Jump to content

Something to get your teeth into, if you have any.


SC
 Share

Recommended Posts

We've been paying average policy complimentaire premiums for the past eleven years and following the latest price hike (to €1680 pa for three people) cancelled our cover at the end or 2010 while we looked around for a better deal.

I've come to the conclusion that cover for day to day medical costs is likely to be a waste of money, but peace of mind "catastrophe" insurance (the 20% tab) at €840 per year for a 65yoM, 63yoF, 22yoF might give me just that.

I'd welcome any views or helpful comments on this course of action.

Steve
Link to comment
Share on other sites

I should have made my post a little more clear, We have always had insurance cover from CPAM, it is complimentary insurance for the part that the state doesn't pay that I am considering reducing or doing without.

When your wife is 60 Joe,hopefully she'll be eligable for an E120.

Steve
Link to comment
Share on other sites

Remember that top-up insurers cannot turn you down for pre-existing conditions, thus if the worst happened you could always up your cover if you needed to.  What I guess I am saying is that if you do go ahead and trim down your policy, then if you had an accident and, say, needed a lot of physio (I've been having treatment now for 30 months including, for part of that time, 5x80k ambulance rides a week- none of which would have been covered by a hospital only policy), or suddenly needed a lot of medication or home visits from a nurse, then you could up your cover if you needed to.  However, some insurers builid in a time delay to stop you doing this (often 3 months or so, so not disasterous) so look at the terms of any policy you take out.

CA Pacifica are quite reasonable.  They do my house policy and have been very easy to deal with.  I'm sure others on here know of more.

Link to comment
Share on other sites

Thank you for your comments. I do hope that your treatment is showing results.

I had been thinking along the lines you suggest lines and I can't help wondering why any averagely healthy person wouldn't do the same. The only time that a monthly repayment by our complimentaire has exceeded our monthly premium was following a cruciate ligament repair, a tricky procedure but common in the skiing season, and even then it wasn't by much. Afterwards the three 30min physio sessions pw for five weeks were 15€ each with the complimentaire contribution being 67€ for the entire physio treatment, monthly premiums at that time being 109€. Fortunately travel wasn't an issue, but I take your point.

On the subject of medical transport MOH spent a night in the clinic alongside (same room, not same bed!) a lady in her eighties who had had a cataract op and was bemoaning the fact that she had a paid 70€ return taxi fare to the hospital each time to see the surgeon, then the anaesthetist, then for the operation, and the only one that her Caisse (and her comp) would pay for was the one to and from the operation.

I stumbled across a 2003 INSEE document the other day that showed that excepting non-european immigrants, the group least likely to subscribe to a complimentaire are those in "Profession intellectuelle supérieure (libérale)". Thats interesting :).

We have had different insurances (buildings,health,cars) with Groupama, Pacifica, GAN, Mutuest and Generali. and have had different issues with them all although the only issue that prompted us to change each time was cost of premiums, making a saving of 500€ in one year for similar cover (or removing unecessary features).

In common with dealing with brokers in the UK, each time one changes one saves money.

I've seen an illustration online that would cover all our usual charges plus the usual minimal amount towards specs and dents for 100€ pm rather than the 140 that our previous insurer wanted and I may go for that. It's a question of that or the "catastrophe" insurance at 70€ pm.

I had been thinking of trying to persuade MOH and our daughter to have a sex change as I believe the premiums are lower for men ;).

Steve
Link to comment
Share on other sites

Coops mentioned the cost of ambulance transport - this in itself is very expensive, even without any other treatment.

We've just taken out top-up insurance after receiving a bill for 1000€+ being a third of treatment and ambulance fares when Eddie was rushed into hospital with a suspected heart attack. CPAM covered the other two thirds.

The full cost of the ambulance was 900€+ per half hour! This was a fully equipped ambulance with a doctor and 3 ?nurses. I tried to find out if this was correct, but got nowhere.

So I would make sure that any cover you get includes ambulance charges.

ps we got what seems to be a good deal from Mutuelle de Poitiers. Not sure if this is advertising?

Link to comment
Share on other sites

In response to Patf's query on ambulance costs. I had similar situation before moving here full-time (so was not on French system) - suspected heart attack, pompier ambulance, nurse and 2 doctors who arrived from hospital and yep, cost was 1100€ and I was responsible to pay one-third of that.

Good service though!

CN
Link to comment
Share on other sites

I understand that one is charged for SAMU services if the callout is considered to be unjustified. If I'm correct I'm sure that the fine detail would be defined somewhere.

Views on justification will obviously differ between the parties, and I do take on board your points and will look carefully at any policy I consider. One wouldn't want to feel inhibited by cost in those situations. Thanks.

Steve
Link to comment
Share on other sites

Thank you for that. Actually on the face of it Myriade is certainly better than the catastrophe insurance I've seen so far.

Although I've not looked at the fine detail the highlights of the offers for the three of us for:

Chirurgie 140%

Médecins Généralistes 100%

Médecins Spécialistes 100%

Pharmacie 95%

Soins dentaires 100%

Prévention 100%

is 57€ per month.

Details here if anyone's interested:

http://www.myriade.fr/Fiches_produit_2010/GALAXIE/GALAXIE_Alpha_1.0.pdf

NOT included is optical, dental prosthesis, and imagery+ actes tech/medicaux except when in hospital 313.68 Euro et 398 Euro global for an IRM.

A private room option is extra 21€ per month which seems steep to me. I paid the extra for a private room when I had an op close to me willy, and it didn't cost that much for three nights. Actually it wouldn't have mattered if one more person had had a look, most of Brittany did anyway.....it wasn't at its best, but no-one laughed openly:)

Steve
Link to comment
Share on other sites

Sharp! I didn't notice that....thanks

The online devis was filled in correctly I can assure you. One does have to be on the mark here, even with supermarket special offers, let alone insurance policies. Perhaps they're just fishing.

I'll follow it up later.

Thanks,

Steve
Link to comment
Share on other sites

I've found out why the Myriad website devis is misleading, it makes the assumption when a couple adds a child to their quotation that they are between 18 and 54 and tailors the policy to suit -actually it includes obstetrics and bandages+similar, and a post accident examination for under 28yr olds, the over 55yr old basic policy doesn't include those.

However, a devis for the two of us that defaults to the over 55 policy, plus a separate basic policy for a 22 yr old, comes to 57€ as before.

A phone call to Myriad didn't give quite the same results, but we're waiting for an e-mail from them.

We still think the deal is good but are concerned about the lack of non-hospitalised imagery in the policy. To cover that would be 116€ pm, just a little more than we were paying last year before the premium hike.

Pommier- Galaxie Myriade is for age up to 54, Serenius for age 55 and over. Within each there levels of cover, maybe you policy changed when you both passed 55. If we do decide to take it up, I believe there's 20€ in it for you. You can drive to Brittany and take us out to lunch :)

Steve
Link to comment
Share on other sites

  • 2 weeks later...
Further to this thread we've been going back over our CPAM statements and found something that we don't understand.

Over the course of the last few years we've had two ops, and each time the major charges at the clinic (3500€ and 1600€) were reimbursed at 100% by CPAM rather than 80%. Does anyone know why? We're "régime génerale" (not CMU) and neither of the ops, a cruciate ligament repair and inguinal hernia repair were life threatening.

All the associated costs, nurses visites, etc were reimbursed by CPAM at 65 or 70% less the franchise as one would expect.

Steve
Link to comment
Share on other sites

Please sign in to comment

You will be able to leave a comment after signing in



Sign In Now
 Share

×
×
  • Create New...