Expat insurance and health insurance in the Isle of Man

Manx Care is the island's health and social care provider, which the Isle of Man Government compares to a British NHS Trust. The island's public health service (IOM NHS) is funded by taxation and reserved for its residents; it is separate from the United Kingdom's NHS. The main public hospital is Noble's Hospital, whose emergency department is open 24 hours a day for serious injuries, illnesses and trauma. An out-of-hours doctor service (MEDS) operates in the evenings and at weekends, and a Minor Injuries Unit at Ramsey hospital is open Monday to Friday from 8 a.m. to 8 p.m.

Access rules depend on status. Residents of the United Kingdom (England, Scotland, Wales, Northern Ireland) visiting the island are treated on the same terms as island residents under a reciprocal health arrangement, limited to stays of less than six months. Visitors from other jurisdictions, including France, are entitled free of charge only to emergency departments, out-of-hours doctor services and minor injuries units; other care, including hospitalisation after emergency treatment, medicines and tests, is at their expense, and inpatients must present their insurance details or pay their costs before discharge. The island's government advises comprehensive travel insurance, notably for any medical repatriation.

• No free movement: since 31 December 2020, citizens of the EU, the EEA and Switzerland wishing to live, work, settle or study on the island fall under immigration control and need an appropriate immigration status (Isle of Man Immigration Service). British and Irish citizens are excluded.
• Visit: Schengen visas are not valid on the island. France Diplomatie states that a French citizen must hold an electronic travel authorisation (ETA, £20, valid for two years) to travel to the Crown Dependencies, unless they hold a visa or resident status, and that a valid passport is required to enter the United Kingdom; check the island's own rules with the Immigration Service before departure.
• Work: a national who is neither British nor Irish and who lives outside the United Kingdom and the Channel Islands applies for entry to the territory under the Worker Migrant route (or Worker ICT Migrant); the confirmation of employment (CoE) is requested by the island employer, who must have passed the sequential labour market test. The holder of a Worker Migrant visa does not need a separate work permit, but their dependants do.
• Work permit: the island's permit system (Control of Employment Act) is independent of the United Kingdom's; a UK Skilled Worker visa does not allow work on the island.
• Health insurance: no mandatory private insurance is described in the island government pages consulted. Holders of the Worker Migrant visa pay no health surcharge, but access to the public service is based on residence; in the early period, as when travelling, insurance covering hospitalisation, medicines and repatriation remains prudent.
• Student: no EHIC recognised in the island government's pages; a student insurance or comprehensive travel insurance covers hospitalisation and repatriation, which the reciprocal health arrangement does not provide for in all cases.
• Seconded employee : CLEISS (the French centre for European and international social security liaison) publishes no page on secondment to the Isle of Man; the 1956 convention applies there, and the duration, conditions and forms are to be checked with CLEISS and the employer before departure.
• Retiree: the immigration pages consulted describe no category specific to retirees; form S1 belongs to European coordination and does not apply here. See the guide health insurance for retirees abroad.

The island's government recommends that all visitors have their own insurance, as the reciprocal health arrangement with the United Kingdom does not cover every case, in particular medical repatriation, which can be very expensive.

The Isle of Man is not a member of the European Union: coordination with France runs neither through EU regulations 883/2004 and 987/2009 nor through the European health insurance card. According to CLEISS, the general Franco-British social security convention of 10 July 1956 still applies in relations between France and the Isle of Man, and France is bound to the island by this text. CLEISS does not include it in its list of bilateral agreements by country and publishes no page on the island's scheme, nor any holiday, secondment, expatriation or retirement section: the practical arrangements (forms, competent local fund, duration) are to be confirmed directly with CLEISS.

• General framework of the 1956 convention, as CLEISS describes it for Jersey (another territory to which it is extended): coordination of sickness-maternity, invalidity, old age and survivors, work accidents, family benefits and death, with provisions on urgent hospital care. Its scope as to persons for the Isle of Man is not detailed by CLEISS.
• Reciprocal health arrangement between the Isle of Man and the United Kingdom: it covers only British residents, for stays of less than six months; it does not apply to a French citizen resident in France.
• Taxation: the BOFiP lists no double taxation treaty with the Isle of Man. France and the island are bound by a tax information exchange agreement signed in Douglas on 26 March 2009, in force on 4 October 2010 (decree no. 2010-1252 of 21 October 2010), which does not define tax residence. An expatriate's tax residence is checked with the French tax administration and the island's Income Tax Division.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Check travel documents: valid passport and ETA if required (France Diplomatie, Isle of Man Immigration Service).
3. Employee: the island employer requests the confirmation of employment (CoE); the visa application is then submitted on the UK Visas and Immigration website, up to three months before the start date.
4. Take out insurance covering hospitalisation, medicines and medical repatriation for the whole period during which access to the public service is not yet established.
5. Seconded employee or retiree: ask CLEISS about the application of the 1956 convention before departure.
6. On arrival: register with a GP in your area when resident status allows it.
7. Tax questions: check tax residence with the French administration and the island's Income Tax Division, as no double taxation treaty exists.
8. Register with the roll of French nationals living abroad (French Consulate General in London, responsible for the Isle of Man).