Health arrangements - still confused...

[MrCanary]

I hope to move to France later this year.

 

Please can anybody tell me, in simple stages, what I have to do to get continuing healthcare.

What I mean is, I take blood pressure tablets every day here in the UK. Obviously when I am in France, I will need to continue the same medication.

How do I register with a local French doctor and how do I arrange the transfer of information from the UK to my new French doctor to enable the continuation of the prescriptions for my medication?

Thanks!

[Dick Smith]

Does this help?

http://www.completefrance.com/cs/forums/860638/ShowPost.aspx

[Will]

There is some very good advice on Dick's link above. If nothing else you will see that doctors, and the way they work, vary widely.

One thing you will probably not find is any sort of medical records, though that is changing gradually. Best thing to do is take the boxes, or the information sheets, from your existing medication to the doctor and they will work with the pharmacy to find the French equivalent. Mostly there will be a direct equivalent, but a few medicines may not exist in France.

Don't compare the French system with the NHS, it is closer to (though still not the same as) the BUPA/Nuffield hospitals in Britain, at least as far as waiting lists, referrals etc are concerned. There are exceptions of course, routine eye tests are one, which can have a 6-month waiting list compared with virtually on demand in Britain. But again things are changing as the system gradually opens up.

[MrCanary]

Thanks Dick & Will, that is really useful.

As for registering, do I just turn up at my chosen doctor and tell him/her that I want to be a patient at that practice? Or are there forms I need to obtain in advance from somewhere to fill in before I approach the doctor?

Thanks...

[Tony F Dordogne]

The transfer of medical records from the UK to France can be a pointless excercise and depending on your PHT who technically own the records - unlike here in France where you end up with an interesting dossier of your medical history - and they can fix the price of the records if you wish to bring them to France with you.  You're looking - usually - at between £50 to £80.

If you are seeing a specialist, get the specialist to write a letter - to whom it may concern type thing - and give that to your new GP.  The GP will almost certainly prescribe for you as Will has described and if he/she thinks that you need to see a specialist for up to date tests etc, he/she will send you off to see one.  If you are not seeing a specialist in the UK, ask your GP to write the letter for you.  In either case, it's likely to cost you a few pounds.

Make a list of the meds that you currently take and give them to your French GP when you have your initial consultation/registration with them.  If they are any good, expect to spend the best part of half an hour whilst they take some sort of medical history from you, have 21 euros about your person and make sure that you've registered with CPAM previously.

Your condition will be investigated here - if it's essential hypertension all well and good but if it's secondary, they will want to know what's causing it and will treat the primary cause.  You should almost certainly get 100%, supported by your French GP or specialist, you wont get it without their support.

Usually a GP will prescribe for 3 months for 100% conditions - some meds or blood tests for six months - and expect to see the GP for at least a BP check every time you ask for the repeat prescription.

Hope that helps.

[Will]

To add to the above, the first thing you should do is affiliate to the health insurance system and get a social security number. If you are employed or are registering a business then this will be more or less automatic, if not working you should go to your local CPAM office, as Tony indicates above. What you need to take etc is covered exhaustively on this forum. As part of this process you will get the form to register with a doctor, otherwise you can get it from the internet (http://www.ameli.fr/fileadmin/user_upload/formulaires/S3704.pdf).

You can visit a doctor before registering with CPAM, but you will probably not get your 21€ fee refunded.

I would not necessarily expect hypertension to qualify for 100% cover. Such cover is on the recommendation of the doctor and/or specialist, as Tony says, and subject to the agreement of the primary health assurer (e.g. CPAM). Whether it gets full cover rather than the standard 70% (65% for medication) reimbursement depends on the nature of the condition as well as the assurer's policy and financial state.

[Tony F Dordogne]

Hi Will

That's why I suggested the difference beween essential and secondary hypertension for the 100% - on re-reading didn't make it too clear.

Just as an example I get the 100% for my hypertension because it's linked to my leukaemia.  Some docs will argue that there is always a cause for hypertension be it medical or social, hence my comment about seeing a specialist.

And of course, if you visit a specialist without registering first with CPAM (whichever appropriate department) or your GP, you wont get reimbursed.

[Will]

I quite agree with you Tony. My own hypertension treatments are refunded at the normal rate in France. They are quite expensive, so the topup insurance is well worth it. A topup insurance is not normally  loaded for existing conditions - just by age, and is still necessary even if you have 100% cover, because the 100% relates only to specific conditions, not other illness or accident. So the 100% thing is not that big a deal, though still well worth having for peace of mind.

[Tony F Dordogne]

It's a big deal when the cost of medication is 700 euros every 28 days Will!

[Sunday Driver]

As Will says, it's best not to get too hung up over the 100% qualification.  My heart condition is covered 100% but if it was only 70% it wouldn't have any effect because my mutuelle would automatically cover the shortfall and I'd still end up paying nothing.

That said, I got a 15% discount on my mutuelle for having an ALD....[;-)]

 

[Cassis]

[quote user="Mr Disenfranchised"]

As for registering, do I just turn up at my chosen doctor and tell him/her that I want to be a patient at that practice? Or are there forms I need to obtain in advance from somewhere to fill in before I approach the doctor?

[/quote]

You can just turn up and he'll fill in the forms with you. 

Ours also told us that if we had any bees swarming in the garden then he would collect them.  But he would not tell us his secret spot for collecting cèpes.

[mint]

does anyone know whether, once you have done all the initial things as listed here and you have bought your mutuelle, you need to wait a certain period of time BEFORE you can be reimbursed by the top-up?

in other words, is it like some types of insurance here in the uk where you need to let a period of time elapse before you claim?

[Tony F Dordogne]

We had to wait as long as it took to process the claim.  I think that it can vary from company to company but with our Mutuelle, we could claim immediately.

[Teamedup]

That is certainly a question that you will have to ask when you are shopping for top up as some do have waiting times and some don't.

[mint]

thanks tony f and tu

will certainly make a point of asking.  i'm asthmatic and OH has glaucoma.  neither of us "ill" as such but he needs his eye drops and i will be needing my drugs in the short term if there are lots of tree pollen about.

i already have a couple of contacts (thanks jonzjob & les lauriers) and i will sort it forthwith!

[Teamedup]

Top ups are complicated. I would personally recommend that people should take 200-300%, 300% being the best and get good dentist and optical cover. The more cover we take, the more it costs, it is a choice at the end of the day. I prefer the assurance that if we need medical stuff  we have less to pay out.

[Tony F Dordogne]

TU has, I think, got it right - for peace of mind go for the maximum that you can afford, we have done that depsite me getting what I get, covers everything else that may happen.

[MrCanary]

Thanks folks for the help and information...

A few more questions - sorry if the answers are already there and I have missed them...

What is CPAM? What is 'having an ALD'? And Tony, are you paying 700 euros for hypertension medication?

And can anybody recommend a good top-up insurance company please?

MrD 

[Tony F Dordogne]

No, without my 100% I would pay a little over 700 euros every 28 days for all my medication.  Two weeks of chemo injections (10 shots) is E262, plus all the other stuff I have for the side effects of the leukaemia, hypertension etc.  And getting the generics means a couple of the meds are only a few euros each so the prices vary wildly.

Before I went on the 100% and back on the chemo the State paid either 60 or 65% of the ordinary meds and my mutuelle picked up the rest.

Do a search for CPAM in the archives here, there is masses of stuff about them - and interestingly was in their local office yesterday sorting out my travelling claim for the last visit to Bordeaux and picked up a copy of their latest information leaflet which is about 'maladie de long duree' and the way to obtain your 100%.

[Sunday Driver]

CPAM stands for caisse primaire d'assurance maladie.  It's the general state health insurance office which manages your health insurance account, processes your reimbursements, etc.

ALD stands for affection de longue duree - a long term or serious illness which qualifies for 100% reimbursement. To be classified as having an ALD, your doctor must submit a recommendation to your CPAM. They will then decide and amend your status accordingly.

 

[Teamedup]

Not everyone uses the CPAM, there are other caisse de maladies for workers, artisans etc. If you are going to be working, perhaps for yourself then don't assume that you have to go to the CPAM, you would need to ask at the Chambre d'Artisans/Metier/Commerce etc etc.

Mr Disenfranchised? surely not. We don't lose some rights to vote if we leave the UK to live in France, we can vote in general elections for up to 15 years and we can vote in local and european elections in France.

[MrCanary]

Teamedup - you are a very switched-on person!

 

[Teamedup]

I didn't say, it's UK general elections, and french local elections and french candidates for european elections. I don't think that that is bad for those of us who like to vote.

[MrCanary]

I do not disagree...

[Teamedup]

[:)] I was just trying to be clearer. Sometimes I'm not.[:$]