Health top up

[johnycarper]

I know some people are going to say we should have know but we did not so I am posting on here to warn others who may not know.We have a health insurance top up and always assume the money we got back was a mixture of the rsi and our insurance company,this is not correct and its worth checking.For the last 2 years we have only been getting back the rsi part as our insurance company was never registered with the health authorities,I sent our insurance company all the invoices and we have just got back 198 euros.I hope this makes sense as its worth checking.

John.

[mint]

The critical phrase to look for, I believe, is "tiers payant".  If you see that, then the payments from the mutuelle should be automatic.

Having said that, when we changed address to another region, the automatic process got a bit lost somewhere in the system and it was months before I realised.

After I sent all the copies of doctor's visits, etc, I got the money back. 

So, as you have pointed out, it's worth checking your statements from the CPAM and from the mutuelle.

[Sunday Driver]

John is referring to the IT convention (NOEMIE) that top-up insurers sign up to with the caisses. Under the convention, the caisse automatically transmits details of the patient contribution to the top-up insurer who then process their reimbursement without requiring a separate paper based claim from the patient.

You can check whether your top-up is a signatory here:

List of organisations signed up under a NOEMIE convention (2011)

 

 

[sid]

That's a useful link SD, thank you.

It's funny how I find out how little I actually know about the way the health system works, but that's another piece in the jigsaw.  [:$]