.
[French-based people travelling in the EU can get one from their caisse (www.ramgamex.fr for professions libérales).]
Carré Neige insurance
Generally, the insurance you are offered at the ticket desk at the ski lift will be this (2.70€ on top of the cost of your ski pass for the day). If you require medical attention on the piste, a pisteur will note down the details of your pass and the insurance company will pay for you to be transported to the nearest medical centre or back to your accommodation on the same day as the accident.
The Carré Neige should also cover any excess hospital fees not covered by your state health cover (EHIC) and other medical insurance. However, it will not always be automatically covered by your insurance and you might have to pay these costs and apply for a refund afterwards.
(See site for more details - http://www.carreneige.com/index.php/garanties-hiver-2008-/-2009.html. In English: http://www.carreneige.com/index.php/carre-neige-cover-2008/2009.html.)
In short, to avoid having to stump up the full amount of your healthcare in France, it is very important that you can produce your EHIC on admission or when you are discharged from a state registered medical centre/hospital.
Once you have given in your EHIC at the hospital there will generally still be a relatively small amount left for you to pay.
Medical insurance
This is where your medical insurance comes in. You can pay this amount and claim it back once you are home. Alternatively, and if it looks like you will be in hospital for a few days, you or your family/friends can contact your insurance company while you are in hospital. The procedure with a French insurance company is that your insurance company will give you a case number and further contact details. They will also ask you for the hospital's contact details. The insurance company will contact the hospital requesting a medical report from your doctor/surgeon. This should then be sent direct to the insurance company, which will make its decision and organise an ambulance etc for a repatriation, if necessary.
For this reason it is important to contact your insurance company as soon as you think there might be a risk of having to be repatriated by ambulance and air ambulance. These costs can quickly mount up and as well as being cheaper, an insurance company should also make all the arrangements for you.
My experience in all this this is largely limited to an orthopaedic ward and here is an example:
If you are unlucky enough to have a skiing accident and break a leg which requires pins, you are likely to stay in hospital for a few nights. Without any kind of insurance you can expect to be asked to pay for your ambulance ride to the doctor's surgery/hospital. An operation and a four-day stay in a surgical ward will cost around 5000€ if you cannot produce a valid (check the dates) EHIC and have not contacted your insurance company, which can liaise with the hospital. This bill comes down to around 82€ (standard daily charge of 16€ plus flat rate hospital charge of 18€ a day) if you can show your EHIC. Most medical/holiday insurance should cover this extra amount.
Do bear in mind that most French insurance policies will only pay any extra costs incurred above the standard rates covered by your state healthcare system (eg. NHS). Hence, the importance of your EHIC.
Top tip: check what kind of insurance and assistance you get with your credit cards. Some will cover repatriation costs.
The key point with all these kinds of cover, if you have to stay in hospital, is to inform the insurance company as soon as possible. The fact that you have been taken from the piste to the hospital does not mean that your insurance company or private healthcare plan know you are there. Hospital staff simply don't have time to contact insurance companies for patients.
In short, my advice to UK residents coming on holiday to France is to make sure they have an EHIC that covers every member of the family with them, and some kind of insurance to cover repatriation costs and excess medical costs above those which are covered by the state.
For seasonal workers and/or ski bums, there's a really good explanation of what's covered by the yearly Carte Neige here: http://www.natives.co.uk/news/2004/10/16cart.htm (although dated 2004, I think it is still applicable).
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