Bertiebe Posted November 11, 2011 Share Posted November 11, 2011 Hope someone can answer this query for me: I have just received the 125 Euro reimbursement for my wig (during chemo) from my Caisse (Ram Gamex), however at the same time they have deducted 50 Euros in various charges. These are all small amounts marked, FR récupérée and PF récupérée, all on different dates and deducted from my reimbursement.If anyone can shed any light on these charges I would be grateful as all my recent treatment has been for an ALD (Affection Longue Duree), and I thought that these Dr's/Hospital appointments were covered 100%? Link to comment Share on other sites More sharing options...
NormanH Posted November 11, 2011 Share Posted November 11, 2011 There are a number of charges 'forfait' which are taken off your reimbursements even if you have an ALD. This applies to each consultation and 'acte médicale' La participation forfaitaire de 1 euro http://www.ameli.fr/assures/soins-et-remboursements/ce-qui-est-a-votre-charge/la-participation-forfaitaire-de-1-euro.phpThis will probably be the pfand 50 centimes for each box of medicines called a 'franchise' probably the frThere is also a small charge towards transport (Two euros I think, for each direction, so 4€ for a round trip but might be wrong on the exact sum)All of these are taken off your payment periodically Link to comment Share on other sites More sharing options...
Bertiebe Posted November 11, 2011 Author Share Posted November 11, 2011 Thanks Norman H, I think you are right. It just came as a bit of a shock when I was expecting 125 Euros and ended up 50 euros short. Amazing how quickly these little things add up isn't it?I assume this is not reimbursable from the Mutuelle? Link to comment Share on other sites More sharing options...
Clair Posted November 11, 2011 Share Posted November 11, 2011 Bertiebe,On the positive side (if there is such a thing here), there is a daily 4€ ceiling (i.e. 4 medical acts like X-ray, doctor or specialist appointments, blood test in a single day) and annual ceiling of 50€ for the Participation Forfaitaire and an annual ceiling of 50€ for the Franchise Médicale.Details in French HERE. Link to comment Share on other sites More sharing options...
cooperlola Posted November 12, 2011 Share Posted November 12, 2011 Ask your Mutuelle if they will contribute to the wig also. Mine forked out double the state amount on top thus I could afford a really good wig - lightweight and very easy to wear. It's well worth asking them.Oh, and pick a hair dresser/wig fitter who knows what they're doing. Their professional advice and knowledge are worth their weight in gold during a depressing business.[:)] Link to comment Share on other sites More sharing options...
Bertiebe Posted November 13, 2011 Author Share Posted November 13, 2011 Thanks for the advice Coops. I did choose my wig from a professional fitter in Toulouse and she was extremely helpful and a totally personal service. However, my Mutuelle, Groupama, only offered me the huge sum of 37.50 Euros. Again this was a bit of a surprise as when we took out the Assurance we were led to believe that this was a fairly good level of cover, but recently have found that while they cover all the basics but none of the niceties.I assume now that I have an ALD it is not so easy or cheap to change Assurance providers.However, on the positive front I did get a very modern "red" wig, which I am still waiting to utilise as the hair is currently going through the "looking dead" stage, but still hanging in there!! Link to comment Share on other sites More sharing options...
NormanH Posted November 13, 2011 Share Posted November 13, 2011 A Mutuelle can't take your health history into account in accepting you.You might ask if they have extra 'modules' for areas you want better cover for.The main hurdle to changing is that sometimes cover is not immediate for all areas. Be careful to check. Link to comment Share on other sites More sharing options...
Sunday Driver Posted November 13, 2011 Share Posted November 13, 2011 Assurance providers don't mind people with ALDs who's treatment is covered 100% by the state because they don't have to pay out. When I originally took out my policy with Groupama, I mentioned my ALD and got a discount on my premiums. Link to comment Share on other sites More sharing options...
Bertiebe Posted November 15, 2011 Author Share Posted November 15, 2011 Thank you for the info Sunday Driver, I hadn't thought about this, but I suppose it is too their advantage if you have an ALD. Glad to see someone is happy about it, ha ha. Link to comment Share on other sites More sharing options...
Benjamin Posted November 15, 2011 Share Posted November 15, 2011 [quote user="Bertiebe"]Thank you for the info Sunday Driver, I hadn't thought about this, but I suppose it is too their advantage if you have an ALD. Glad to see someone is happy about it, ha ha. [/quote]Don't hold your breath. Not every insurer sees it like Sunday Driver's. From memory AXA and MAAF didn't want to know about a reduction. Link to comment Share on other sites More sharing options...
NormanH Posted November 15, 2011 Share Posted November 15, 2011 Nor mine..my premium went up not long after.. Link to comment Share on other sites More sharing options...
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