Llantony Posted January 2, 2010 Share Posted January 2, 2010 We have a Carte Vitale and top up insurance and have been to the GP for the first tiime paying 2 x 22 euros at the surgery.I wondered how we'd get the money back and on checking the bank statement have been credited with 8.40 and 13.40. How does that relate to 22 euros?We now have a bill for 53 euros for blood tests and I guess we will have to pay then get the money back from Groupama. I gave them a bill for a mamogram weeks ago but no sign of them paying! Link to comment Share on other sites More sharing options...
Clair Posted January 2, 2010 Share Posted January 2, 2010 You will find a breakdown of the reimbursements here.Assuming you have declared your GP, you should get 70% (€14,40) less €1 per visit from the CPAM. Groupama should then make up the difference.As for blood tests, you should get 60%, less €1 from the CPAM and the balance from Groupama, depending on your cover. Details here.You can create an online account to see your reimbursements as they happen. See here. Link to comment Share on other sites More sharing options...
babcock Posted January 2, 2010 Share Posted January 2, 2010 The government keep €1 as a "forfait" which you never get back. The reimbourse 70% of the cost. Your mutuelle will reimbourse the rest or the agreed amount after taking another "forfait. Those figures are for a simple visit to the doctor. Check out www.ameli.fr where you can check the amounts reimboursable etc. I thought hat a mamograph was free. I don't remember paying. Likewise smear tests and checks for bowel cancer. Link to comment Share on other sites More sharing options...
Clair Posted January 2, 2010 Share Posted January 2, 2010 [quote user="babcock"]I thought hat a mamograph was free. I don't remember paying. Likewise smear tests and checks for bowel cancer.[/quote]These are free if required as part of an agreed screening program. They have to be paid for (and are partly reimbursed) if undertaken outside a screening program. Link to comment Share on other sites More sharing options...
Iceni Posted January 2, 2010 Share Posted January 2, 2010 [quote user="babcock"]The government keep €1 as a "forfait" which you never get back. [/quote]Not so - depends on terms of your top-up insurance.The reason you don't have to pay for the bowel cancer tests is the amount of work that you have to do.John Link to comment Share on other sites More sharing options...
Sunday Driver Posted January 2, 2010 Share Posted January 2, 2010 According to ameli.frÀ noterLa participation forfaitaire de 1 euro n'est pas remboursée par les organismes complémentaires de santé dans le cadre de leurs contrats responsables. Vous pouvez vous renseigner auprès de votre organisme complémentaire. Link to comment Share on other sites More sharing options...
Weegie Posted January 2, 2010 Share Posted January 2, 2010 [quote user="Llantony"]We now have a bill for 53 euros for blood tests and I guess we will have to pay then get the money back from Groupama. [/quote]You could ring the lab and find out if they have "tiers payant" and, if so, is Groupama one of their companies. If that is the case they may take your Groupama account details and claim direct from Groupama. Worth a try. Link to comment Share on other sites More sharing options...
Jay Posted January 2, 2010 Share Posted January 2, 2010 [quote user="Iceni"]The reason you don't have to pay for the bowel cancer tests is the amount of work that you have to do.John[/quote]What does that mean? Link to comment Share on other sites More sharing options...
Llantony Posted January 2, 2010 Author Share Posted January 2, 2010 No, I had a letter to go for a mamogram, I did not request it, and was sent a bill for about 6.24.The nurse came (at 7.00am in a power cut!) and took blood for my husband'stest, charged us 7 euros and we got the bill for 53 euros by post.I realised after my first post that in fact the 2 amounts credited come to 21.80, which is nearly 22 euros. I don't know why they are under different ref. numbers, nor why we haven't had credit for the 2nd visit to the GP.. Our insurance agent must deal with loads of Brits (tho we only speak to her in French) but doesn't seem to understand that it's all new to us. I guess it's all a learning curve! Link to comment Share on other sites More sharing options...
Iceni Posted January 2, 2010 Share Posted January 2, 2010 [quote user="Jay"][quote user="Iceni"] The reason you don't have to pay for the bowel cancer tests is the amount of work that you have to do.John[/quote]What does that mean? [/quote]I will try to keep my reply as seemly as poss.Having generated the raw material to be tested, I had to carefully preserve it not allowing contamination, select 2 lentil sized morsels, apply them to the card (with the assistance of the half lolly sticks provided), keeping within the designated areas, place card into envelope and seal. Then repeat on days 2 and 3.I can only guess Jay that as you had to ask you have not participated in this scheme.Delighted to say that after all this the test yielded a negative result.John Link to comment Share on other sites More sharing options...
Jay Posted January 2, 2010 Share Posted January 2, 2010 Thank you - now I understand! Link to comment Share on other sites More sharing options...
Benjamin Posted January 2, 2010 Share Posted January 2, 2010 [quote user="Llantony"]No, I had a letter to go for a mamogram, I did not request it, and was sent a bill for about 6.24.The nurse came (at 7.00am in a power cut!) and took blood for my husband'stest, charged us 7 euros and we got the bill for 53 euros by post.I realised after my first post that in fact the 2 amounts credited come to 21.80, which is nearly 22 euros. I don't know why they are under different ref. numbers, nor why we haven't had credit for the 2nd visit to the GP.. Our insurance agent must deal with loads of Brits (tho we only speak to her in French) but doesn't seem to understand that it's all new to us. I guess it's all a learning curve![/quote]I think it's pure coincidence that the two amounts come to nearly 22 euros. 'Phone or visit your CPAM and ask them to explain.As far as the blood samples are concerned go to the lab who sent you the bill and register your carte vitale and top up insurance details with them and then you should see things happen automatically but in the meantime send the bills for the nurse and the test results to CPAM and let them sort your refund out. Always but always keep copies. Link to comment Share on other sites More sharing options...
suein56 Posted January 2, 2010 Share Posted January 2, 2010 [quote user="Llantony"]I realised after my first post that in fact the 2 amounts credited come to 21.80, which is nearly 22 euros. I don't know why they are under different ref. numbers, nor why we haven't had credit for the 2nd visit to the GP.[/quote]Do you have 2 separate carte vitales, but share the same reference number? You paid 2 x lots of 22€ and you have been reimbursed twice, once at 8€40 and once at 13€40 for each of the 2 consultations. Don't know why the different reimbursement - ask CPAM. You have both, separately chosen and signed up for a médecin traitant, ie you signed 2 separate sheets of paper at the Drs? Link to comment Share on other sites More sharing options...
Pommier Posted January 3, 2010 Share Posted January 3, 2010 The refund of €13,40 is correct (€14,40 less the €1 forfait). The other refund is €5 short, so did you have any prescriptions or other treatment as they all have amounts of between 50 centimes up to €3 deducted from your reimbursement.Your top up insurance will make up your payments, except for these deductions which do however have an annual limit. Link to comment Share on other sites More sharing options...
Benjamin Posted January 3, 2010 Share Posted January 3, 2010 Silly, I should have mentioned this yesterday.You can view your CPAM account on line at ameli.fr. On the opening page click on Mon compte and follow the instructions to request a code confidentiel so that you can see your reimbursements on line. Link to comment Share on other sites More sharing options...
Llantony Posted January 3, 2010 Author Share Posted January 3, 2010 One carte vitale (as I am the pensioner) covers both of us. I was told that the 22 euros per GP visit would be reimbused minus 1 euro.We also had prescriptions, but vith the CV and the insurance 'card' did not have to pay anything. I must have a look at the CPAM website, or go and see their rep at the Mairie. Link to comment Share on other sites More sharing options...
kathyc Posted January 4, 2010 Share Posted January 4, 2010 We're in the same position as you (and live in your are) and we have separate cards. I wonder why the difference? Link to comment Share on other sites More sharing options...
suein56 Posted January 4, 2010 Share Posted January 4, 2010 [quote user="Llantony"]One carte vitale (as I am the pensioner) covers both of us. [/quote]I was under the (possibly mistaken) impression that everyone needed their own health card, even though the social security number might be shared ie the same on both cards, as in our case. Link to comment Share on other sites More sharing options...
Polly Posted January 4, 2010 Share Posted January 4, 2010 Remember, when you are re-imbursed for the GP etc., CPAM (or whoever your healthcare is with, we are not all with CPAM) periodically deduct the 'franchise medicament' due per pack of prescription medicines you have obtained from your pharmacie. This is usually 50cts per pack.Thus the re-imbursement you think you are due may have been paid LESS the franchise medicament. Link to comment Share on other sites More sharing options...
suein56 Posted January 4, 2010 Share Posted January 4, 2010 [quote user="Llantony"]The nurse came (at 7.00am in a power cut!) and took blood for my husband'stest, charged us 7 euros and we got the bill for 53 euros by post.[/quote]Just a thought but when the nurse came to take a blood sample for a specific test for my OH I seem to remember that there was a non-repayable forfeit of about 2 or so euros for her visit. Link to comment Share on other sites More sharing options...
Llantony Posted January 4, 2010 Author Share Posted January 4, 2010 We did all the paperwork and gave it to the CPAM rep who visits the village most Thursdays. We were told that as I have reached state retirement age, and he hasn't, my husband would be covered for healthcare as my dependent. Our attestation has both names but one social secturity number.Re prescriptions, I didn't realise we still paid - I was given 5 different things - about 11 tubes/packets of tablets! My husband just had 1 packet of tablets, so I it still doesn't add up. Link to comment Share on other sites More sharing options...
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