Even rich bankers retiring to France will need health insurance His first step is to register within the UK social security system for an S1 certificate (formerly E106). Polly Parsons, of Exclusive Healthcare, insurance providers based on the French Riviera and specialists in expat medical cover, says: "As long as he has paid his NI, he'll be OK for two years within the French system. Had he retired at 49 and not paid NI, purchase of private health cover would be mandatory. The French health system is very good but only covers around 70 per cent of costs, so he'd probably take out top-up insurance to cover the remainder, like most French do. Being well-off, he'd go for our top one at €900 a year. Problems begin after two years. Ms Parsons says: "At that point, he would absolutely be required to buy insurance. With his heart condition, he won't get cover without exclusions or loading. Each case is different, individually assessed and underwritten accordingly. Clearly, a 51-year-old man with such deep pockets might not be too phased by paying a heavy excess two years down the line. But to give an idea of what he could face then, a healthy man of 53 on current rates would pay €2710.74 a year for the top Platine policy with Exclusive Healthcare. And that sum takes no account of premium loading. On the other hand, as well as giving cover in France, the policyholder does get 90 days annual cover anywhere in the EU, including his home state. A less comprehensive Exclusive Healthcare plan for a 53-year-old currently costs €1,643. This provides no cover outside France. "He would have to buy travel insurance to go outside France because he would have no right to (state) health care in Europe," adds Ms Parsons. His history of heart trouble and high blood pressure could plague the banker. Lee Gerry, underwriting manager at London-based insurers Expatriate Healthcare, says: "Most providers would simply exclude the condition and if he went for a fully underwritten policy [including the heart condition] it would certainly be loaded or declined." He adds: "Our policies are moratorium-based so if the policyholder went two years from taking insurance without treatment or advice on the condition, he would be fully covered from then on. A moratorium does at least give you the assurance that if, after two years, you've stayed the course, you are covered, while the underwritten policy could mean permanent exclusion or, to get cover, a heavy loading. Mr Gerry said the 51-year-old would pay €4,140 a year for a comprehensive Primary Plus policy with Expatriate Healthcare without an excess. That would cover hospital and primary (GP) care but exclude top-end items such as dental, health screens and check-ups, and (for women) maternity cover on a top-range Expatriate Select plan. To include such items under a Select plan, the annual nil-excess premium rises to €6,436. As ever, taking an excess can lead to significant savings. If the individual opts for a €500 excess per condition on the comprehensive plan, the premium plummets to €2,312 a year. Mr Gerry says many expats reckon they will not be making much use of primary care and therefore opt for hospital-only Primary cover. On a nil excess, this would cost €2,130 a year. The case of the banker also points up the problem facing pre-retirement age emigrants heading for popular Mediterranean countries that don't want their pressurised health systems clogged up by foreign nationals. With Europe in its current financial situation, it would be fanciful to expect any improvement from the patient's standpoint.