stan Posted August 13, 2011 Share Posted August 13, 2011 My wife and I have been paying about 80 euros a month to a mutuelle that we took out when we came to live here following our receipt of Carte Vitales with for E121 (underlying entitlement to UK Incapacity Benefit).Are we elegible for CMU Complimentaire Santé, as, following receipt of our Avis d`Impot, our joint Revenu Fiscal is now 11,720€ (which includes an "Abattement personne invalide" for me)I have had a look at the CMU website, but see there are 2 plafonds for this (one above and one below the Revenu Foscal figure), and I cannot work out which is which.Any ideas? Link to comment Share on other sites More sharing options...
NormanH Posted August 13, 2011 Share Posted August 13, 2011 on this chart the plafond seems to be 11657€ for a couple to get the CMUwww.cmu.fr/userdocs/232-2-2011v3.pdf but for the ACS they add 26% bringing it to 14688€see also:http://www.cmu.fr/site/cmu.php4?Id=17the old figures are at http://www.securite-sociale.fr/chiffres/baremes/plafondcmu.htmIt seems also that they add a figure into your resources if you own your property. Link to comment Share on other sites More sharing options...
stan Posted August 13, 2011 Author Share Posted August 13, 2011 Thanks NormanH, the links you provide are the websites I was referring to. The 2 plafonds are for CMU-C and ACS, but my problem is that, I dont know what the difference is between CMU-C and ACS, and, as per my post, my Revenu Fiscal is above that for CMU-C. What is ACS?..as I am below that. Link to comment Share on other sites More sharing options...
NormanH Posted August 13, 2011 Share Posted August 13, 2011 The ACS is the Assurance Complémentaire de Santé, which is what I believe you are asking about.It is the plafond for the CMU plus 26%. Link to comment Share on other sites More sharing options...
Pommier Posted August 13, 2011 Share Posted August 13, 2011 I thought ACS was Aide Complementaire Sante which is financial help towards your top up insurance and which you can claim if your income is too high for CMU C but is still below a certain figure (I seem to think it's 20% more than the figure entitling you to CMU C) Link to comment Share on other sites More sharing options...
Pommier Posted August 13, 2011 Share Posted August 13, 2011 Sorry, my message pretty much repeats what's already been said!Must read previous postings more thoroughly! Link to comment Share on other sites More sharing options...
NormanH Posted August 13, 2011 Share Posted August 13, 2011 No harm in confirming[:)] Link to comment Share on other sites More sharing options...
stan Posted August 13, 2011 Author Share Posted August 13, 2011 Thanks Pommerier, you answered my question. Thanks to NormanH too. Link to comment Share on other sites More sharing options...
Gardener Posted August 14, 2011 Share Posted August 14, 2011 How long have you been in France Stan? I am pondering over whether you would have to be here 5 years to be eligible for the top up, as people recently had to be here 5 years before they could join the CMU. Hopefully though with the changes, this won't be a problem for you. Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 An interesting point Gardner.I rather assume the two are separate, since I could imagine a low paid worker (on the Smic say) who qualified for health cover by working, and so would not be on the CMU, having an income low enough to get the ACS.That person would not have to have waited for five years.What I don't know is if it is only for people who get their health care under the CMU, or whether anybody under the 'plafond' can claim it.If the latter is the case it could open up possibilities for those who have started an AE business and get their cover this way. Link to comment Share on other sites More sharing options...
Gardener Posted August 14, 2011 Share Posted August 14, 2011 I understand and agree with your point re SMIC workers. I was thinking along the lines of inactifs and I don't know anything about the OPs circumstances so this is hypothetical, but if non French inactifs cannot get access to the basic cover, I don't suppose it would be easy to get the top up. In that set of circumstances do you think thet would be linked and not separate ? Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 You have me stumped on that.I bet the French authorities didn't think about it either when they brought in the CMU.It would seem unlikely that people who can afford e private health insurance would have an income below the rather low 'plafond', but of course it is not impossible Link to comment Share on other sites More sharing options...
Sunday Driver Posted August 14, 2011 Share Posted August 14, 2011 [quote user="stan"]My wife and I have been paying about 80 euros a month to a mutuelle that we took out when we came to live here following our receipt of Carte Vitales with for E121 (underlying entitlement to UK Incapacity Benefit).Are we elegible for CMU Complimentaire Santé, as, following receipt of our Avis d`Impot, our joint Revenu Fiscal is now 11,720€ (which includes an "Abattement personne invalide" for me)I have had a look at the CMU website, but see there are 2 plafonds for this (one above and one below the Revenu Foscal figure), and I cannot work out which is which.Any ideas? [/quote]According to one of your earlier threads, you are registered with your CPAM under an E121/S1 issued on the basis of invalidity and therefore entitled to 100% reimbursement of your medical expenses. On that basis, why would you have taken out a mutuelle at 80 euros a month which you now seek to replace with a free one under CMU complimentaire? Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 Does an E121/S1 cover all expenses at 100% unlike an ALD in the usual system?What happens for 'dépassement des horaires' etc? Link to comment Share on other sites More sharing options...
Sunday Driver Posted August 14, 2011 Share Posted August 14, 2011 Only if it is issued on the basis of invalidity. An E121/S1 issued upon receipt of a UK state pension only entitles the holder to the standard percentage reimbursements. Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 Thanks SD Link to comment Share on other sites More sharing options...
tinabee Posted August 14, 2011 Share Posted August 14, 2011 [quote user="NormanH"]You have me stumped on that.I bet the French authorities didn't think about it either when they brought in the CMU.It would seem unlikely that people who can afford e private health insurance would have an income below the rather low 'plafond', but of course it is not impossible[/quote]One of the key aspects of CMU-C is that they will also check assets and "lifestyle" factors in assessing whether you qualify, so it is not only the "plafond" that is taken into consideration. Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 But does that apply to the ACS too? By the way the ACS is like a grant towards a Mutulle, which goes up in bands according to agehttp://www.securite-sociale.fr/chiffres/baremes/montant_aide_cplmtaire.htm Link to comment Share on other sites More sharing options...
tinabee Posted August 14, 2011 Share Posted August 14, 2011 [quote user="NormanH"]But does that apply to the ACS too? [/quote]Yes, as far as I can tell based on this guidehttp://guide-pratique.lefigaro.fr/C39ssect12/la-couverture-complementaire-sante/ Link to comment Share on other sites More sharing options...
Benjamin Posted August 14, 2011 Share Posted August 14, 2011 [quote user="Sunday Driver"]Only if it is issued on the basis of invalidity. An E121/S1 issued upon receipt of a UK state pension only entitles the holder to the standard percentage reimbursements. [/quote]Not everything is re-imbursed at !00% on the basis of invalidity. Items re-imbursable at 35% are just that. If you don't have a mutuelle you end up paying the remaing 65%.The other cost that you pay is the B & B element of a hospital stay.When Mrs Benjamin established acceptance of her invalidity she took the decision to cancel her mutuelle.(Sorry for cross posting). Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 "Les mêmes dispositions s'appliquent pour l'aide au paiement d'une complémentaire santé" Yes looks like you are right .. Link to comment Share on other sites More sharing options...
tinabee Posted August 14, 2011 Share Posted August 14, 2011 If anyone is interested in how "lifestyle" factors are assessed, it is explained herehttp://www.securite-sociale.fr/comprendre/dossiers/fraude/train_de_vie.htm Link to comment Share on other sites More sharing options...
stan Posted August 14, 2011 Author Share Posted August 14, 2011 [quote user="Sunday Driver"][quote user="stan"]My wife and I have been paying about 80 euros a month to a mutuelle that we took out when we came to live here following our receipt of Carte Vitales with for E121 (underlying entitlement to UK Incapacity Benefit).Are we elegible for CMU Complimentaire Santé, as, following receipt of our Avis d`Impot, our joint Revenu Fiscal is now 11,720€ (which includes an "Abattement personne invalide" for me)I have had a look at the CMU website, but see there are 2 plafonds for this (one above and one below the Revenu Foscal figure), and I cannot work out which is which.Any ideas? [/quote]According to one of your earlier threads, you are registered with your CPAM under an E121/S1 issued on the basis of invalidity and therefore entitled to 100% reimbursement of your medical expenses. On that basis, why would you have taken out a mutuelle at 80 euros a month which you now seek to replace with a free one under CMU complimentaire? [/quote]I took out the mutuelle because I thought it was the normal thing to do. One of my earlier posts re this subject also mentioned that I was looking for a way to get out of the contract as I could no longer really afford 80€ a month for top up. Yes, my registration with CPAM covers 100% reimbursement of my medical expenses relating to my invalidity, although as you will know, it does not cover other medical conditions, and any medical treatment my wife my require. My plafond would only make me elegible for assistance towards a complimentaire santé and not a free one. Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 [quote user="tinabee"]If anyone is interested in how "lifestyle" factors are assessed, it is explained herehttp://www.securite-sociale.fr/comprendre/dossiers/fraude/train_de_vie.htm [/quote]I was amused by this one:"Il s’agit de personnes qui ne fraudent pas mais qui peuvent, en l’état de la réglementation de droit commun, se voir attribuer des minima sociaux alors même qu’elles disposent d’un patrimoine important. Ces situations rares dont la presse s’est fait l’écho ont permis de constater que pouvaient bénéficier de minima sociaux des personnes ne faisant état d’aucune ressource tirée d’une activité professionnelle mais qui étaient néanmoins propriétaires d’un ou de plusieurs biens immobiliers de grande valeur (manoir en Dordogne) Link to comment Share on other sites More sharing options...
NormanH Posted August 14, 2011 Share Posted August 14, 2011 From all you have said stan it seems to me that you qualify for the ACS, but I am not the one to convince...Good luck if you need it. Link to comment Share on other sites More sharing options...
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