Expat insurance and health insurance in Norfolk Island

There is no fund comparable to French Sécurité sociale. The Australian public scheme, Medicare, has applied on the island since 1 July 2016, as has the Pharmaceutical Benefits Scheme. Services Australia and Home Affairs reserve it for citizens, permanent residents, applicants for permanent residence (under conditions), temporary visa holders covered by a ministerial order and citizens or permanent residents of Norfolk Island, the Cocos (Keeling) Islands, Christmas Island and Lord Howe Island. Home Affairs specifies that, in most cases, visitors are not eligible and bear all of their healthcare costs. France is not on the list of countries linked to Australia by a reciprocal health care agreement (Services Australia).

On site, care is provided by the Norfolk Island Health and Residential Aged Care Service (NIHRACS), a multi-purpose service funded mostly by the Australian government: emergency department open day and night, inpatient care, general practice clinic, dental clinic, allied health and aged care. The service states that there is no operating theatre and that patients with a surgical emergency or who are seriously ill are evacuated to the mainland. Tertiary specialist care is provided to residents by a Queensland hospital service. See the page healthcare system in Norfolk Island.

• Short tourist, family or business stay: France Diplomatie states that French nationals must hold an electronic travel authorisation (eVisitor, subclass 651) or a visa. According to Home Affairs, France is among the countries eligible for the eVisitor, which allows stays of three months at most on each entry, is requested from outside Australia and is not a work visa.
• Reaching the island from the mainland: the Department of Infrastructure specifies that a passport and a visa are not required for this journey, but that photo identification must be presented for each passenger, children included; the passport is the recommended document. Flights arrive and depart through international terminals: a passenger card must be completed and baggage and passengers may be checked by the Australian Border Force and biosecurity officers.
• Longer stay, work or study: a suitable visa is necessary (working holiday visa, sponsored skilled worker visa, student visa, visitor visa for a longer tourist stay), to be requested from Home Affairs. Australian immigration has applied on the island since 1 July 2016.
• Health insurance: Home Affairs strongly recommends private health insurance for visitors not eligible for Medicare, and several visas are subject to condition 8501, which requires adequate health insurance to be maintained. The island's health service, for its part, advises travel insurance for visitors without a Medicare card. France Diplomatie deems an assistance contract covering all medical costs and medical repatriation imperative.
• Biosecurity: the Australian Biosecurity Act 2015 applies to arrivals on the island; certain foods, plant material (including wooden objects) and animal products must be declared on the passenger card, with no penalty when everything is declared.
• Student: no EHIC outside the European Union; Assurance Maladie (French health insurance) recommends an assistance or insurance contract, and CFE membership remains possible. See student insurance abroad.
• Seconded employee : without an agreement, secondment "outside an agreement" maintains the French scheme for three years, renewable once (CLEISS); the CFE and an assistance contract remain recommended in addition.
• Retiree: Assurance Maladie no longer reimburses care received in a country without an agreement; the CFE (retirees' plan) or private insurance takes over (ameli; CLEISS).

No individual fine for lacking insurance is mentioned in the sources consulted for a visitor; the risk is financial, as a person not eligible for Medicare is considered a private patient and pays for their care (Home Affairs).

No social security agreement links France and Australia. France Diplomatie says so in so many words ("there is no bilateral agreement between France and Australia in the field of social cover") and Australia does not appear in CLEISS's list of bilateral agreements in force. These rules apply to Norfolk Island, where Australian social security applies. See also the Australia page.

• Sickness and maternity: no coordination; no S1 form, no EHIC. During a temporary stay, only urgent and unforeseen care can possibly be reimbursed on return, based on French flat-rate tariffs (Assurance Maladie).
• Secondment: in the absence of an agreement, secondment "outside an agreement" lasts three years, renewable only once, with a two-year waiting period before a new secondment in the same country for the same company; the employee has a dual status and the host country may require its own contributions (CLEISS).
• Expatriation: a local employee falls under the scheme of the country of employment; they declare their transfer of residence to their fund within the month and hand back their carte Vitale and their EHIC before departure (Assurance Maladie). The CFE makes it possible to remain insured in France by contributing in addition to the local scheme.
• Retirement: without an agreement, no totalisation of periods is provided for; the Australian old-age pension, which is non-contributory, requires in particular a period of residence in Australia (CLEISS).

Status of the territory. According to the Australian Department of Infrastructure, Norfolk Island is an external territory of Australia, falling under section 122 of the Constitution since 1 July 1914. Between 1979 and 2015, it had a limited self-government regime with a legislative assembly; the 2015 act and associated texts handed national and state-level services to the Australian government, created an elected regional council and allowed the extension of Australian systems to the island. Local governance has evolved since: the Department publishes the up-to-date state of the arrangements on its governance page.

Tax treaty. The French-Australian treaty of 20 June 2006 (decree of 18 June 2009, in force since 1 June 2009) defines in its article 3 the term "Australia" in the geographical sense excluding external territories, with the exception in particular of the territory of Norfolk Island: it therefore applies to the island. Tax residence is determined under article 4, after applying each State's domestic law (service-public.fr recalls the French criteria for tax domicile: home or main place of stay, main professional activity, centre of economic interests). The ATO states that Australian taxation has applied to residents of the island since 1 July 2016, with the exception of the goods and services tax and a few other indirect taxes.

1. Before departure: notify French agencies of your departure (health insurance fund, CAF, France Travail, pension funds); hand back your carte Vitale and EHIC if you are expatriating.
2. For any stay, including a short one: take out an assistance contract or insurance covering all medical costs, medical evacuation and medical repatriation, imperative according to France Diplomatie.
3. Apply for the eVisitor from outside Australia for a stay of three months at most, or for the visa matching the planned duration and activity; carry photo identification for the journey from the mainland.
4. Seconded employee: the employer carries out the "outside an agreement" secondment formalities with Urssaf (CLEISS); keep paid invoices for the reimbursement claim.
5. Long-term settlement: check eligibility for Medicare with Services Australia (permanent residence, application for permanent residence or ministerial order); in the meantime, private insurance or the CFE.
6. Taxation: have your tax residence validated with the French tax administration and the Australian tax administration (ATO), relying on the treaty of 20 June 2006.
7. Retiree: arrange the CFE (retirees' plan) or private insurance; for stays in France, register with the Cnarefe (ameli).
8. Bring personal medication for the whole length of the stay, as the island's pharmacy may not have every product in stock (island health service).
9. Register on the roll of French nationals living abroad, recommended beyond six months' stay: the French Consulate General in Sydney provides consular services for the whole of Australian territory, outside the Melbourne district; as the island is not named, confirm the competent post with the French embassy in Canberra.