Alice through the French Health Care System

I’ve been enrolled in the healthcare system in France since early 2015. In typical fashion (for me), I’ve been avoiding needing it. However, I’ve recently had some health concerns that require a doctor.

Healthcare in thiah_has country is so different from healthcare in the US…and not just for the obvious reasons. But before I start blogging about my healthcare excursions in France, let me start by saying that I have never enjoyed going to the doctor…ever. I have a history of mistrust with them, for some very good reasons. There is nothing more irritating than a know-it-all doctor who gives me no credit for knowing my own body, let alone credit for being able to understand the complexity of medicine, a doctor motivated by big pharma to prescribe garbage that doesn’t even address the core issues of illness, a doctor who slaps a diagnosis down with alarming inaccuracy and rolls his eyes at the possible validity of alternative means of well-being.

I realize not all doctors are like this (thank God), but far too many of them are. I avoid them like the plague…which I guess means I’d rather HAVE plague that see a doctor!

In the United States, I didn’t have any healthcare insurance for many years. I only worked part-time at a college and part-time for myself, so I was out of luck. Being healthy, it wasn’t much of an issue. I neither smoked nor drunk alcohol, I exercised daily, and I ate with my health in mind. Recently, I’ve seen a meme going around called MEDS: meditation, exercise, diet, and sleep. Those remain my first line of defense and have served me well.

I was in my transition to France at the time Obamacare became mandatory, so I managed to escape it for the most part. I won’t get into what I think of the Affordable Healthcare Act, so ineptly named. This is about France, after all.

But I do have one more US-related perception to address. I know people (I’m related to some of them) who believe that socialist healthcare as found in other countries is a horror of ineptitude and out-of-date practice with long wait-times and little to no freedom of choice. Granted, this perception is one mostly instilled by propaganda and the corporations in the US that don’t want to lose their moneytrain, but I was beginning to wonder after watching my husband deal with some medical concerns here. The jury has remained out in that regard.

But now, I have my own first-hand experience to share, and so I will.

Yesterday, I saw a general practitioner. My husband had to “encourage” me into keeping my appointment, and I knew I should just get it over with, but I really wanted to cancel. The days leading up to it, I had to keep my anxiety in check. Turned out, I had nothing to worry about. The doctor was a lovely woman with a direct but warm manner. I trusted her immediately. She fortunately spoke enough English for us to be able to communicate sufficiently, too.

I’ll be sharing more about my first appointment (okay, truthfully, it isn’t my first appointment…I’m trying to forget the first appointment…long story!) and subsequent experiences as a patient in France. Stay tuned…

 

Obamacare & International Health

I was, as a single person, not all that enthused about Obamacare until I realized that I qualified for free care. Not having had any health insurance for the last 10+ years of my life due to cost, learning that gave it a bit more luster. Now that I’m married, though, I no longer qualify for subsidies and the cost of insurance has gone up 4000%. Bummer. And of course, if I don’t purchase, penalties ensue. Fortunately, Stuart and I have decided to settle where he is now, in France. This will exempt us from having to enroll in Obamacare. Good thing, too, because if we both had to, we’d be talking around $8000 a year. Ridiculous! That money is better spent, in my opinion, on maintaining our good health through whole, healthy foods and alternative care, like bodywork and acupuncture, for well-being. That’s my two cents, but of course, each must come to his or her own conclusions.

Thing is, I’m not in France yet, and we’re not sure when things will be in place for that to happen. So, it seems I will be required to purchase health insurance or face the penalty consequences. Ironically, the penalty is based on AGI (Adjusted Gross Income) of household income. I don’t know anything about anything about any of this, but it sounds to me like the IRS is expecting me to report my nonresident alien spouse’s income to determine my penalty. Excuse me? He has absolutely no obligation to the US government to report his foreign income. He isn’t American! How can they justify penalizing me based on his income??? It’s messed up!

Aside from the tangle of US taxes and Obamacare, one of the things we are currently trying to figure out is whether Stuart can enroll me as his spouse on his insurance in France. We’re waiting for quotes from the insurer. If I need to hold a Cart de Sejour before being allowed to enroll, in other words, be permanently in France, then I will need some kind of international medical insurance in the interim. Fortunately, international insurance plans don’t cost $4000 a year like Obamacare!

I’ve been looking at Cigna Global and HTH among others. Anyone out there have experience with international health plans, good or bad?

Helpful Quick Bits: To File Jointly or Not?

Ah, the joys of a new international marriage and figuring out what to do about our taxes. It’s complicated! Here’s what I’ve learned so far:

  • As a nonresident alien, Stuart does not have to report any income to the IRS. That’s good.
  • Because Stuart and I were married this year, I’ll have to file “married filing separately”, and that means higher taxes. In fact, I’ll lose what would have been a very nice refund. That’s bad.
  • However, we have the option to elect to have Stuart treated as a resident alien for tax purposes and file jointly. That’s good.
  • But if we do that, Stuart will be taxed on his worldwide income until such time as we rescind “the choice” as it is called. And that choice can only be made once in a lifetime. Now might now be the time. That’s bad.
  • That’s because, right now, we’ve decided to settle in France, meaning there’s really no reason to drag Stuart into the US tax system. That’s good.
  • But apparently, I’ll still need to file US Income Tax as well as the infamous FBAR on all bank accounts, even those I share with Stuart. That sucks.
  • And once I establish myself and my microentreprise in France, I’ll have to file taxes in France and the US. That really sucks.
  • Fortunately, there are things like tax treaties, foreign earned income credit, and foreign tax credit. That’s good.
  • And thank God there are financial planners and accountants who specialize in the confusing, complicated web of expat taxation. That’s even better!

(Well…I am TRYING to end on a positive note.)