johnycarper Posted January 29, 2012 Share Posted January 29, 2012 After 5 years of living here we thought we had been getting all the money we should back,part from carte vittale and the rest from the mutual.A french friend now says we have been doing it wrong and we should send all the invoices to our insurance company as not all money is sorted by the rsi.I believed that they sent the part outstanding to the insurance for them to pay us back, I hope this make sense and can anyone explain in plain English please. Link to comment Share on other sites More sharing options...
NormanH Posted January 29, 2012 Share Posted January 29, 2012 If you have a Carte Vitale there aren't any 'invoices'. The idea of the Carte was to avoid the feuille de soins, the old piece od paper which you had to send to the CPAM. With the Carte Vitale this is sent electronically. The CPAM re-imburses you their part directly, and then the Mutulle pick up he tab for the rest, if it is covered.You pay your GP 23€ for a consultation for example, and the CPAM gives you back almost 16€, and the Mutuelle around 6€, leaving you the 1€ forfait to pay.In no case would the Mutuelle expect to receive an 'invoice' from you, unless it is something you have paid for (such as a single room in Hospital) which they didn't pay directly. Link to comment Share on other sites More sharing options...
idun Posted January 29, 2012 Share Posted January 29, 2012 Won't this depend on the contract the OP has with his mutuelle?We had a couple of things on ours that were not covered by the secu and for all the mutuelle wouldn't pay the full amount did contribute towards the bill, off the top of my head a couple of dental things were covered by ours. Link to comment Share on other sites More sharing options...
NormanH Posted January 29, 2012 Share Posted January 29, 2012 Yes, that would be covered by my 'unless' bit above where you have paid something but can claim a bit back. The OP spoke of 'sending all the invoices'' which is not the case. Link to comment Share on other sites More sharing options...
Chancer Posted January 29, 2012 Share Posted January 29, 2012 Is it indeed possible to have a mutuelle if you dont have a carte vitale?I am in the system but without a carte vitale, I have to ask for and send off feuilles de soins for remboursement, I dont have a mutuelle nor the money to pay for one but I thought one could not have a mutuelle unless I had a carte vitale, am I wrong? Link to comment Share on other sites More sharing options...
idun Posted January 29, 2012 Share Posted January 29, 2012 I reckon that you are right Chancer. No state health cover, no mutualist.And now you have made me wonder about the retraite complementaires. I think that they don't pay if there is no state pension, something for me to find out about. Link to comment Share on other sites More sharing options...
johnycarper Posted January 30, 2012 Author Share Posted January 30, 2012 Thanks for all your replies,but I am still not clear about the payments.We receive from the rsi(our mutuelle) an invoice showing what they have paid as a percentage of the total bill and there is a column that has a header saying votre mutuelle but there is never anything in the column.I hope this is clear as i cannot see how I can copy a invoice onto the site to show people as that would be easier.John Link to comment Share on other sites More sharing options...
EmilyA Posted January 30, 2012 Share Posted January 30, 2012 It isn't normally RSI who reimburse you, it is the health caisse that you chose when you set up your business. Ours is set up so that our health caisse Adrea / Muti pay their bit and the top-up bit is sent to the top-up insurerer for payment. It is all done automatically and we get statements of payment from both of them once a month. I think you need to go in and ask! Link to comment Share on other sites More sharing options...
JSKS Posted January 30, 2012 Share Posted January 30, 2012 [quote user="Chancer"]Is it indeed possible to have a mutuelle if you dont have a carte vitale?[/quote]If you mean by this, top up insurance then yes. As long as you have an attestation of health cover you can join a top up scheme - we chose Adrea as both out caisse and for the top up. After 3 yrs we finally got the Cartes Vitale last week up until which time we would have to send the Feuilles de soin directly to Adrea. Link to comment Share on other sites More sharing options...
NormanH Posted January 30, 2012 Share Posted January 30, 2012 But I think when Chancer says 'Carte Vitale' he is using it as a shorthand for the attestation.Remember that it is the paper attestation which proves you have health cover. The Carte Vitale is only a handy piece of plastic to shortcut the process of re-imbursement Link to comment Share on other sites More sharing options...
Chancer Posted January 30, 2012 Share Posted January 30, 2012 I have neither a carte vitale nor an attestation, the doctors etc I pay direct and claim a remboursement from the CPAM using a feulle de soins, for bigger bills like hospital stays they claim direct from CPAM and just send me a facture for the 30% plus other bits and bobs that remain at my charge that avoids paying out large sums and waiting for remboursement, I have also done this for ambulance journeys. If they have any doubts they phone the CPAM who confirm that I have rights until a certain date. I have never thought to ask CPAM for an attestation as to date I have never found the need for one although on reflection it may be handy to carry in my wallet as the next time I am wheeled off to hospital I may not be conscious or lucid! Link to comment Share on other sites More sharing options...
NormanH Posted January 30, 2012 Share Posted January 30, 2012 I have sent you a pm Link to comment Share on other sites More sharing options...
Chancer Posted January 30, 2012 Share Posted January 30, 2012 Replied. Link to comment Share on other sites More sharing options...
idun Posted January 30, 2012 Share Posted January 30, 2012 Never mind carte vitales, the most important thing is an attestation and you should have one, if they are reimbursing you then you are entitled to one. IF for example you had to go into hospital they would be most happy with an attestation. I just had a new attestion sent out last week as it was ages since we had the last one and I like to have a new one every so often. Link to comment Share on other sites More sharing options...
Will Posted January 30, 2012 Share Posted January 30, 2012 [quote user="Chancer"] Is it indeed possible to have a mutuelle if you dont have a carte vitale?[/quote]As far as I know, you can buy a topup policy virtually anywhere as long as you have a French social security number, as JK suggests. I had a topup without a carte vitale for at least two years. Paying and claiming back was a right pain, but it more or less worked.In fact I'm not sure that you even need a SS number. There are specialist companies like Exclusive Healthcare that sell topup policies to EHIC holders in France. Link to comment Share on other sites More sharing options...
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