Georgina Posted June 8, 2011 Share Posted June 8, 2011 I am covered with the health insurance through work but as I am finishing shortly and they are totally useless at giving information, I need to know this for my hospital operation.My hospital told me that I can get transport to and from the hospital. I am reluctant to do this as I thought this was only for people seriously ill. However I am not allowed to drive when I go home. How do I know if this is reimbursed. Is it usually reimbursed if you are under your work scheme? And if not, how much do I pay. It is the first time I have been to hospital and don't want to use transport but looks like I have no choice. But I don't want a big bill either. I can ask a friend to pick me up but as it is 50km, I feel it too much to ask. Link to comment Share on other sites More sharing options...
Albert the InfoGipsy Posted June 8, 2011 Share Posted June 8, 2011 I had several trips to hospital reimbursed after my cancer op. Talk to the taxi-ambulance company and to the hospital or your medecin traitant. Essentially you need a 'bon de transport' that you'll probably get from the doctor treating you at the hospital. The first time I went there was a mix-up and the driver sorted everything out for me. I was hardly in a fit state to argue the toss in English, let alone French. Link to comment Share on other sites More sharing options...
Val_2 Posted June 8, 2011 Share Posted June 8, 2011 The CPAM would give you the info regarding transport and any costs involved regarding the frais etc. Link to comment Share on other sites More sharing options...
Cat Posted June 8, 2011 Share Posted June 8, 2011 I don't know if you have an ALD, but there is some info in this thread that may help...http://www.completefrance.com/cs/forums/2469333/ShowPost.aspxOr, if your journey is more than 150 km one way, or if you expect to be making at least 4 trips of over 50 km (one way) during a period of 2 months (for the same treatment) then you will need to contact your caisse and ask for an Accord PrealableOtherwise, best to phone your caisse for advice. Link to comment Share on other sites More sharing options...
idun Posted June 8, 2011 Share Posted June 8, 2011 What is a 'work scheme'? The company my husband worked for actually used to run their own mutualist, is that what you would call a 'work scheme'? I don't suppose that many do that any more. In the end his employer transferred everyone over to a mutualist company and his pay was debited every month with his cotisation.edit, just realised that you are talking about a mutualist via work. Will this mutalist stop when you finish work? (as I take it that your salary is also debited each month), or can you continue your payments yourself? Link to comment Share on other sites More sharing options...
Renaud Posted June 8, 2011 Share Posted June 8, 2011 What are friends for? Link to comment Share on other sites More sharing options...
Benjamin Posted June 8, 2011 Share Posted June 8, 2011 [quote user="Albert the InfoGipsy"] Essentially you need a 'bon de transport' that you'll probably get from the doctor treating you at the hospital. [/quote]The first bon comes from the person (normally your french GP) who refers you to the hospital/Consultant.If you are subsequently given another hospital appointment, you then get the bon when you attend for the appointment. Ensure they fill it in correctly. Link to comment Share on other sites More sharing options...
Georgina Posted June 8, 2011 Author Share Posted June 8, 2011 Thanks everyone, lots of help. I do have a friend that has offered but it seems a bit much to ask her to get me there for 7.30am. The hospital has told me that the transport is included but I am reluctant to use it as it is not an emergency. I guess I will just have to bite the bullet and see if it is covered later. Idun - yes I was wondering if it was covered with work that will finish after the operation date. I don't want to ask them as they are so disorganised. Too many chefs!!! Val I think Cpam won't cover it being as I am now covered by my work's health insurance? Should I ask anyhow? Link to comment Share on other sites More sharing options...
idun Posted June 8, 2011 Share Posted June 8, 2011 Oh, that sounds strange to me, works health scheme? Do you work for the military or functionnaires or agriculture. I realise that there are lots of caisse de maladie which have their own way of dealing with things, but the employer often only helps towards the mutualist, not full health care and main part of your health care paid for from part of the state's system, whichever a person is obliged to be a member of.I still find out all sorts of interesting things, so you may well be telling me about something new. Link to comment Share on other sites More sharing options...
Albert the InfoGipsy Posted June 8, 2011 Share Posted June 8, 2011 [quote user="Georgina"] The hospital has told me that the transport is included but I am reluctant to use it as it is not an emergency. [/quote]That's about as sensible as offering to pay for all your other treatment 'as it is not an emergency'. If you need to stay in hospital will you be taking your own camping stove or laundering your own sheets? [quote user="Georgina"] Val I think Cpam won't cover it being as I am now covered by my work's health insurance? Should I ask anyhow?[/quote]CPAM would seem to be the best people to advise on this. Usually I'd expect 'work's health insurance' to just cover the 30% that the state (CPAM) doesn't reimburse. What happens at the moment if you need to claim for doctor, dentist, pharmacy or whatever? Link to comment Share on other sites More sharing options...
Val_2 Posted June 9, 2011 Share Posted June 9, 2011 When you started work did you apply to the CPAM for your own personal Carte Vitale for your boss to register for your charges etc? I had to and they are the people who deal with health cover locally when I have needed to use the dentist etc, the pension and other charges come from elsewhere that your boss is affiliated to for his particular trade, so yes, have a word with them down in the rue de Brest and see what they say,it dosn't cost anything to do that. Link to comment Share on other sites More sharing options...
Sunday Driver Posted June 9, 2011 Share Posted June 9, 2011 As a salaried employee, you are covered by the state assurance maladie. Whatever 'works insurance' you think you may have is immaterial.If you have to go into hospital, you have the right to a bon de transport covering the 'to and from' journeys. The bons will specify whether this is by normal taxi or a light ambulance if you need specialist assistance. CPAM will cover the transport costs up to 65% of the tariff (up to 100% if you qualify) leaving the rest down to you or your mutuelle. You can also opt to use your own vehicle and claim a mileage allowance.Alternatively, if you don't want to do what everyone else in France does, then you can ignore all this and pay for it all yourself..... Link to comment Share on other sites More sharing options...
Patf Posted June 9, 2011 Share Posted June 9, 2011 It can be very expensive. We had a bill of 600€ as a third of the bill for a 25k journey. CPAM paid the rest.This was before we had a top-up policy. Link to comment Share on other sites More sharing options...
Benjamin Posted June 10, 2011 Share Posted June 10, 2011 [quote user="Patf"]It can be very expensive. We had a bill of 600€ as a third of the bill for a 25k journey. CPAM paid the rest.[/quote]This fairly straightforward thread is turning into a nightmare.You were charged nearly €2000 for a 25k (kilometre?) journey?Was it by private jet? Link to comment Share on other sites More sharing options...
Georgina Posted June 10, 2011 Author Share Posted June 10, 2011 How can that be possible, think that included the stay in hospital yes???Thanks everyone for your help.I went to CPAM and they said my card did not work and that I was covered by my own work's assurance.!!!!I went to the assurance for work and they told me they only do interview appointments on Thursday and Friday, like I would know that!!!! There was no signSo I have no carte vitale ): and a hospital appointment, no transport AGHGHGHG Link to comment Share on other sites More sharing options...
Georgina Posted June 10, 2011 Author Share Posted June 10, 2011 [quote user="Sunday Driver"]As a salaried employee, you are covered by the state assurance maladie. Whatever 'works insurance' you think you may have is immaterial.If you have to go into hospital, you have the right to a bon de transport covering the 'to and from' journeys. The bons will specify whether this is by normal taxi or a light ambulance if you need specialist assistance. CPAM will cover the transport costs up to 65% of the tariff (up to 100% if you qualify) leaving the rest down to you or your mutuelle. You can also opt to use your own vehicle and claim a mileage allowance.Alternatively, if you don't want to do what everyone else in France does, then you can ignore all this and pay for it all yourself..... [/quote]Thanks for that SD, good advice as always with a bit of sarcasm thrown in LOL. However I am not covered by CPAM I am covered by MSA - do they pay 65%? I have no idea. I have not been covered through work before and my company as I said just does not even tell me how to do my job let alone give any information out about health insurance. Link to comment Share on other sites More sharing options...
idun Posted June 10, 2011 Share Posted June 10, 2011 As I asked, do you work for other than a normal employer? The CPAM do not deal with everyone by any means, but someone other than your employer must have you on their books. How could your employer afford to pay for full health care for it's employees. My husband's employer couldn't afford it's own mutualist in the end, so went to a 'mutualist company'. Also as you have said, they are already a bit off as to how they pay you in the first place. This is most odd, really it is. Link to comment Share on other sites More sharing options...
Cat Posted June 10, 2011 Share Posted June 10, 2011 It's not add idun, georgina is, as she has said, covered by MSA, the caisse for agricultural and rural workersTheir website gives advice on travel by taxi or VSL...http://www.msa.fr/front/id/msafr/S1096461900197/S1098192456447/S1098192459853/publi_Transports-medicaux.html Link to comment Share on other sites More sharing options...
Georgina Posted June 10, 2011 Author Share Posted June 10, 2011 Thanks for that, I never knew that. Link to comment Share on other sites More sharing options...
Georgina Posted June 10, 2011 Author Share Posted June 10, 2011 So, just to clarify, please CAT my french gets complicated when I worry, can you tell me does that mean that i am covered 65% for journeys by taxi to and from hospital with a prescription without prior arrangement with MSA??? I don't have to tell them who I am using?? Or get written permission? Link to comment Share on other sites More sharing options...
Patf Posted June 10, 2011 Share Posted June 10, 2011 [quote user="Benjamin"][quote user="Patf"]It can be very expensive. We had a bill of 600€ as a third of the bill for a 25k journey. CPAM paid the rest.[/quote]This fairly straightforward thread is turning into a nightmare.You were charged nearly €2000 for a 25k (kilometre?) journey?Was it by private jet?[/quote] It was a fully equipped emergency ambulance with nurses and a doctor.The charge on the bill was for 2 times half an hour at 900€ per half hour. It could have been more as they had to come from Tarbes.The hospital treatment was on top of that.I spent ages checking it out - the hospital, CPAM, our doctorwho had called the ambulance. I tried SAMU themselves but couldn't get hold of anyone.So reluctantly had to pay - in 4 installments.Hoping you get your costs covered Georgina, and all goes well for you. Link to comment Share on other sites More sharing options...
Georgina Posted June 10, 2011 Author Share Posted June 10, 2011 Still there is no price too high for saving your life I guess Link to comment Share on other sites More sharing options...
idun Posted June 10, 2011 Share Posted June 10, 2011 [quote user="Cat"]It's not add idun, georgina is, as she has said, covered by MSA, the caisse for agricultural and rural workersTheir website gives advice on travel by taxi or VSL...http://www.msa.fr/front/id/msafr/S1096461900197/S1098192456447/S1098192459853/publi_Transports-medicaux.html [/quote] Yes, I was writing as Georgina was posting. Yes, it is no longer 'odd' now.[:)] Link to comment Share on other sites More sharing options...
idun Posted June 10, 2011 Share Posted June 10, 2011 [quote user="Patf"][quote user="Benjamin"][quote user="Patf"]It can be very expensive. We had a bill of 600€ as a third of the bill for a 25k journey. CPAM paid the rest.[/quote]This fairly straightforward thread is turning into a nightmare.You were charged nearly €2000 for a 25k (kilometre?) journey?Was it by private jet?[/quote] It was a fully equipped emergency ambulance with nurses and a doctor.The charge on the bill was for 2 times half an hour at 900€ per half hour. It could have been more as they had to come from Tarbes.The hospital treatment was on top of that.I spent ages checking it out - the hospital, CPAM, our doctorwho had called the ambulance. I tried SAMU themselves but couldn't get hold of anyone.So reluctantly had to pay - in 4 installments.Hoping you get your costs covered Georgina, and all goes well for you.[/quote] Patf, was there any reason why the SAMU was called? Maybe your Dr did?I would never call the SAMU myself if I lived in the french countryside, always the sapeurs pompiers. I'd do this as they were sur place and the SAMU would have had at least a 15 minute drive to get to us. And that is what everyone told me to do if I ever needed emergency transportation to hospital. Strangely the SAMU were called when the lady next door died, she was dead when they got there and I never understood why, and never had the courage to ask her distraught husband why. Link to comment Share on other sites More sharing options...
Cat Posted June 10, 2011 Share Posted June 10, 2011 [quote user="Georgina"]So, just to clarify, please CAT my french gets complicated when I worry, can you tell me does that mean that i am covered 65% for journeys by taxi to and from hospital with a prescription without prior arrangement with MSA??? I don't have to tell them who I am using?? Or get written permission?[/quote]That's right Georgina, you are covered by your caisse, MSA, fo 65% (or 100% if you have an ALD). You will need to ask for a bon de transport from the hospital, and make sure that it is signed by your consultant. The only reasons you would need to get prior permission are as I described before...[quote user="Cat"] ... if your journey is more than 150 km one way, or if you expect to be making at least 4 trips of over 50 km (one way) during a period of 2 months (for the same treatment) then you will need to contact your caisse and ask for an Accord Prealable[/quote] Link to comment Share on other sites More sharing options...
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