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 Healthcare


International healthcare, medical insurance


Universal health care is provided through the social security system, administered through the social security portal. Most doctors and hospitals have an agreement with the system making fees for procedures charged at standard rates. Before visiting a health professional or organization, find out if they are conventionné. (Private clinics usually are not.) For clinics that are not conventionné, refunds from social security will be lower than normal.

Sécurité sociale refunds 70 percent of most medical care. However, the more ill a person becomes, the less they pay. People with serious or chronic illnesses (cancer, AIDS, severe mental illness) are reimbursed 100 percent of expenses and waives their co-payment charges.

Refunds

If you are subscribed to the French social security, you need to send a completed form (feuille de soins) to the CPAM (Caisse Primaire d'Assurance Maladie) to make a claim. Enclose bank account details (RIB, Relevé d'Identité Bancaire) for payment within 2-3 weeks.

Carte Vitale

A new system allows facilities that are wholly or partly refundable by social security to simply present a Carte Vitale and reimbursement is automatically triggered and deposited directly into your bank account within a week. Excess charges (dépassements) may be redeemable from a voluntary insurer. If not, costs are charged to the patient.

Everyone over 16 years of age is required to have one. Children under 16 years are included on the card of their parent or guardian.

Polices Complémentaires/Mutelles

Also known as "top-up insurance", these insurance plans help to cover the difference between what the social security system covers and the cost of care. Note that this is not private health insurance.

There are a variety of providers and a competitive market. This kind of insurance may be subsidized by an employer. Someone who is in generally good health may only wish to cover items like hospitalization. Households that fall below a certain threshold and you do not have a police complémentaire are eligible for complementary state-funded health care, CMU complémentaire. While helpful, this only offers an average level of cover.

Private Healthcare

Private coverage may be purchased from private insurers. Most are nonprofit, mutual insurers. This is still an uncommon step with only a small portion of hospital treatment costs reimbursed through private insurance.

Prices

Some plans can cost as low as €10 a month, but this offers only the most basic coverage. The more you spend, the better your coverage. Premiums are charged for private health insurance plans are based on several factors.

European Health Insurance Card

The European Health Insurance Card (EHIC) allows access to state-provided health care in all European Economic Area (EEA) countries and Switzerland at a reduced cost, or sometimes free of charge. The card can be used at any kind of health service, like at a general practitioner, hospital or pharmacy. Benefits depend on the country's standard of care.

The pocket-sized plastic card is free and necessary to receive treatment. Carry your EHIC with you at all times to prove you are entitled to health care. The card contains basic information such as the card holder's name and surname and date of birth, but no medical details. It is easy to use as it has a gold chip that contains complete medical history and records. The EHIC replaces the E111 form and E111.

What Can the Card be Used For?

The EHIC covers any medical treatment that becomes necessary during your trip. The card gives access to reduced-cost or free medical treatment from state health care providers.

It is not permissible to use it if the patient intentionally decides to obtain medical treatment abroad. The EHIC is also not an alternative to travel insurance. The card does not cover private sector health care providers. It is important to have both an EHIC and a valid private travel insurance policy.

Who is Eligible?

How to use the Card

If you require treatment while abroad, you should first locate a facility using the database. Card holders should be able to simply supply their card for care. Through the database, you can find institutions involved with the reimbursement of health care services. Users are able to select country and keywords, and are supplied with the facilities contact information (address, phone number, e-mail address, fax number).

How to Claim a Refund?

You may need to apply for a refund depending on the coverage offered in your home country versus that of the country in which you receive care. Some European health systems expect you to pay your bill when you are treated and then claim a refund using your EHIC. To find out what the requirements are of the country you are in, consult the country guide. Keep all receipts and paperwork to file a claim. Try to apply for reimbursement before leaving the country, or at least as soon as possible.



13/02/2013

Comments

 BZH56

17/11/2010

Epatriates health insurance in France : Complement of French Health System (CPAM) or direct line in First Euros
COMPLEMENT OF FRENCH HEALTH SYSTEM (CPAM)

Expatriates in france have 2 choice :

1) They can apply an health insurance plan for expat residents of France who are registered with the State Healthcare System (CPAM).

This specialist health insurance plan pays the full difference between the amount paid by CPAM and the actual cost for any in-patient treatment within France.

This plan is designed to meet the difference in costs between the actual amount paid by you for treatment undertaken in France and the amount that is reimbursed for these costs by the CPAM (Caisse Primaire d’Assurance Maladie). This is the temed as the « Full difference ». Unless otherwise stated, the Benefits applicable to the policy will be deemed to by on a « Full Difference » basic.

2) They do not have an access to the french health system - Sécurité Sociale Française.
They do not have others solution to apply for an International Health Plan in 1st Euros.

There are many plans and many International insurance companies.
You can have the choice between a English solution or a European solution.

Unlike the first excludes pre-existing conditions and chronic conditions with a moratorium and the second can apply without pre-existing condition upon acceptance medical team with a medical questionnaire.

There are of course many other points such as age, budget, guarantees, outpatient limits, deductible but also the treatment of cancer and serious diseases.

This is for why we must take services of a comparator in Expatriates Health Insurance as AOC Insurance Broker. They compare for you and they negociate the best solution to your needs.


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