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This is a direct quote...............


Llwyncelyn

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From an article apearing in The Connextion and penned by Lary Fulton.

' There is a much more serious dimention to Long-term Incapacity Benefit/Invalidity Pension when the subject reaches the official age of retirement, in both the UK and France, the State Retirement Pension replaces the invalidity benefit/benefit.  A French national does not lose 100% care but a UK national does.'

Essentially Mr Fulton was discussing both EHIC as well as E121's and then goes on seemingly to direct those who are approaching or have 'hit' State Retirement Age towards COTOREP.

Please is Mr Fulton saying that without the involvement of COTOREP in such matters those who have the current benefit of 100% for long-term cover through their now Carte Vitale then lose such a facility and then 'Top-up cover' clicks in?

I am aware that Incapacity Benefit and upon reaching say sixty for the ladies ceases and that State Retirement Pension cuts in but I was unaware that at the same time here in France the availability of 100% cover despite the illness appearing within the top thirty conditions ceases.

Being mindful of recent postings I have both tried to search for this precise subject area as well as taking time to look towards my punctuation in this posting!

rdgs

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The paper is spelt Connexion and the site is www.connexionfrance.com , though it really isn't very helpful as you have to pay to receive articles etc though you can have a free copy of the paper just by asking. I have received two or three but don't want to subscribe.

Sue

Edit: sorry I did not mean to imply that the Connexion paper might be unhelpful, I meant that the web-site is unhelpful as there is no free access to the articles on the site ie you have to buy to download the articles etc.

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[quote user="Llwyncelyn"]

From an article apearing in The Connextion and penned by Lary Fulton.

Essentially Mr Fulton was discussing both EHIC as well as E121's and then goes on seemingly to direct those who are approaching or have 'hit' State Retirement Age towards COTOREP.

[/quote]

So if we're not going to be able to see the article let's first deal with the inaccuracy quoted above.

Apart from EHIC's and E121's dealing with health matters that's about as close as they come to being anything to do with one another. An EHIC is a UK issued document/plastic card dealing with short term visits to another Member State. It entitles the holder to the same medical cover as the full time residents of that Member State.

Therefore the most that you will be reimbursed under the EHIC is the same that a French resident is ordinarily reimbursed i.e. 65/70%. An EHIC will never, in France, mean a reimbursement of 100%.

E121's and their coverage has been done to death on here recently so I don't intend going any further there.

On a personal note Mrs Benjamin gets 100% reimbursement for her ALD and has continued to receive this in France since she passed 60 years and moved from UK Incapacity Benefit to UK State Retirement Pension.

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COTOREP deals with matters concerning handicap and incapacity benefit in terms of support services or financial assistance.  Their published role and practical competence contains no reference to restriction of healthcare rights.  Given that French incapacity benefit also expires upon receipt of an old age pension, I can't see why the reader is being directed there.

As Benjamin points out, reimbursement of treatment for affections de longue duree is not dependent upon receipt of benefits or income, it's purely on medical terms.  There is no discrimination between UK or French citizens, so if you are registered for CMU and you are medically categorised as having an ALD, then you receive 100% regardless of who you are.

 

 

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Spg of course a typo and I am sorry

I do not subsribe but from time to time do read it.  Again I read other periodicals but do not subscribe.  However there are periodicals and to which I do subscribe and thus read.  Its a matter of choice of course.

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Benjamin I posted the quotation to obtain debate and nothing else.  I did not nor do I vouch for its accuracy.  But thats how it is word for word and if anyone does so wish I will try to scan it and post it here.  Thats what he says Benjamin!  I truly know about EHIC and E121 and COTOREP and the half share due to a Disabled Partner in respect of tax.

My wife had an E121 before we left the UK and thus I qualify as well.  However I too had in my own right an E121 before leaving the UK in that I have a medical problem and where there is a growth in the spine and which is pressing on the spinal column.  No one wants to touch it so bear the pain and when the pain gets too bad we will think about it but its dangerous.

Thus my wife qualifies for her 100% cover by virtue of her Rheumatoid Arthritis.

As you say Benjamin the cover should continue after my wife reaches retirement age this year.

However as Mr Fulton purports to be able to understand the French system either his article is wrong or it has been subject to an incomplete posting.

Whatever he says one thing you say another.  So please do not shoot the messenger.

I am with you on this one but perhaps and if I am so inclined I will email him.......perhaps

rdgs

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I have just read the article in question and stumbled on exactly the same part that drew your attention, LL.

When you are in receipt of  UK Incapacity Benefit, you get 100% free medical cover in France, for every condition, not just the medical problem which led you to receiving Incapacity Benefit.

Since Incapacity Benefit ceases when one reaches pensionable age, 60 (women) or 65 (men), you will continue to be entitled to free medical cover for your ALD (Affection de Longue Duree), i.e. the medical condition which is on the famous 100% list. But I do understand that for other medical problems, you are no longer entitled to 100% free care: for those other medical problems, you are just like any other person, ie.reimbursed 65% by the Secu, and having a top-up health insurance to pay for the rest.

My OH has long-term incapacity benefit from the UK. He does not have to pay for anything medical, except for the "board and lodging" part of any hospital stay. He has taken a special top-up health insurance just for that, which is only about 100 euros annually. When he loses his Incapacity Benefit at 65 and his UK state pension kicks in, then he will have to have a full top-up health insurance like I do, for which I pay around 650 euros annually. However, he will still receive free treatment for the two ALDs he suffer from.

At least, that is how I understand it.

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Hi 5-element how are things in the Languedoc?

Have read your posting with interest are you sure as to the fact that 100% applies not only due to the medical condition which led to the Incapacity Benefit being awarded but that other conditions also attract 100% cover from CPAM.  I do not dispute what you say indeed agree with you but my advice from a number of sources including these archives and other associated forums lead me to believe that it is only the ALD condition which qualifies?

Upon that advice I have obtained top up both for my wife and myself and as I am 62 I have some three years paying as you say about 600/800 euros a year for cover.  Looking at my CPAM statement most medications are covered most consultations save for the one euro deduction all blood tests are covered and most other things and purely in isolation it looks expensive to have top up at this time. However I have not been in hospital for a stay not had an operation and certainly one that is not connected with my medical problem.

Why then should I pay top up if as you say CPAM pays 100% of everthing and that all eventualities are covered by CPAM.  For the sake of this discussion let us exclude dental and opticians for they cloud the picture.

I am risk averse that is some of my background so decided to take top up budget for it and getting the claims back from Groupama is totally another matter but safety first is my approach.

Would welcome your views.

rdgs

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Just because something is in print does not mean that it is right, unfortunately. There is a lot of misleading information, or more accurately ambiguous or out-of-date information, that gets passed around and changed a little.

One person who knows a lot about such subjects is Peter Owen. He uses this forum from time to time. He wrote most, if not all, of the health-related articles at www.frenchentree.com. I would suggest looking at those for confirmation, or otherwise, of the Connexions item.

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Sorry, some of the information given above is incorrect.

Receipt of Invalidity Benefit in the UK does not entitle a claimant to receive 100% ALD in France.  Invalidity Benefit is the old Sickness Benefit and whilst the rules are dis-similar, longer term IB can attract ADL in France, but it is NOT automatic and you have to make your case for ADL when you come to France and register with a GP or specialist.

100% cover only, ever covers a specific condition or set of conditions - for example, all my medication is covered because the leukaemia has caused a number of other problems which need medication, therefore they are all related.  If I - say - found that I had a short term condition, it would not be covered 100%, even before the age of 60/65 and with the ADL in place.

Also the holiday cover card (ex-E111) does NOT cover you for the same level of assistance and help as everybody else in the country in which you seek medical assistance.  Usually you are only covered for emergency hospital treatment - for example you cannot present the card at a hospital for non-emergency treatment nor can you use it for basic medical care through a generalist, it is for emergencies only.

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Tony, this is a little odd, although I believe you. I can only relate our own experience, which is to repeat what I outlined above. My husband is 100% covered for all medical expenses here in France, and this is (according to CPAM) due to him receiving long-term Incapacity Benefit from the UK. I have just checked that with him as you made me doubt, but it is totally correct.

He has TWO recognised medical conditions (recognised, as being on the list that warrants 100% cover in France). One could think that these 2 conditions overlap so much that virtually any medical problem could be ascribed to one of them, but I very much doubt it. Or that his GP and other medics ascribe any of his "other" problems to one or the other ALD, but I also doubt that.

I cannot explain it any other way. It is unlikely that there would be any regional variations, or variations according to which CPAM office one goes to? It is not either a question of our income falling below the free CMU cover, as it does not. So I am quite puzzled why we seem to have a different experience and understanding of the UK long-term Incapacity Benefit rules as applied to medical care in France.

I also heard (maybe this is a slight digression) that COTOREP rules have become very very stringent, that you have to be practically immobilised before you can qualify for the AAH (Allocation Adulte Handicape) here. In spite of his heavily disabling medical conditions, it is likely that my husband would not qualify for a COTOREP AAH at this point. One of the specialists treating him said that you have to be practically tetraplegic before you can qualify now as 80% disabled, with the new COTOREP criteria.

LL - Things are fine in Languedoc, it is pouring with rain today, which we desperately need this year...

Have you visited Languedoc yet?

 

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I think there may be some confusion over the term 100% care.

If you are in receipt of UK incapacity benefit, then you qualify for a form E121 which entitles you to French healthcare without having to pay CMU cotisations - ie, your state heathcare insurance costs are covered 100%.  Perhaps that's what 5-element meant by 100% free medical cover?

Even with an E121 (issued through incapacity benefit or otherwise), unless you have an ALD, you will only receive the normal reimbursements up to tariff and you cover the shortfall with a top-up.  

Edit:  Posts overlapped...

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Hi 5-e

I understand what you're saying with the 100%.  I actually have 5 conditions all of which are inter-related and for convenience - and I think because the doctors are pragmatic about that sort of thing here - I usually get 100% blue forms whatever I need.

However, earlier in the year when I needed a scan and the generalist thought it was an unrelated matter, he gave me a prescription and I got the brown form - when he rewalised it was the 100% condition, he made sure that I was reimbursed.

I still have a top up in case a leg falls off and it's not related to the other conditions tho ....................

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[quote user="Tony F Dordogne"]

 I actually have 5 conditions all of which are inter-related and for convenience - and I think because the doctors are pragmatic about that sort of thing here - I usually get 100%

I still have a top up in case a leg falls off and it's not related to the other conditions tho ....................

[/quote]

I wonder: when your medical condition is undoubtedly completely systemic, as leukemia surely is, then virtually everything can be related to this underlying problem. In your case Tony (and in my husband's case too) it is quite straightforward to claim that even a leg falling off (to use your example) is actually due to your ALD. Just like some dental problems would, or a number of aches and pains, digestive disturbances, virtually anything, can be seen as a secondary problem. I am not sure whether it is a case of doctors being purely pragmatic, or realistic.

This being the case, I will try and find out exactly who advised us, in the medical or CPAM world, to only take a top-up health insurance for my husband, just to cover the daily fee during a hospital stay. So far, everything else has been 100% reimbursed, as we can see from the CPAM 3-monthly statements. Those statements are the way you can tell how much you are being reimbursed. Mine are only 65%, and the mutuelle pays the rest (when they remember, but that is another story).

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According to Peter Owen's articles, if I read them correctly, there is a distinction between long term invalidity benefit (receipt of which does seem to entitle one to 100% refunds of everything, though apparently only until state retirement age) and short term invalidity benefit, i.e. relating to a condition which is disabling but not necessarily permanent. Of course, how such conditions are defined is another matter altogether, as 5E says.

The EHIC replaced several other forms beside the E111, so it can be used for more than just emergency treatment. But that only applies to certain cases, and often the EHIC needs to be backed by another E form.

Tony F - some of us know the full story (which I don't think you do) and care about free speech on the forum (which you appear not to care about). By free speech I mean free speech within the code of conduct set by the owners of the forum - not other petty rules thought up by other users. I find your signature comments both inflammatory and unhelpful.

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[quote user="Will"]

 there is a distinction between long term invalidity benefit (receipt of which does seem to entitle one to 100% refunds of everything, though apparently only until state retirement age) and short term invalidity benefit, i.e. relating to a condition which is disabling but not necessarily permanent.[/quote]

Thank you Will: that makes sense and confirms our experience, Mr. 5-E is on long-term incapacity benefit, no chance that his condition could improve, it is seen as treatable (palliative treatment) but incurable. That does explain why he gets refunds on everything, except on some dental treatments and opticals for which he gets the same as everyone else. So maybe Peter Owen has got it right after all.

I hope that sheds some light, LL.

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Hi 5-element glad to hear about the rain if we can set up a transfer system for some of it from Normandy to you!  However a week or so ago fantastic and the week ahead looks good as well.

Ok just seeking positive clarification.  Whilst I agree the Connexion may not be correct Mrs LL has suffered from Rheumatoid Arthritis for over 30 years and it is not going to get better and there is no cure.  Yes treatment to try to stop the continuation of the disease but it a flair up then further damage to the joints and all that entails.  Mrs LL is also registered in the UK as a Disabled Person and obviously we have contacted COTOREP but still waiting and I am told that six months is the normal period for them to return to you.

However I made representations to the tax guys with all of Mrs L's details and they agree that the Disabled Person status is transferable from the UK and tant pis to COTOREP.  Indeed they have refunded a sizeable amount of tax.

I am still not there on this and is Sunday night and following a long day in the garden and I am tired but we are concerned that when Mrs LL reaches retirement age in August does the continuation of 100% for her condition continue.  There seem to be differing viewpoints on this forum and certainly between Peter Owen and Lary Fulton.  I think I will consult these people as soon as I am able as well as speaking to CPAM.

Finally I am totally unaware of the situation in relation to St Malo and know it only as a reconstructed town probably after the second world war.  I prefer Cancale.  However is this forum the place to air grievances which are obviously of a personal nature?  Still I will keep out of the argument.

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[quote user="Will"]

Tony F - some of us know the full story (which I don't think you do) and care about free speech on the forum (which you appear not to care about). By free speech I mean free speech within the code of conduct set by the owners of the forum - not other petty rules thought up by other users. I find your signature comments both inflammatory and unhelpful.

[/quote]

With respect Will neither do you. You have only heard one side and as Dick always says there is two sides to every story. Have you emailed Forum Admin and asked him why a ban was put in place? This was only between Miki and Forum Admin even the moderators don't know exactly what was in the communications that passed between them. The only thing the moderators know is that it does not relate to any one singular incident or person. I know that one or two people have assumed that it relates to an individual but it didn't. If you want to know more then as I said you will have to ask Forum Admin. You may have to wait a while for a reply as he has quite a list of replies to make at the moment but he will get round to answering every one when he has time.

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