New changes in Health Care cover

[EuroTrash]

That's very interesting, TB, thanks for sharing.

I'd wondered that too, but couldn't face even starting to try and work it out!

Would have guessed slightly higher than that. 33000€ is only around £27k - more than I will ever see as an annual income, but not much to a lot of people.

[Sprogster]

tinabee, you have highlighted a very good point and I recall in the past posts from early retired expats complaining they had to join the French health system when it was compulsory, because private health insurance was a better and cheaper option for them. Many private health insurance policies automatically provide Europe wide cover for no more cost, enabling someone for example to use privately a top hospital in London if they wished. That is probably part of the dilemma the French have with early retiree expats in that those on lower incomes and or poor health are probably more drawn to CMU than those with higher incomes and good health where private health insurance could be a cheaper and better option until their S1 kicks in. 

[Judith]

Been too busy to reply sooner, Sweets, and make the the point that it is not dangerous, if you have taken into account your own personal situation and decided to bear the risk yourself ... but of course if you are not retired, and you have no income, it could be ... however, I would hope that anyone moving to another country would have done their sums and made allowances, first.  We fall into the retired (so covered by UK) without mutelle cover ... in reasonable if by no means perfect health, and so far any treatment, even hubby who had a year of ops and treatment for kidney stones, for which he would have paid dearly for a  mutuelle because of his history with this complaint .. even after all that,  what we paid was much, much less than a mutuelle would have cost.

The danger is in not having done your sums properly, rather than in itself, not having a mutelle.

[Jay]

[quote user="Judith"]even hubby who had a year of ops and treatment for kidney stones, for which he would have paid dearly for a  mutuelle because of his history with this complaint ..

[/quote]

That is not the case, top-up does not in any way depend on your past medical record.

[Pickles]

[quote user="Jay"][quote user="Judith"]even hubby who had a year of ops and treatment for kidney stones, for which he would have paid dearly for a  mutuelle because of his history with this complaint ..

[/quote]

That is not the case, top-up does not in any way depend on your past medical record.

[/quote]

So they don't work on the US HMO model of "we've already paid for you to be cured of that, so it's not possible for you to be suffering from that problem again"?

[EuroTrash]

Mutuelles are not allowed by law to take previous medical history into account.

However, the law doesn't appy to private companies who also offer top-up insurance.

[Pickles]

[quote user="Judith"] ... it is not dangerous, if you have taken into account your own personal situation and decided to bear the risk yourself ... but of course if you are not retired, and you have no income, it could be ... however, I would hope that anyone moving to another country would have done their sums and made allowances, first.  ... (snip)

The danger is in not having done your sums properly, rather than in itself, not having a mutelle.[/quote]

And therein lies the problem: it seems that there are still people who haven't done their sums or who think that because we are all in the EU, France (or Spain, or Germany) is just like the UK ...

[Pickles]

[quote user="EuroTrash"]Mutuelles are not allowed by law to take previous medical history into account.[/quote]

Ah, I suspected that must be the case. Thanks for clarifying that.

[idun]

It was always my understanding that a mutuelle could not take medical

history into account, although they may have clauses to not give

'immediate' cover, there could be a waiting period.

BUT don't private medical insurance companies take medical history into account?

I

would take issue with doing one's sums in advance, and ask just how one

could.  We can ask all the questions we want, but let us face facts,

whosoever we ask doesn't know what we don't know and people do assume

that we are au fait with things that every french person knows or should

know and we do not. So they answer our questions, but don't think to

add X Y or Z because they assume that we 'know' that bit because we

haven't asked about it.

Personally I would always have a

mutualist in France as well as being in the CPAM. One could be like my

Dad and only need a little health care at nearly 90 or end up being

unwell for years with things that are not classed as an ALD in France

but without mutualist cover could erode one's savings and then if one

lived long enough maybe find oneself eventually being unable to join a

mutualist because not all take on new clients when they are over a

certain age.

That is me, maybe some of you are well off enough

to have lotsa savings that really would cover your medical bills. I

wouldn't risk it and for me it could also leave me in the situation of

losing everything to pay my medical bills. I wouldn't do that.

Re the surgeon, well accidents happen, we are all built differently and some people will simply have less sturdy bits to them than others. There will always be surgical accidents, you cannot have people going inside any of us with very sharp blades and not realise that there is 'risk' involved. Unless this surgeon was really bad and was killing people off right left and centre, then how could one attack him or his insurance. Anyway, the french are not really litigious and that IMO is a good thing.

Re the S1 covering that huge bill of 165000€, well I do not get that at all. There is something very wrong with that happening, that is not how the system should work at all. The ONLY cover afforded to anyone with an S1 is the exact same cover as 'locals'. That means that we with our french S1's in the UK have to pay exactly the same for dental treatment, prescriptions as a local, no more, no less. And if they introduce payments to GP's etc, then we will have to pay that too, no exception because we are in effect under a foreign scheme.

[EuroTrash]

Very often the UK did used to reimburse medical costs in full, although it had no obligation to do so, as you say an EHIC holder in France is only entitled to the same refunds that would be given under the French system. IIRC the NHS website used to explain this but then say that you 'may be required to' meet some of the costs yourself or something like that.

The document that announced the end of the S1 for early retirees also referred to this and acknowledged that it had been the custom in many cases for the UK to meet the full amount of treatment abroad, it is not obliged to do so and is going to stop doing this in future.

Top up insurance is like any other insurance - if we knew in advance whether we were going to need it, the insurance companies would soon go out of business. As it is, we don't, so what they sell you is not your doctor appointments and maybe an op or two, it is peace of mind.

[idun]

Remember Val2 said that these people had been in France for some a long time and

had NOT taken out mutuelle cover. AND that they ended up being covered under pensioners

S1 and I reiterate, that is NOT how the S1 that took over from the old E121 works.

We, as pensioners with a french S1 in the UK and paying UK

tax and french social security charges, I do not think that anyone

should be covered by either system IF they could not be bothered to make

sure that they were properly covered themselves. 

I don't mind anyone not wanting to take out a mutualist, that is a choice that any adult can make, but don't expect 'me' to pick up the bill when they really cannot afford it.

This has really annoyed me, as much as that bloody MP and her expenses to be honest!

[terry51]

Has anyone heard of or had experience with the "Legislation Letter" the Overseas Health Care Team in Newcastle have mentioned to me which can be presented to CPAM in lieu of the S1 form?

[EuroTrash]

I assume that the 'legislation letter' is the letter issued to confirm that you are not eligible for an S1, ie the UK confirms that it is washing its hands of you and is no longer your competent state.

When you apply for CMU, CPAM might ask for this confirmation because obviously they want to be sure that you aren't entitled to cover from the UK, before they start considering your application to join the French health system.