Aide Médicale de l'Etat

[Sunday Driver]

Some interesting background to AME which (according to the leaked French statement) was the proposed option for people who do not hold a current E106/E121 or have CMU cover and who have medical conditions....

It's normally only available to non-EU 'sans papiers' resident here with limited resources, but can be extended on a humanitairian basis to people like tourists/short term visa holders who are not covered by their home state or do not have access to private health insurance.  In the latter case, the authority does not lie with the CPAMs, but with the ministry for social action, so all individual applications must go there for approval.  Up until now, very few humanitarian applications have been approved, but that will clearly change under the proposed procedures.

The approval process would probably require the use of medical commissions to confirm pre-exisiting conditions (as is the case with ALDs) in order to establish rights to AME. 

The ceiling on resources is the same as for CMU, but unlike the latter, there is no legal basis or mechanism for collecting contributions from those whose income exceeds the limit. So at the moment it's free for all applicants - and they receive 100% reimbursement for everything.

People on AME do not qualify for a carte vitale, so the CPAMs will be faced with increased costs through every treatment claim being subject to manual processing.

Nor do AME people qualify for an CEAM, which means that as EU citizens, these excluded people would remain deprived of health insurance cover whilst travelling in the EU. 

I suspect these are some of the objections put forward by the CNAM.  Let's hope their message is that it'd be cheaper and administratively simpler to allow them to affiliate to the CMU.  Perhaps the new delay is because they're having to rework the figures....

(Edited following Will's comments.....)

 

 

[Will]

I thought it was the non-E106 (or E121) holders with existing conditions who were at the root of the problem...

Also, I read elsewhere that Sarko intends to reform the ALD system, most likely making the 100% reimbursement subject to means testing.

[Sunday Driver]

You are right.  I was referring to those with an expiring E106.....

 

 

[johnt]

The long awaited announcement is now posted on the french social security site  ........at last!!!!!!!!!!!!!!!!!!!!!