OAP

[Llwyncelyn]

My wife and I live in (50) and with my wife suffering from one of the 30 grave illnesses recognised within France and indeed she was forced to retired early on ill health grounds.  She has suffered from the illness for over 30 years.

As a result she was awarded an E121 and we moved to France in 2005.

Her care and cover under CPAM is at 100% but with all things figures can be made to lie so we hve approached a number of complimentaires including one who regulary advertises in the Anglo/French press and has received mentions on this site.  It has something of an exclusive background.

This morning we have received an email from the complimentaire which indicates that when my wife reaches 60 next year her invalidity benefit ceases and the OAP cuts in. Furthermore my wife was awarded DLA for life and on the highest level but that has now ceased for we are in France.  We do understand that

However what he said was then that the 100% facility for the reciprocal agreement with CPAM ceases and that 100% no longer applies and whilst this is against EU law thats what is going to happen.  Our attestation with the CPAM continues until currently 2009.  If then at 60 we have to invest in complimentaire that would be a nightmare for the medication for my wife is currently at a level (it is a specialist injection) at £1200 per month.

I just do not understand what the complimentaire is saying and they may well be correct? As it is DLA is lost at a high level and whilst this and the complimentaire will not forced us or be the catalyst for us going back to the UK the signs are not very good.  Does anyone have any experience please.

 

[Polremy]

I currently have an E121. I will be 60 next year (eeeek!). does this mean that i will lose all the 100% benefits? That would be a shame.

[Benjamin]

Mrs Benjamin reached 60 years last November. Prior to that she had been in receipt of UK long term incapacity benefit (or whatever it is called now) since 1992.

When we came to France last year her disability was accepted as one of the 30 ALDs and her treatment was reimbursed 100%. Since her birthday she has only had a couple of scans relating to her diability but these have been reimbursed 100%. She has had treatment for another problem not related to her disability and this has been reimbursed 70% ish with our Mutuelle paying the balance.

There has been no mention from either the French "system" or the UK of this situation changing.

My advice in your situation would be to talk with a French Mutuelle and see what their reaction is.

Benjamin

[Sunday Driver]

I think there may have been some misunderstanding over what your insurance agent has told you.  As Benjamin says, there has been no mention of any changes either to the reimbursement of ALDs or to the UK/France reciprocity arrangements. 

I'm not sure about figures being made to lie, but you will still need to arrange a complimentaire now to cover any shortfall in reimbursements relating to non-ALD treatment for your wife as well as for yourself.  The premiums should be reasonable and you may even receive a discount because of your wife's ALD.

 

[Llwyncelyn]

I am grateful to you for your help.  I may have misunderstood and that is quite likely.  However the source of the information was Exclusive and I have re-read the email and it definately says that after becoming an OAP that the situation changes!

However have appointment this pm with Groupama so thanks for the suggestion

[Will]

Looking into this, the information you have received does seem a bit strange. The illness does not go away just because the insured person reaches the age of 60. And so the status within the French health care system should not change either. What I believe does happen is that you may be contacted from time to time by the issuer of the E121 (i.e. the DWP) to see if the situation has changed in any way. But that should not be related to age, or be anything to do with the complementaire provider.

[Russethouse]

Llwyncelyn - how did this afternoons meeting go ? Any update ?