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Refused Medical Cover


Moulin Neuf
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After two years in France, on an E106, we have filled in  all the necessary forms and because my husband and I are not of retirement age, we have been refused medical cover through CMU/CPAM.  Has any one else encountered this?  What are we supposed to do?  Apparantly we have no cover since 31 Dec 2005.  We thought we would simply pay 8% of our revenue.

 

Jan

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Yes, we declared in Sept 2003 that we were here, filled in a tax form for 2004 and paid taxes this autumn.  We have fully complied with absolutely everything.  My husband is a retired serviceman - and although he declares his taxes here (and pays some here) he pays tax on his pension in UK as a foncionaire.  We are totally shocked by this refusal.

 

Jan

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http://vosdroits.service-public.fr/particuliers/F1072.xhtml

 

Well that says you can as long as you are resident in France for three months.

 

I would suggest that you contact the Caisse de Maladie again in writing, lettre recommande avec accuse de reception ( and keep all copies of every thing including envelopes you receive ) stating that you believe that you are eligible to join them and are appealing against their decision.

I would state clearly in my letter that photocopies are enclosed of tax declarations and of the letter stating that you are no longer entitled to E106 cover.

Also I would phone Newcastle and ask what they think about this. Don't know what they would say, but I would do it anyway.

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[quote user="Moulin Neuf"]

After two years in France, on an E106, we have filled in  all the necessary forms and because my husband and I are not of retirement age, we have been refused medical cover through CMU/CPAM.  Has any one else encountered this?  What are we supposed to do?  Apparantly we have no cover since 31 Dec 2005.  We thought we would simply pay 8% of our revenue.

 

Jan

[/quote]

Read your posting and wanted to ask, did the CMU/CPAM contact you by letter and tell you that you were not entitled to cover?  My reason for asking is that we too have no cover from Dec 2005 and we too have filled in all the various forms including copies of the required documents, to date we have heard nothing from anyone.  We also are French resident, tax paying, and have had our letter from Newcastle saying our cover has run out, and we are now wondering if we should be looking out for a letter or should we be contacting CMU/CPAM to ask for confirmation? 

We visited the CMU/CPAM main offices in Amiens rather than using our local offices in the hope this may hasten the process, but in the end we had to go back and forward three times as the forms we were given originally were the wrong ones.  At our final visit the young lady we spoke with assured us that the forms would be processed, but to date, as I said, we have had no confirmation, no demand for payment nothing.

[*-)]

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We were wanting to go to Spain for a month and I telephoned to ask if I could have a Carte International.  We have not to date had a letter - and infact have updated our carte vitales at the pharmacie since the beginning of the year.  I was told that there was a letter on its way to us refuing us affiliation.  I have telephoned everyone every where.  UK are sorry but not interested. The British Consul in Bordeaux was sorry but could not help.  Eventually, I am being told by one of the big bosses at CMU Poitiers that it is because we fall into a very particular category.  According to Para 383.3 of the Code de la Securite Social (I wrote a transalation down and think it is accurate)  "People founctionaire of a foreign state and their families are not allowed to affiliate to the CMU."  This includes all ex-miliitary, and all civil service and practically everyone who has ever worked for the governnment.  We can be taken back on charge at age 65 when we have a state pension. 

Jan

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I can't understand this at all - my husband is ex military and in

receipt of a pension paid and taxed in Uk - I am ex Civil Service and

in a similar position. We complete a tax form here each year and send

in copies of the pension details - and yet we have had no problem at

all affiliating with CPAM.  It almost sounds as if they think you

are still serving.

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[quote user="Suandpete"]I can't understand this at all - my husband is ex military and in receipt of a pension paid and taxed in Uk - I am ex Civil Service and in a similar position. We complete a tax form here each year and send in copies of the pension details - and yet we have had no problem at all affiliating with CPAM.  It almost sounds as if they think you are still serving.
[/quote]

Is your husband under 65?

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EEC and therefore UK goverment pensions such as for instance Fireman's pensions which are funded on a pay as you go basis ( from current taxation  rather than having accumulated funds) are taxed in the country which pays them out of current revenue rather than the country of residency of the person who receives them.  If this is the case for you have a go at Newcastle and see what they have to say, try and climb past the first person who answers the 'phone. I suspect they have a duty to provide cover.  Also have a look at escalating via 'your' MEP who I think covers Cornwall. 

 

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Tha nk you all for your concern.  Now that our anger has deminished abit, we are appealing against the decision.  Meanwhile we have found a company who have given us cover at about the same price of affiliating and having a mutuelle.  Also if we win our appeal CMU will give us the first 3 months of the year for nothing - and on the production of an attestation from CMU the insurance company will cancel our cover without penalty.

One of the staff in one of the insurance firms we visited actually told us she thought we were very lucky as we could choose - and our policy covers us world wide.  She thought many a French person would like the choice.

We will post the outcome - my main anger is someone saying 'no' and also not having notified us before the cover ran out.  One good thing is that the prescriptions signed before the end of last year will be honoured by both CPAM and the mutuelle.

One question we shall be persuing - if we have the special status given to serving diplomats, soldiers, etc,  then will they allow us the priviledges with regard to not being subject to taxes, inheritance laws and capital gains tax.  Could be an amazing advantage.

 

Jan

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Jan,

Could you let us know more about this health insurance that will cover

you for all the normal obligatory health cover here in France.

I ask this because some time ago it was, I thought, made interdit for

any insurers to sell any more than a top up and that residents in

France had to go through their own "works" cover, CPAM or to be on the

CMU and no other health cover could be given. Are you sure yours will

cover all types of Doctors visits, hospital visits, all forms of Ops, medecines

etc for a resident here ?

I must say that this refusal by CPAM to allow you CMU, is a first as

far as I am aware and hopefully is not the start of a further trend of some

kind against foreigners

here. If, as you say, it is some law that they have found, it cannot be

too old as CMU has only been with us since around 2000 and I am

surprised that it was not known before and been posted. Good luck

anyway.

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The assurance we have taken out has been with a company called April Assurances.  It is their Premier Euro Non assujettis L'assurance sante des non-assujettis.  - Une garantie sante individuelle specialment cocue pour les personnes ne beneficant d'aucun regime obligatoire d'Assurance Maladie.

Their address: April Assurances, Siege social, 27 rue Maurice Flandin BP3261  69403 Lyon cedex 03.  Fax 04 78 53 65 18 Internet www.april.fr.

Jan

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Well, that's another legal law made by the French thats gone pear shaped !!

I saw the part about L'assurance sante

des non-assujettis and how it is for those that do not have "normal"

assurance santé. There was not enough info to see exactly what one

gained in the obligatory section but the top up with April looked

pretty normal.

How did that come about I wonder, when supposedly since 2000, everyone

is legally allowed to have assurance santé through CPAM (CMU) ! The

small print must have been made even smaller than normal eh !

What I don't get, is that CMU came about, due to a bad loophole that

allowed some people (the poorer Fench and others without ability to pay

or out of work)   to find themslves without health cover. In

came CMU,  at the same time, out went companies that offered folks

health cover and we were led to believe that these companies could now

only offer top ups in the way  mutuelles  etc were allowed to do.

After many years in France, I am still getting to the bottom of it all, oh yes, you live & learn daily here alright.!!

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Snap...  we had a letter on Friday giving us cover but on Saturday we recieved a letter that rectified the last letter saying that we have been refused cover.  My husband like you is in receipt of an army pension , and at 63 is not quite pensionable age.

Like you we will be fighting this  please keep us informed of any progress you make, as we will with you.

good luck

patter

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Just as a reminder; CPAM de la Manche has an English-speaking helpline, specialising in health cover questions for British people moving to France, and available, as far as I know, to those in, or thinking of moving to, any part of the country. The number is (in France) 0820 904 212. It is open Mon-Fri 0900 to 1800.

Hope you get this sorted out. It all sounds wrong to me

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On querying our refusel we were told that it was because  my husband was still getting a wage from the army (ie his pension) then we were not elligable.

we are sending proof of civvy employment for the last 25 years or so. and explaining that what he recieves is his pension. but how long it will take to get an answer I dont know.

patter

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Is it just possible that you filled in the wrong box on your tax return and they think your O/H is getting a wage not a pension? Just a thought, because nobody I know in your situation has been refused cover by CPAM.

 Have look back at your tax returns, retirement pensions are recorded separately on the French tax forms.

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Our E106's ran out on 31/12/05 and we trotted off to our local CPAM office mid December with the letter from Newcastle and a copy of our tax form. Mr hubby is ex-navy and  in receipt of a pension even thought he is not yet 50. We received the leter from CMU yesterday advising us how much we are to pay and when I went the the pharmacy yesterday to collect my tablets I didn't have to pay anything!! I am confused as when we were covered by the 106 I had to pay a proportion. Please can someone explain this to me??
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we checked the tax form today. and it was filled in properly, but thanks for the advice.

my husband had also faxed and emailed newcastle, couldnt get them on the phone, always engaged, had a phonecall from newcastle. today, we were told that her manager would be phoning France to get an explanation.. On querying about the E111 as  i am going to england next month she said that I do not need it for England

The saga goes on........

P.S. What department is Mayennaise in. I hope you are not like us we had thast letter but it was cancelled the next day.

Patter

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