Krin Posted March 14, 2004 Share Posted March 14, 2004 Hubby has a condition that we are alsmost certian will qualify for 100% cover when we move to France. Can anyone tell me if this is likely to be 100% of everything related to this condition, or does it mean 100% of convention (sp?). For example if he sees a consultsant who charges more, is he fully covered or do we need to make sure that we have a mutuelle that will cover the additional cost. We will have a mutuelle anyway, but don't want to pay out more on that each month than we need to.Three year old daughter also has a condition from birth which is permanent that will also mean doctors and hospital visits from time to time. Is this also likely to be covered 100%?Have checked the archives but can't find the precise answers to these questions, but apologies if they have been asked, and answered before ThanksKrin Link to comment Share on other sites More sharing options...
LesLauriers Posted March 14, 2004 Share Posted March 14, 2004 This question has come up before and the answer as I remember it was that 100% is 100% of convention. Link to comment Share on other sites More sharing options...
Zippy Posted March 20, 2004 Share Posted March 20, 2004 100% of convention I am afraid. However if you need medical treatment that a doctor will certify is life threatening they pay the full amount. Link to comment Share on other sites More sharing options...
Poozel Posted April 5, 2004 Share Posted April 5, 2004 The 100% is confusing because it is used in 2 ways.1.You have 100% cover referring to the tarif of convention(which applies to everyday medical situations and lesser illnesses/conditions and covers only a percentage of the costs, leaving the rest to you and /or your top up insurer)2. You have 100% exoneration of costs. This is for affections de longue duree. This means that charges are taken in hand 100% by CPAM and cover the following circumstances: (1)30 listed illnesses of long duration (2)other conditions considered grave and not listed above and incurring high costs for treatment for a period longer than 6 months (3)situations where several lesser conditions group together to cause a long period of treatment, of more than 6 months. (ie an elderly person breaks a hip and then cannot walk and requires further medical intervention.Your doctor must apply for an exoneration of expenses to the CPAM. You will get a letter stating that you are exonerated for a fixed period of time (7 years, 20 years, whatever).Note that the forfait journalier and the added cost of a private room are up to you/your assurer as in all other cases.The 100% exoneration applies only to the particular condition for which it was given, for example diabetes - if you fall and break your arm, the usual reimboursement will come into force.You can visit the website www.amelie.fr (Assurance Maladie on line)for lots of other info. Good luck!Poozel Link to comment Share on other sites More sharing options...
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