A Glimmer of Hope?

[Ninthace]

We went into our local CPAM at St Gaudens (dept 31) today armed with a copy of the latest changes printed off from the social security website.  We explained that we had applied previously on 12 Dec 07 when our E106s were about to run out but had been refused under the rules at the time.  She read the printout and asked for a copy of the refusal letter which we did not have.  She said that our dossier would have been archived and that we would have to complete a new application supported by a letter asking that our dossier be reconsidered.  We asked why the old dossier could not just be resurrected but she said she could not get the file out of the archive (presumably they use old dossiers to heat the building).

I went back this pm armed with all the paperwork and a newly completed CMU application form.  She took copies of everything and accepted the dossier.  There was no hint of a refusal this time  - so fingers crossed.

For info the documents we supplied were:   a CMU application form and questionnaire on sources of income, are you working etc; letter asking to be reconsiderd under the new rules; copy of new rules from the website; 2005 tax declaration form where we stated the date we arrived in France; Avis d'Impots for 2005 and 2006; EDF bill from just after our arival in France; birth certificates; marriage certificate; passports; proof of pension income; E106s and letters from DWP confirming that they could not be extended; and finally a RIB.

[Helen]

It seems perhaps  that the CPAMs are beginning to act on the circulaire now. On anglo-info Brittanny two posters have said that they have received letters from the CPAM  today saying that they will continue to be affiliated to the CMU.

[Sunday Driver]

All credit to those CPAMs for their prompt action - their authority to proceed was only issued on Friday.

The French don't hang about when something needs sorting......[;-)]

 

[cooperlola]

That is good news; that makes four that we know of who are co-operating.  Helen, do you know which two CPAMs were mentioned on Anglo-Info?

[Helen]

Coops,  Three now : St Brieuc, Vannes and Loudeac

 

[cooperlola]

Thanks. [:)]

Slowly, slowly, catchee monkey...

[minnie]

This is not my message.  I have just pasted this from the latest message in Jim Murphy's blog.  Hopefully things will now start happening!

re: French Health Care

PRIORITY !!! TO ALL YOU WORRIED EX-PATS. I HAVE BEEN TO MY CPAM OFFICE TODAY 15TH AND BEEN TOLD I WILL REMAIN IN CMU AFTER MARCH. THEY RECEIVED THE INSTRUCTIONS TODAY. I WILL RECEIVE WRITTEN NOTIFICATION SOO, AND WILL JUST NEED TO GO TO A PHARMACIE TO TOP UP MY CARTE VITALE. I AM IN DEPT.36 (INDRE) CHATEAUROUX CPAM.

We, as E106 expirees, sent in a request, which should arrive on Monday 18th Feb,  for a review of Agen (47) CPAMs  refusal last week to let us join CMU.  We live in hopes!

[cooperlola]

THESE are the accepting CPAMs so far, that we know of. 

Even Perigueux, which was very recalcitrant up until now, has fallen into line - as one of our founders discovered yesterday to her great relief.

Please keep informing us of your own experiences, both positive and negative.

[Sunday Driver]

Referring to 'the accepting CPAMs' and those who are 'co-operating' might give the misleading impression that some CPAMs may be considering acting outside their official remit and refusing re-entry to the CMU. 

A more positive message to those still awaiting their 'letter' would be that all CPAMs will now be actioning the new instructions, and any current delay is purely down to the efficiency of an individual caisse's postal administration.

If you want to continue monitoring the situation, then perhaps it would be better to describe them as 'those CPAMs who appear to be quicker off the mark than others'.....[;-)]

 

 

[Ninthace]

I started this thread because the St Gaudens CPAM had accepted our paperwork to apply for CMU-B after the expiry of our E 106.  Our new application quoted their initial refusal to let us join, gave dossier numbers and included a copy of the latest rules for E106 holders issued by the Securite Sociale.  Today we have received a letter dated 15 Feb  which adds insult to injury.

They say thank you for our application to renew our membership of the CMU but we have been refused because of the change in EU law in 2004 and decree 2007-371 of 21 March 2007.  We must have sufficient resources and have private heatlth insurance etc.  However, as a goodwill gesture, our membership of the CMU has been extended to 31 Mar 08 and we should present our Carte Vitales for update as soon as possible.  Moreover, they say we owe them €478 for the quarter Jan to March 2008!

1.    We did not ask to renew - we asked to join following E106 expiry on 5 Jan 08.  We have never been members of the CMU-B.

2.   We do not have a Carte Vitale to update - when we asked for one in July 2005 we were told we could only have one when after E106 expired.

3.   Since we were not covered  by the CMU after our E106 expired - why on earth should we pay €478 for this privilege?

Suggestions please?

[cooperlola]

Grr...

Well, go to CLEISS in the first instance as you should now be a shoe-in, as an E106 holder.  Personally, I would agree to pay pro rata from the date of the letter, as you had no cover for the interim period.  But talk to CLEISS first.  I will pass this on to the Embassy, Ninethace.

EDIT : You should now have a copy of my e-mail to the Embassy, Ninethace.

[Boiling a frog]

[quote user="Ninthace"]

I started this thread because the St Gaudens CPAM had accepted our paperwork to apply for CMU-B after the expiry of our E 106.  Our new application quoted their initial refusal to let us join, gave dossier numbers and included a copy of the latest rules for E106 holders issued by the Securite Sociale.  Today we have received a letter dated 15 Feb  which adds insult to injury.

They say thank you for our application to renew our membership of the CMU but we have been refused because of the change in EU law in 2004 and decree 2007-371 of 21 March 2007.  We must have sufficient resources and have private heatlth insurance etc.  However, as a goodwill gesture, our membership of the CMU has been extended to 31 Mar 08 and we should present our Carte Vitales for update as soon as possible.  Moreover, they say we owe them €478 for the quarter Jan to March 2008!

1.    We did not ask to renew - we asked to join following E106 expiry on 5 Jan 08.  We have never been members of the CMU-B.

2.   We do not have a Carte Vitale to update - when we asked for one in July 2005 we were told we could only have one when after E106 expired.

3.   Since we were not covered  by the CMU after our E106 expired - why on earth should we pay €478 for this privilege?

Suggestions please?

[/quote]

 

Go back to your CPAM office and explain to them your circumstances.

They have obviously made an admin error which is not surprising what with all the various changes made in previous months.

[Ninthace]

There are errors and there is incompetence.  The dossier we submitted contained a copy of their previous rejection letter at the end of December; a letter asking them to reconsider their decision in light of the new rules, including a quote of the relevant paragraphs; a copy of the new rules and a new application to join the CMU-B, together with copies of all the supporting certificates, evidence of residence etc. 

The individual who replied made no reference to any of these and treated it as a request to renew.  He could not have made this error if he had bothered to read the dossier and, had he checked his records, he would have known we were not members of the CMU-B

I am going back to the CPAM this pm to give them a chance to recover the error but I am not going in hope.

Edit:

Postscript.  We spent a long time at the CPAM this afternoon trying to sort this out.  Fortunately we were dealing with the same individual who had accepted our reapplication.  She read the letter as said she could understand why we were "excited".  After discussion with her supervisor, she issued us with an attestation for the CMU de Base so we are in the system at last.[:)]

The bad news is that they still want us to pay cotisations back to January as the cost of membership is charged quarterly and we are in the system before the start of the next quarter.  We pointed out that we had taken out private insurance as required by their last rejection letter in December so in effect we would be paying for a service we had not only not used but had been refused.  She was sympathetic but no dice, let's hope my private insurer is as sympathetic when we cancel.  We did also ask if we could join at the start of the next quarter as we had already paid premiums up to that date but that came under the heading of too difficult.

 

[seb47]

Ninthace - commiserations. We can understand how exasperated you must feel. We too have taken private insurance as directed, but have not yet re-applied to CPAM as we're waiting for some documents to arrive from England. We're inclined to wait a good while before applying in the hope that this sorry mess will be sorted out. Do you have a date for the start of the next quarter?

Good luck, Sue,

[Ninthace]

Sue,

Next quarter is 1 Apr 08.  CMU year is 1 Oct to 30 Sep.

[Boiling a frog]

So it was an error and you are in the system.

I have never used French health care but pay every quarter

Do you think I should demand my money back

[cooperlola]

To be fair, BaF, you were not told that the state system would not cover you and that you needed PHI - then took it out only to discover that you could be in the state stytem, but would have to pay for both, during the period in which the government dithered and subsequently did its spectacular u-turn!  It really is one of the fallout problems from the delay, nothing else, and thus, imho, the ministry's problem.  Ninethace should not have to pay for the period when he was covered by PHI, but because of the system can do little else.

[Ninthace]

BaF, of course there was an error otherwise I would have been admitted as a result of my reapplication which post dated the rule change.  The error was the failure to investigate the application properly, read the paperwork submitted and to investigate and apply the published rules.

Fortunately I did not have to find out but presumably had I tried to see a doctor any time between Jan 05 and the present day I would have been refused support from the CMU as non entitled.  BaF, there is a difference between paying for a service you are entitled to, but do not use, and being made to pay for a service you were told you were not allowed to use. I expect my insurance company may well take the same view when it comes to refunding the premiums I paid.

[Boiling a frog]

If you feel so strongly about it why not follow the correct process and put in an appeal against the charges to the concilliator .

You can find all details on the CPAM website for your region.Our first year CPAM tried to charge us for  October to December but when we wrote to the conciliator pointing out that we had an E106 for that period they quickly revised their demand.

 

[Ninthace]

A useful suggestion BaF.  I am happy to pay for CMU or private insurance for the intervening period but I think I may be breaking some rule to have 100% private cover when apparently I was "covered" by the CMU and therefore be paying for both at the same time.  I have contacted my private insurer and am waiting for a response.  Article 18 of Loi 99-641 may be relevant.

[bellaboo]

I too have received a letter from CPAM at St. Gaudens today saying that we are now in the system (E106 expiree's) and we have also been asked for money from 6th January - 30th September.  If only we could have known, we could have  gone to the doctors, got the brown forms and saved them for this day!!!! instead of nearly having heart failure over private insurance and then having to cancel it all again.  Lets hope it only gets better (at least the weather is good!)

[cooperlola]

I see from THIS thread, Ninthace, that aj-dr's CPAM has stated that any costs incurred since the back-dated inclusion date, will be refunded.  Thus, I suspect that your best course of action is to talk to the insurance company and to try to get your premiums back, under the legislation I quoted.

Bellaboo, it may be worth talking to your gp to find out if he/she can or will issue your feuilles de soin retrospectively.  It's worth a go!

[Keith CHANNING]

I think it unlikely that insurers will refund premium moneys payable in respect of the period from commencement of the policy until you notify them that you are accepted into CMU. I certainly don't expect that.

Their position will probably be that had you made a valid claim during that period, not knowing that it could have been made against the state system, they would have paid it, therefore they have been on risk, therefore they need the premium.

Like many people, I can't afford to pay two lots of premium/cotisation for that period, but am pretty much resigned to the reality that I shall have to.

[cooperlola]

I think you are right, Keith, in that you should be able to cancel the policy, but backdating is unlikely.  However, on the principal of nothing ventured etc... I think anything is worth a go - certainly the cost of a stamp!

[Keith CHANNING]

Absolutely - provided it is tempered with the lost beatitude - Blessed is he who expecteth nothing, for he shall not be disappointed!