Health cover

[Joe]

Went to CPAM in Pontivy today with someone who can speak French.

We were told i would get an email before Friday.Received it 2 hours later stating that they had not yet heard about the new ruling from the EU which means that things stay the same as was stated in 2007.

Deep joy!

[cooperlola]

Thanks for the feedback, Joe.  Sorry you didn't succeed although I suspect this saga won't end here (nor the debate about it!)

[Joe]

I sent an email to the Gov' dept,but I never received a reply.

I have just paid out 2000 euros for 6 months hospital cover only. I reach UK retirement age in September so I will get my form to to go into the system,but it does annoy me that by law I should be in it by now.

[Sunday Driver]

There has been no change in the law which requires 'inactive' EU citizens without an 'S form' to have private health insurance until they acquire legal residency status.

The recent circular issued to CPAMs reiterates the current regulatory position, then goes on to explain that its purpose is to clarify the 'accident of life' provision whereby individuals faced with serious difficulties or unforseen circumstances beyond their control may apply for CMU, which the original 2007 circular did not make fully clear.

It also requires a comprehensive review of an applicant's lifestyle in order to determine whether they meet the 'accident of life' criteria, so anyone rocking up at their CPAM in a Ferrari to complain that the private cover they knew they had to budget for is getting a bit expensive is likely to be disappointed....[;-)]

 

 

[Joe]

Yes I knew about the"means test" that you have got submit to.Luckily I am under the threshhold which is why I sent the email in the first place.

[Sunday Driver]

What is this 'means test' threshold that you are you talking about?

 

 

[Joe]

All income has to be declared before you can get in.Too little, your a burden, too much you can fend for yourself.In my case the only income is a company pension which brings me into the middle bracket.

If I receive a reply I will give all the information that they require.

[Sunday Driver]

You seem to be missing the essential point...

In order to be considered for CMU, you first have to show that unforseen circumstances beyond your control have prevented you from maintaining your obligatory private health insurance cover.

In your case, you've just spent 2,000€ on private cover, so it's hard to see how you would fulfill this primary condition.  If you don't, then your 'middle bracket' income is immaterial.

 

 

[Keni]

Okkkkayyy -

So, as Coops knows, for us it goes like this. He 53 me 57. One year S1, so Carte Vitale expired 31/12/11.

We turm up at the CPAM offices with letter from Newcastle, our Titre de Sejour cards,, copies of everything we could think of, includng bank accounts for the previous year and we get given a form to fill in.

We then had to go to Limoges, where our Carte Vitales were taken and replaced with Aide Medical d'Etat cards, for which we paid 30 euros (Timbre Fiscal). This gives us Prise en Charge, 100% medical health cover until the end of the year. We did not ask for this, we were given them upon them looking through our bank accounts.

So, if the Carte Medical d'Etat is for illegal aliens (?),not for EU members(!), why were we given them. The website says:

'L'aide médicale de l'État (AME) est un dispositif permettant aux étrangers en situation irrégulière de bénéficier d'un accès aux soins, sous réserve de remplir certaines conditions.

(Google translate)The state medical assistance (AME) is a device that allows illegal aliens to benefit from access to care, subject to certain conditions.

It then says:

Vous pouvez bénéficier de l'AME si vous êtes dans une des situations suivantes :personne étrangère en situation irrégulière au regard de la réglementation relative au séjour en France (absence de titre de séjour ou de récépissé de demande),personne ayant droit du bénéficiaire de l'AME ( enfant, personne à charge),   personne étrangère placée en rétention administrative,personne (française ou étrangère) gardée à vue.À savoir : les ressortissants communautaires ne disposant pas d'un droit au séjour au-delà de 3 mois de résidence en France relèvent de l'AME.

(Google translate) You can take advantage of the AME if you are in any of the following:
 illegal foreign person under the regulations governing the stay in France (no residence permit or receipt of application)
 Person of the recipient of the soul (child dependent)
 foreign person placed in administrative detention,
person (French or foreign) in custody.
Namely: EU nationals do not have a right to stay beyond three months of residence in France within the MEA.

So now...? It goes on to state:-

Vous pouvez bénéficier de l'AME si vous résidez en France :de manière ininterrompue depuis plus de 3 mois, et de manière stable. La résidence stable signifie : soit avoir en France son foyer, c'est à dire sa résidence habituelle, qui doit avoir un caractère permanent, soit avoir en France le lieu de son séjour principal, c'est à dire y séjourner pendant plus de 6 mois par an.Si vous demandez à bénéficier de l'AME et que vous ne remplissez pas la condition de 3 mois de résidence en France, vos éventuels enfants mineurs sont inscrits sans délai au dispositif de l'AME pour la prise en charge de leurs soins pendant les 3 premiers mois de leur présence en France.

(Google translate) You can take advantage of the AME if you live in France: uninterrupted for more than three months, and stably. Stable residence means: or have his home in France, that is, habitual residence, which must be permanent, in France or have his place of principal residence, that is to stay for more than six months per year. If you ask to benefit from the MEA and that you do not meet the requirement of three months of residence in France, your potential minor children are enrolled without delay disposition of the soul for the management of their care during the 3 first months of their presence in France.

So if you live here for more than 3 months, stably and permanent you are ok, on the other hand if you are an Eu member you can't be in it for more than 3 months - so why is our card set to expire 31.12.12?

To us it seems great, we have health care and yes, we are on low income, but with our Titre de Sejour, we can't be illegal aliens (Can we?) x

Answers on  a postcard to.......[:-))]

.

[Joe]

Booze up in a brewery comes to mind!

This is what I have found out.Nobody seems to know what is going on at CPAM.

I am going back again soon to insist on written refusal which they must do by law.Then you are entitled to take it further.

[tinabee]

[quote user="Keni"]

To us it seems great, we have health care and yes, we are on low income, but with our Titre de Sejour, we can't be illegal aliens (Can we?) x

Answers on  a postcard to.......[:-))]

.

[/quote]

I would imagine that you are classed as "illegal" since you do not fulfil the conditions required for EU citizens, i.e. after 3 months residence to have appropriate healthcare and enough income to support yourselves. It may now be that since you are in receipt of AME you cannot count this time towards your 5 years of  uninterupted "legal" residence.

[pachapapa]

[quote user="tinabee"][quote user="Keni"]

To us it seems great, we have health care and yes, we are on low income, but with our Titre de Sejour, we can't be illegal aliens (Can we?) x

Answers on  a postcard to.......[:-))]

.

[/quote]

I would imagine that you are classed as "illegal" since you do not fulfil the conditions required for EU citizens, i.e. after 3 months residence to have appropriate healthcare and enough income to support yourselves. It may now be that since you are in receipt of AME you cannot count this time towards your 5 years of  uninterupted "legal" residence.

[/quote]

The french bit of your post suggests that your situation is irregular rather than illegal.

[Keni]

Funnily enough, today we have received a letter, (suprise) with the exact form from them that we filled in a month ago. Also asking us not to use our Carte Vitales (strange, they took them off us).

The letter contradicts itself all the way through, so we fill in the form (again), send it with a letter explaining (again) or failing that, get our French neighbour (and union representative) to come with us to CPAM and really let them have both barrels! He is always up for sorting out the French Government.[:)]

Also in the letter they refer to the Nov. 2007 declaration, only when we went to their offices, we had the update from last year and they knew nothing about that!, Which is why they took all our bank information, as well as Impots, etc., and they read the bit about under circumstances etc., etc., - we have a Titre de Sejour and we have had more than 3 months health care and continual residence here in the past year.

So the games' a foot (sorry a' trente centimetres!)

[NormanH]

What is a Titre de Sejour?

[tinabee]

[quote user="NormanH"]What is a Titre de Sejour?
[/quote]

Residence Permit

explained here

http://vosdroits.service-public.fr/F16003.xhtml

[NormanH]

But I meant is it the same as a 'Carte de Séjour'?  I wasn't aware of any other permit for EU citizens.

[tinabee]

[quote user="NormanH"]But I meant is it the same as a 'Carte de Séjour'?  I wasn't aware of any other permit for EU citizens.
[/quote]

Yes it's just another name for Carte de Séjour

[NormanH]

Then my reading is that:

You got a Carte de Séjour because you satisfied the conditions. However at some point some thing has happened that you no longer do (for example not enough income, or no Health insurance)

So you have become 'irregulier' ...not illegal.

Rather than booting you out, as sometimes been advanced as the lot which awaits, they are giving you the AME which is often on a year to year basis.

My neighbours have just been through the process of applying for a second year.

[Keni]

So Norman, as you say, we have the AME, we had the Carte Vitale, which ran out 31/12/11. So is this something that counts against us? We have again received this form to fill in, which we have filled in the same as before. We still have our top up insurance, which we pay monthly and we have enough income to live on.

We have spoken with our neighbour tonight and he thinks someone somewhere has got things wrong, so he's going to phone for us on Monday to see what is what. He's never even seen this card!

[woolybanana]

The most difficult stage is getting someone to see that there has been a cockup ....... Yeah? What is on paper is always right; have you never seen a fonctionnaire look at a piece of paper whichis known to be wrong and say "but it says here........"?

Then putting is right is a whole new ball game.

Remember that the system can never be wrong because that implies a mistake which means some has been incompetent which means sanctions etcetc. 

[idun]

[quote user="NormanH"]What is a Titre de Sejour?
[/quote]

 

NH my last card has Titre de Sejour on it and was issued in 2007.

[AnOther]

[quote user="Keni"]We have spoken with our neighbour tonight and he thinks someone somewhere has got things wrong, so he's going to phone for us on Monday to see what is what. He's never even seen this card![/quote]Probably in common with 99% of other French nationals then, why would he have ?

It's an outdated document which only immigrants needed, in the days when they did need it !

Turn it around, do you know or would you recognise whatever documentation an immigrant to the UK might need to carry or produce ?

I too suspect that they have got it wrong in granting you AME but I think I'd be a little careful at this juncture and adopting a combative approach (really let them have both barrels!) may well prove counterproductive and backfire on you.

Let's stand back and take stock shall we, and sorry to be blunt but these appear to be the facts: (I will assume you fully were appraised of the requirements for legal residence when you moved over ?)

You took a flyer and came to France about a year ago with an S1 covering you for one year only.

When that S1 expired you applied for cover under a controversial and untested EU ruling.

You were refused but mistakenly (or possibly generously - have you considered that?) given AME which covers you not for 70% but 100%.

Your presence here on AME no longer counts towards 5 years of legal residence.

Remember now that you wanted health care, well rightly or wrongly you've got it - and on a 100% basis to boot - so as I see it you have two choices, neither of which are ideal but then you did voluntarily place yourself in the situation.

1. Duck down behind the parapet and sit it out, with luck they will renew the your AME almost automatically. In a year or two the position on the EU ruling may well become clearer allowing you to reapply on that basis if necessary.

2. Argue the toss, risk lose the AME, alienate CPAM, then take them on again to try and persuade them to let you back in, all the time without health cover which, by the definition of having been granted AME, you cannot afford top pay for privately.

I'm pretty sure which I would choose !

 

[Keni]

Hi, AnOther,

Regarding this AME card, believe me I was quite happy to duck down, and will continue to try do so, just returning the form they require is our first step, and we will take it from there. It's our neighbour who is concerned for us.

We did not take a flyer as you say, I have been trying to see the route in which one enters the system - having worked all my life, and after the health problems I have had, serious enough, but not life threatening, I wanted space to breathe. If the worst comes to the worst I am happy to enter the workplace again, however, as to moving goalposts, perhaps someone would mention this to Uk governments, whereby we are having ours moved -  from 60 to 64-65 now for me 66. I do not mind coming in line with the men of the country, but would have appreciated time from the government to be able to sus out how to work out my pension in such a short space. I was not given the luxury of time, the government moved my goalpost without much thought for what I must do!

PS Not whinging or complaining in any form, merely curious. x[blink]