List of Illnesses covered 100%

[Agenais]

This has probably been posted before, if so, apologies in advance, of not, hope it is of some good to the many people who ask what is covered 100% by CPAM.

• Accident vasculaire cérébral invalidant,

• Aplasie médullaire,

• Artériopathie chronique et évolutive (y compris coronarite) avec manifestations cliniques ischémiques,

• Bilharziose compliquée,

• Cardiopathie congénitale mal tolérée, insuffisance cardiaque grave et valvulopathie grave,

• Cirrhose du foie décompensée,

• Déficit immunitaire primitif grave nécessitant un traitement prolongé et déficit immunitaire grave acquis (syndrome immunodéficitaire acquis),

• Diabète insulino-dépendant ou non insulino-dépendant ne pouvant pas être équilibré par le seul régime,

• Forme grave d'une affection neuro-musculaire (dont myopathie),

• Hémoglobinopathie homozygote,

• Hémophilie,

• Hypertension artérielle sévère,

• Infarctus du myocarde datant de moins de six mois,

• Insuffisance respiratoire chronique grave,

• Lèpre,

• Maladie de Parkinson,

• Maladie métabolique héréditaire nécessitant un traitement prolongé spécialisé,

• Mucoviscidose,

• Néphropathie chronique grave et syndrome néphrotique pur primitif,

• Paraplégie,

• Périarthrite noueuse, lupus érythémateux aigu disséminé, sclérodermie généralisée évolutive,

• Polyarthrite rhumatoïde évolutive grave,

• Psychose, trouble grave de la personnalité, arriération mentale,

• Rectocolite hémorragique et maladie de Crohn évolutives,

• Sclérose en plaque invalidante,

• Scoliose structurale évolutive (dont l'angle est égal ou supérieur à 25 degrés) jusqu'à maturation rachidienne,

• Spondylarthrite ankylosante grave,

• Suite de transplantation d'organe,

• Tuberculose active,

• Tumeur maligne, affection maligne du tissu lymphatique ou hématopoïétique.

 

[Will]

Thank you for that.

I think it is worth pointing out that these are conditions that are most likely to qualify for 100% cover if your doctor recommends it and your organisme conventioné (e.g. local CPAM office) agrees. It is not necessarily the case that if you suffer from any of these you automatically qualify for 100% cover, and neither is the list exhaustive - you can still get 100% cover for other serious conditions if recommended and agreed.

Also, the 100% cover applies only to treatments and medicines related to that particular condition.

[Agenais]

Of course Will, like most lists, there are always exclusions and additions, naturally, ask your Drs advice. 

[Will]

Sorry to appear pedantic above, it's just that there seems to be a myth, perpetuated on forums like this one, that if you are a diabetic, for example, you can move to France and automatically get 100% health cover. That is not, of course, how it works. I would hate anybody here to fall into that trap.

[Agenais]

Not at all, I wouldn't want that to be the assumption either.......... it has taken me three years + to fathom some of the "mysteries" of the CPAM and learning every week. If it wasn't for the Drs here, I would have carried on paying when I was covered on two counts from said list.  The pharmacist tried to explain the category of invalidity I have, I glazed over and even he got confused over the minefield of differing clauses and options and asked if it was easier in the UK with our strong Saxon heritage and courage? 

As I understand it, if a medicine is listed as vignette bleue then you pay 35%, all other medicines are free.  This was quite a surprise when I gathered my last precriptions and had no charge at all.    I will be asking my pharmacist for furter details, after the pending fetes.

[Agenais]

As an extra to the above list, there are two further categories that are newly added to the list, namely Alzheimers and other forms of Dementia and severe mental illness.