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Renewal of Carte Vitale refused


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My wife and I have been in the CMU for 5 years.  I was working for a French company when we joined, but stopped working for them the following year and have lived on our own resources (private pensions from UK) ever since.  Neither of us qualify by age for a UK state pension, although both my wife and I will be entitled to full pensions on reaching qualifying ages of 60 and 65 respectively.  My wife will be 60 in July next year, I'll be 65 in 2013.  

Our Cartes Vitales expire on 31 October so in July we went to our CPAM to arrange for renewal.  They have refused to renew the Cartes Vitales on the grounds that we can't produce any "justificatif" of retirement entitlement.  Presumably they mean state pension eligibility.  After sending us round the houses they now say they want to see an E121.  Presumably, we can't get one until July 2009.  Meanwhile we won't be covered from October 31.

I believe we are entitled to remain in the CMU as we've been in it already for 5 years and our continuity of residence is not in doubt. 

Any suggestions?

Patrick

  

     

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I do not quite understand. If you worked originally for a french coy you would not get health care via CMU .Having said that if you now do get health care via CMU do you not complete an application for CMU every year in August showing your revenue fiscal de reference(which you get having completed a French tax return) .CPAM should have sent one out to you in early August every year.
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If, as you say, you have been French fiscal resident for five years, first through working and then as inactifs, you will surely have tax and/or social security documentation to support this. If you show this to your CPAM office, you should be able to remain covered.

Don't get too bogged down in references to CMU. In this context it means 'couverture maladie universelle', which is the scheme that made access to the French health system available to everybody who was entitled to join, and, moreover, made it compulsory to join and contribute according to your income. Which body actually handled your health care is largely irrelevant.

Neither is it necessary to have a carte vitale; as long as you have a social security number you can reclaim the standard percentage of health costs.

Unfortunately some officials are not as well informed as they should be about the entitlement (or otherwise) of non-French nationals to health care. If you continue to meet resistance you can try calling one of the CPAM help lines. There is even an English speaking one for those who need it - although it was suffering a bit from the chocolate teapot syndome during the recent confusion, things have now been clearer for almost a year now so it should have correct and current information to hand.

 

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[quote user="Will"]

If, as you say, you have been French fiscal resident for five years, first through working and then as inactifs, you will surely have tax and/or social security documentation to support this. If you show this to your CPAM office, you should be able to remain covered.

[/quote]

Thanks for a bit of calm reassurance.  I had heard of other people having problems, but when I read that anyone already in the scheme before November last year was automatically entitled to remain in it, I stopped reading any further healthcare topics on the forum and went into self-congratulatory mode.  No news is good news, after all.   

Yes, naturally we have Avis d'Impot going back 5 years and also records of our Contributions Sociales.  The people at our local CPAM office have seen these and seem not the slightest bit interested in them.

[quote user="Will"]

Neither is it necessary to have a carte vitale; as long as you have a social security number you can reclaim the standard percentage of health costs.

[/quote]

Really?  That's great, but how?  If I have to pay the full amount for a visit to the doctor or a prescription, how do I put in a claim without a Carte Vitale or a valid attestation?  Does it really work if you just put your social security number on the claim form?

[quote user="Will"]

Unfortunately some officials are not as well informed as they should be about the entitlement (or otherwise) of non-French nationals to health care. If you continue to meet resistance you can try calling one of the CPAM help lines. There is even an English speaking one for those who need it - although it was suffering a bit from the chocolate teapot syndome during the recent confusion, things have now been clearer for almost a year now so it should have correct and current information to hand.

[/quote]

You can say that again.  The people at our local CPAM office seem not very bright and they don't even agree with each other most of the time.  I did know about the helpline, but suspected it would just be manned by the same people who have already been so useless.   

I suppose we could just put the whole thing on the back burner until my wife becomes entitled to her UK Pension in the middle of next year.  One problem with that is, as I understand it, that we would technically become illegal immigrants unless we took out comprehensive private healthcare insurance in the interim.  

And anyway, I don't want to let this go now.  I am entitled and I want what I'm entitled to. 

It's back to the CPAM office tomorrow to make a nuisance of myself again.  Perhaps that's all they understand.

Patrick 

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The procedure for reclaiming without a carte vitale is simple. You pay the doctor, pharmacy, or whoever, and make sure you get a 'feuille de soins' i.e. the receipt, usually brown in colour although I have seen green ones. You fill in the spaces on the back with your name, social security number etc. Your social security number will still be current in view of the fact that you qualify for health care through residence. Send the form to your medical caisse (CPAM for most people) and the reimbursement will be paid into your nominated bank account. If claiming for medicines, make sure the vignettes (stickers) are attached to the feuille de soins, the pharmacist should do that, and enclose a copy of the prescription.

If your CPAM is still being awkward you may have to wait for reimbursement a bit longer, and it's a very good idea to take copies of everything just in case.

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It seems you have two strings to your bow, 1. resident in France for 5 years and 2. you were in the CMU system in November 2007.

You can not now be refused entry into CPAM except in extreme circumstances. You didn't answer B.A.F.'s question did you complete this years CPAM renewal form?

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[quote user="Cat"]

[quote user="Cat"]The FHI link for 5 year residence.[/quote]

IS THAT BETTER RON???

[/quote]

Well as you ask can you move it 25mm to the right and show the link in red like the red cross[:P].

PS .....and don't shout its naughty[:$]

I think the OP's problem is that they were not in the CMU Base in November 2007 so therefore it really does matter as to how this can be resolved.  The fact that they were not in the CMU Base before is probably why CPAM is refusing them admission to the CMU because as far as they are aware,  having been covered by another Caisse, they are new applicants/entrants as if coming off an E 106 and therefore cannot now join.   What they need to do is explain this to their CPAM with documentary evidence and then apply to join the CMU Base under the 5 year residence rule again with documentary evidence of continued residency, like a C de S or tax bills/returns, utility bills don't really prove residency, only that you own a house in France.

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Ron wrote

"I think the OP's problem is that they were not

in the CMU Base in November 2007 so therefore it really does matter as

to how this can be resolved.  The fact that they were not in the CMU

Base before is probably why CPAM is refusing them admission to the CMU

because as far as they are aware,  having been covered by another

Caisse,
"

"My wife and I have been in the CMU for 5 years.  I was working for a

French company when we joined, but stopped working for them the

following year"

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[quote user="gosub"]Ron wrote
"I think the OP's problem is that they were not in the CMU Base in November 2007 so therefore it really does matter as to how this can be resolved.  The fact that they were not in the CMU Base before is probably why CPAM is refusing them admission to the CMU because as far as they are aware,  having been covered by another Caisse,"


"My wife and I have been in the CMU for 5 years.  I was working for a French company when we joined, but stopped working for them the following year"


[/quote]

Les

If he was working for a French Company or covered by an E 106 if working in the UK but living in France in that period he was NOT in the CMU despite what he thinks or writes.  As Jotty posted "Surely if you were working for a company you wouldn't be in the CMU. You would be in the Régime général des travailleurs".....

which is absolutely correct.  The CMU Base is NOT for workers, its for inactifs and the poor, hence my post.

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I think you will find that the OP said he has been here more than 5 years only worked for a french coy for 1 year and after that what?

If he had been receiving health care via CMU for the past 4/5years then surely he would have known that in August every year you are sent a form to renew your  CMU B and to establish your cotisations. There would have been no need to go to CPAM in July because you would know that the application would be arriving in August .

Have you ever actually completed an application for CMU at any time in the past 5 years Or am I missing something.

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My understanding was that the person concerned worked in France some time ago, but would have had CMU cover on the vital date last year. In any case, the five-year-residence rule would also apply.

As I mentioned before, there is confusion over the use of the term CMU. It actually stands for couverture maladie universelle, and is the general term used for health coverage for everybody who is eligible. It has come to be misused on this forum to mean CMU Base, or CMU-B, which is what you actually join when you cease to be covered by an E form - see http://www.cmu.fr/site/cmu.php4?Id=5. CMU B is not just for those on low incomes, as I hope the link will make clear.  

Here is a Google translation of the first part:

Universal coverage of basic allows access to health insurance for all persons residing in France on a stable and steady for more than three months, and who are not entitled to health insurance to another title ( professional activity, etc.).

If you're in this situation, you will be supported by the general system for your home in France.

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If the op had CMU B cover in November last year then surely he would have known that an application form would be sent out in August to renew their CMU B ,especially if they have been in France for 5 years .Why go to CPAM in July ,why not wait as everyone else does /did until August for the application form, why are CPAM asking for an E121(I suspect that the OP,s do not have sufficient French to explain that they want cover via CMU B),why not answer the question about applying for CMU B

PS Will

You are confusing things by quoting partial legislation  re entitlement to CMU B because as you are aware "" all persons residing in France in a stable manner for more than 3 months""  no longer applies to EU citizens who were not registered with CPAM on 23rd? Nov 2007 either via an E 106 form or via CMU B

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True BaF, but the person concerned clearly was in France, with CMU cover, on the date in question, as they had a carte vitale. I agree with you about the application forms - it is looking as if there may be things that we are not being told about this particular situation.

Yes, 23 November 2007 is the vital date. That is the date on which the French government issued a circular:
http://www.securite-sociale.fr/comprendre/europe/europe/0711123_circ_dss_cmu_ue.pdf
That made it clear that those with five years residence would have access to the health system in France.

The government issued a further note in December 2007, with further information:
http://www.securite-sociale.fr/comprendre/europe/europe/cmu_inactifs.htm

Part of this reads (in translation):

"For persons having lived in France continuously and legally less than 5 years in total, access to the CMU can only be allowed when, after having obtained a right of residence, these persons encounter a setback that causes a loss of financial resources or their medical insurance.
Nevertheless, EU citizens who had already been given access to the basic CMU on or before the 23 November 2007 can continue to benefit from the CMU."

Clair's FHI link goes further, in that it says anybody with an E106 or E109 form who was already resident in France before 23 November 2007 is eligible for access to CMU (sorry, I don't have an official source for that).

Which I would have thought made the OP's position pretty clear-cut, if all is as they say.

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If you work you are covered by the payments you have made.(In the case of the OP apparently a year)

If you are made redundant or are sacked (but not if you resign) you then get Assedic for a period (about 7  months minimum but it can be longer) and the Assedic pays your social security charges.

After that you get gradually reducing cover until you start to pay again.

At no point in this process (say 2 and a half years) would you be in the CMU.

I am neither a tax expert nor a lawyer, but I have been there and have the T shirt.

I am not,   never have been and never will be in the CMU.

That is often the case with people who work or run a business in France.

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