It is currently Tue Oct 17, 2017 10:46 am

All times are UTC + 1 hour





Post new topic Reply to topic  [ 17 posts ] 
  Print view Previous topic | Next topic 
Author Message
 Post subject: Reclaiming medical expenses
PostPosted: Fri Jul 25, 2014 9:15 pm 
Offline
User avatar

Joined: Mon Feb 02, 2009 3:57 pm
Posts: 3487
Location: Sussex and Cantal
Can anyone help?

Last week, my wife fell in the garden and badly broke her wrist. I took her into Aurillac hospital, where she was x-rayed, and operated on that same day. She came out the next day with a pot on her arm, and we have subsequently been back to see the surgeon. I showed my EHIC card, but was told that without a carte vital I would have to pay. So far, the bills are about 1200 euros.

Looking at the NHS choices website, it says that I go to my local CPAM to get a refund. I duly went tody to be told that firstly, they were surprised that the hospital had charged me as I have an EHIC card, and secondly that any refund should be applied for in the UK.

Whilst I should add that we are very grateful for (and impressed by) the French health service, does anyone know how I go about getting the cost refunded?


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Fri Jul 25, 2014 10:03 pm 
Offline
Site Admin
User avatar

Joined: Sat Jan 31, 2009 2:29 pm
Posts: 14178
Location: Was Plouasne 22830, now Ploeuc sur Lie 22150, France
Will this help you Elstow

http://ec.europa.eu/social/main.jsp?catId=1021&langId=en&intPageId=1737

A bit of a cut and paste from the link above

Unforeseen medical treatment -
France
undefined
Emergency

Call 112

Centre des Liaisons Européennes et Internationales de Sécurité Sociale (CLEISS)
(Centre of European and International Liaisons for Social Security)
Detailed information in French, English, Spanish, German, Italian and Portuguese.

Tel: +33 1 45 26 33 41
Email: ceam@cleiss.fr

Hospital treatment

Be sure to present your European Health Insurance Card on admission. This will save you from paying any refundable costs up front and ensure you pay only the patient contribution.
You will be charged a daily hospital fee.
For any major medical treatment, you will be charged a flat-rate contribution in addition to the daily hospital fee. These charges are non-refundable in France, but you can always seek reimbursement once you return home.
If you are admitted to a private hospital or clinic, make sure that it is also registered to provide state healthcare ("conventionné") .

Reimbursement

Reimbursements are claimed in France from the local CPAM office (Caisse Primaire D'Assurance Maladie).
You will need to provide the treatment form ("feuille de soins"), copies of receipts and prescriptions, a copy of your European Health Insurance Card, your address of residence and your bank details, including International Bank Account Number (IBAN) and Bank Identifier Code (BIC). Confirmation of your refund will be sent to your home address.
You can claim back around 70% of the standard treatment cost.
If you were unable to submit a claim during your stay in France, contact your national health insurance provider when you return home.

If you are having a problem try ringing the CLEISS Tel: +33 1 45 26 33 41
Email: ceam@cleiss.fr

French edition of the same ec.europa.eu/socia link

Soins hospitaliers

N'oubliez pas de présenter votre carte européenne d'assurance maladie lors de l'admission. Cela vous évitera d'avancer de l'argent inutilement. Vous ne paierez que les frais à la charge du patient.
Vous devrez payer un forfait journalier.
En cas de traitement important, vous paierez une contribution forfaitaire en plus du forfait journalier. Ces frais ne sont pas remboursables en France, mais vous pouvez en demander le remboursement à votre retour.
Si vous êtes admis dans un établissement de soins privé, assurez-vous qu'il peut aussi fournir des soins conventionnés.
Remboursements

Les remboursements doivent être demandés en France, à la CPAM locale.
Vous devrez fournir la feuille de soins, une copie des reçus et des prescriptions, une copie de votre carte européenne d'assurance maladie, votre adresse en France et vos coordonnées bancaires, y compris les codes IBAN (numéro de compte bancaire international) et BIC (code d'identification des banques). Une confirmation de votre remboursement sera envoyée à votre domicile.
Vous pouvez être remboursé à hauteur de 70 % des frais de traitement normaux.
Si vous n'avez pas pu demander de remboursement durant votre séjour en France, contactez votre organisme d'assurance maladie une fois rentré chez vous.

All I have to add is try your best to get paid in France, 'cos from my experience you will get sod all from the UK

_________________
Three meat and one veg

An old wild fowling motto : little powder, plenty lead, kill 'em dead

English born, Living in France, Therefore European

http://www.peakeenergies.fr/

Forum Admin


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Fri Jul 25, 2014 11:12 pm 
Offline

Joined: Mon Sep 06, 2010 10:48 pm
Posts: 756
Location: South East England
Not true about getting sod all from the UK, that is BS and you know it. Appears from the original poster that you are getting told lies from the local services. Since we have been in France, over ten years, we've got paid here through the EHIC and also from the UK, especially in the early days when we didn't understand the system properly; and didn't claim in France

_________________
Alfsmate


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sat Jul 26, 2014 12:37 am 
Sorry Alfsmate but are you saying you have been using the EHIC (Old E111) for the last 10 years of you living in France or using it outside France and getting reimbursed in France, or used it in the UK and got repaid there or /and France?

Seems rather bizarre if it is as you have stated and the way you are using the EHIC. As you know, it is a card for temporary/emergency health care within the EU but not for use in the country of ones residence, which in your case is France, as you have said "Since we have been in France, over ten years" which I have taken to mean resident in France?


Top
  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sat Jul 26, 2014 10:52 am 
Offline

Joined: Mon Sep 06, 2010 10:48 pm
Posts: 756
Location: South East England
We have a holiday home in France and are UK residents. When we have had to use our health card in an emergency, as my wife had peritonitis , we got reimbursed by the local CPAM or what ever it's called as when we visited them they said do you have a French Bank account, we said yes, they then said we'll pay the appropriate refund into it. Before that when I had forgotten some UK prescribed tablets I went to the local Dr who gave me a prescription, I paid him; got a health form, paid the chemist, got a health form and claimed back in the UK, as at that time we didn't know about CPAM. Very simple only thing I would add is that the UK refund was not as quick as the French one. Sorry for confusing you Basil.

_________________
Alfsmate


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sat Jul 26, 2014 11:10 am 
No problem Alfsmate, good to have someone who has done something and who can offer their own experiences, rather than the links to the supposed way to do something. Links are of course useful more often than not but I bet Peake would even admit that when one branch of French "authority" tell you one thing, you can be positive there is another part (usually many more !!) of the same authority who will offer different "advice".

To be honest, Forums are usually pretty good for many to get info from but in the days well before forums and being in a region where people with a fellow language were short on the ground, it meant one thing...you went direct to the department concerned with your problem (URSSAF. Impôt, CPAM, Trèsor, Chambre de Commerce/Metier, Greffe de Tribunal, Etude and all the concerns that you go through from Maternelle to Uni and so on and you found out early on that the advice one person gave you was not always entirely correct. You found out through long and often painful experience through getting it wrong, who you could trust and who to give a swerve to BUT at the end of it all, you had "real" experience of how it all worked and I bet those on here who had the same start out will know exactly what I mean.

I recall all too clearly the recently arrived people in France who used to post on forums that a fonctionnaire told them this and that so it must be true and no matter what you told them, they had to be right as a fonctionnaire told them so....And that peeps is how Chinese whispers and the man in the bar got a hold on forums :D


Top
  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sat Jul 26, 2014 12:42 pm 
Offline
User avatar

Joined: Sun Feb 22, 2009 5:26 pm
Posts: 2524
If you do go back to Sussex, call the number here

................ call the Overseas Healthcare Team on 0191 218 1999. Lines are open Monday to Friday, 8.00 am to 5.00 pm.

They'll take details to check you're in the EHIC system as well as bank details for refund.

They'll send you a form and a claim number.Fill in the form.
Write the claim number on top of every receipt from the French treatment centres you went to.
Return it all and you will then be refunded directly into your UK bank account.

NB: You can only claim for treatment received from French state facilities-not private.

_________________
Human history becomes more and more a race between education and catastrophe.
(H G Wells)


I.C.U...............Jimmy........20/20 vision.


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sat Jul 26, 2014 11:01 pm 
Offline
Site Admin
User avatar

Joined: Sat Jan 31, 2009 2:29 pm
Posts: 14178
Location: Was Plouasne 22830, now Ploeuc sur Lie 22150, France
Basil,
I can assure you that I found out the hard way in getting correct information from the authorities in France, I raised three teenagers on my own in France, the youngest one was 13 when he started in the school in France, all three of the went through Affobat has part of their final schooling, so I do know about claiming child benefit amongst other things from the CAF, being told by the assistant social that I was cruel, by not giving the boys a hot cooked meal at night, although they all had a hot meal midday "in France all children have a hot meal at night, so you will cook them one as well, instead of giving them an English tea of sandwiches"

Having a partner who suffers from a mental illness, I now know my way around the Tutoral, Juge d'instruction, how to write a request for a person to be detained against their will, etc

I found the EU documents about looking for work in another member state, and being able to claim unemployment benefit at the local rate (the old E 119 & E 303) in the ANPE in St Brieuc, when I returned to the UK for a visit way back in the late '80's, I asked at the Liskeard job centre for forms E 119 & E 303, only to be told that there were no such forms, on insisting that there was such forms, they rung Plymouth, to be told that there were no E forms, so I said ring Steel City House Sheffield, at the time this was the office dealing with this type of form, Sheffield told Liskeard office that there was such a thing has E 119 & E 303, but were only kept at Sheffield, and only given out on request and then only after a claimant had been signed on for over a month

Having to go back to the UK in '95 for tidying up a divorce, when I went to sign on in Epsom I was asked to fill in a 12 page document on why I wanted to come and work in the UK, (because I hold a UK passport, was not a good enough reason, it took me 6 month fighting plus faxing all my French pay slips to Newcastle, before I could claim proper unemployment benefit, Newcastle accepted my French payslips as my being in the system and paying for unemployment benefits) I decided at 50 plus I was to old to go back on the buildings, and took up bus driving, lodging near to the garage, the person where I was a lodger was on handicapped benefit, after about a year of my being a lodger she had a very bad fall, and had to be hospitalised, and I started to look after her and her needs whilst she was in hospital, the upshot of this was the DHS stopped all her allowances and told me to take over her mortgage and become her career, all on 30 quid a week for both of us

Then when I squashed a rather careless Asian person who decided to walk between my moving bus and his van, I was left in a bit of a limbo and unemployable for 18 months whilst I was waiting for my trial, so we decided to have a trip to France, I had a bit of work lined up, so asked at Mitchum jobcentre for forms E 119 & E 303, same old rigmarol, no such forms, yes there are, ring Newcastle, Newcastle said that they had the forms some where so find them, after a fortnight and Mitchum had still not produced the forms, I told them that I was going to France the following week, they said that if they had not found the forms that they would send them on to me, did they did they hell, so when I returned for my trial, after 65 quids worth of needle work done to the back of my hand being sown up again, I went and asked what happened to the forms that they were supposed to send me, "Oh we forgot" OK can I have them now, "no you cannot you have to be signed on for over a month"
5 weeks came and went, and after I was found not guilty at my trial, I asked again about forms E 119 & E 303, I was asked to wait for an inspector to interview me, all the inspector said to me was, "If you keep on asking about these E forms, we will investigate you for fraud, take my advice forget the forms and go back to France, or we will prosecute you

Having seen has a visitor to a patient mental hospitals both in the UK and then in France, and the difference in the treatment of the patients and how my partner was left laying in her own filth more than once whilst in St Georges Tooting, you can stick the great uk, personally speaking I would not piss on it if it was on fire

_________________
Three meat and one veg

An old wild fowling motto : little powder, plenty lead, kill 'em dead

English born, Living in France, Therefore European

http://www.peakeenergies.fr/

Forum Admin


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sun Jul 27, 2014 12:30 am 
Peake,

I don't know what you are on but we know all about you, some of us have read it often enough over the years, on here and elsewhere. If you read my post again you will see I am stating that you, as well as I, learned through going up to the many different departments and finding out for ourselves without the aid and safety net of a French forum..

As Admin/Mod it would pay you to read posts not once but a few times, to ensure you have understood. If I was taking pops at you it would be as clear as the day.

As far as the EU documents you mention, that was my point, surely you have found that what the "book" says, is not always the way a fonctionnaire reads it and why I said experience is the better way to find anything out over here. As for the UK denying you anything, seems to me to be rather strange to be honest.

I have not the slightest idea what the last few paragraphs were about suffice to say, it was rather bizarre, sad nonetheless. As for the UK, it is about time that huge chip on your shoulder was rid of. I bought back in the UK on the sale of the last business and where it is in West Sussex is superb. So just like France, basically it comes down to location, location, location.
To misquote Samuel Johnson:
"Why, Sir, you find no man, at all intellectual, who is willing to leave the UK. No, Sir, when a man is tired of the UK, he is tired of life; for there is in the UK all that life can afford."


Top
  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sun Jul 27, 2014 6:51 am 
Offline
User avatar

Joined: Sat Jan 31, 2009 2:44 pm
Posts: 11449
Location: The Republic of Limousin
None of this is really helpful to Elstow right now. I imagine he'd appreciate being repaid in France - in Euros. Perhaps printing the reimbursement provisions in French (Peake's link) and taking same to CPAM might work?

_________________
http://traduction.juridique.free.fr
I've been rich and I've been poor. Rich is better.
(Tracy de Scartes)


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sat Aug 02, 2014 10:46 am 
Offline
User avatar

Joined: Mon Feb 02, 2009 3:57 pm
Posts: 3487
Location: Sussex and Cantal
Thanks everyone, and my apologies for my lateness in sending my thanks - computer problems as well as everything else.

Since the last posting, we contacted the DSS in England who confirmed that we are able to get a refund from CPAM, but that CPAM could be forgiven for not being up to speed as the regs changed on the 1 July. There is now a new form (E126) which should be completed by France and sent to the UK for confirmation. France should then pay. I can wait to do this once I return to the UK, but they will simply contact Aurillac and ask them to send the E126. Also, as Mad points out, I would welcome payment in Euros.

However, I think that I would rather deal with UK bureaucracy than French.


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sat Aug 02, 2014 5:18 pm 
Offline
User avatar

Joined: Sun Feb 22, 2009 5:26 pm
Posts: 2524
Yep-after 1st July the 'co-payment' paid by residents of the country where the treatment is given cannot be reclaimed in the UK.

_________________
Human history becomes more and more a race between education and catastrophe.
(H G Wells)


I.C.U...............Jimmy........20/20 vision.


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Mon Sep 01, 2014 1:25 pm 
Offline
User avatar

Joined: Mon Feb 02, 2009 3:57 pm
Posts: 3487
Location: Sussex and Cantal
An update on events. Poor Mrs Elstow had to go back to the hospital last friday to have the pins taken out of her wrist - another operation under general anaesthetic, but this time only day surgery. I went to pay again, and was told that the bill would be about 940 euros. In order that they could access my wife's details, I gave them the EHIC card, and the lady then told me that as we had one of these, the bill would be only 18 euros! I asked about the 1200 already paid, and after much consultation she told me that this was a mistake,and we should only have paid 18 then as well. I asked if I could have my money back, and she told me that the hospital could not do that, I would need to see CPAM in Aurillac.

I went to CPAM this morning with no hope in my sceptical heart, but when I outlined the situation, and the lady on the desk had asked a colleague, she tok my RIB and told me that all but 18 euros would be paid into the account in a month's time. Hurrah (guardedly, as I will wait until the euros drop into the account before putting the champagne on ice).


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Mon Sep 01, 2014 2:18 pm 
Offline
User avatar

Joined: Sat Jan 31, 2009 2:44 pm
Posts: 11449
Location: The Republic of Limousin
Oh goody! We'll all come round to help the medicine go down... :ymparty:

_________________
http://traduction.juridique.free.fr
I've been rich and I've been poor. Rich is better.
(Tracy de Scartes)


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Mon Sep 01, 2014 2:52 pm 
Offline
Site Admin
User avatar

Joined: Sat Jan 31, 2009 9:02 pm
Posts: 11543
Location: 24, Jumilhac-le-Grand
Good result Elstow! :-bd Hope Mrs Elstow has a quick recovery so she can join you in that celebration ....... :D

_________________
"What is this life if, full of care,
We have no time to stand and stare."
W H Davies


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Mon Sep 01, 2014 7:45 pm 
Offline
Site Admin
User avatar

Joined: Sat Jan 31, 2009 4:03 pm
Posts: 24009
Location: Ille et Villaine (35)
Oh that's great news, Elstow :-bd I hope Mrs Elstow isn't in pain and that her wrist recovers quickly :)


Top
 Profile  
 
 Post subject: Re: Reclaiming medical expenses
PostPosted: Sun Sep 07, 2014 12:47 pm 
Offline
User avatar

Joined: Mon Feb 02, 2009 3:57 pm
Posts: 3487
Location: Sussex and Cantal
Thanks. Actually, now she only has a small bandage on her arm which has to be changed every 3 days. She has been able to go to see her Father in Sheffield leaving me to look after the dogs in Sussex. So neither of us is in pain!


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 17 posts ] 

All times are UTC + 1 hour


Who is online

Users browsing this forum: No registered users and 1 guest


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Jump to:  



Powered by phpBB © 2000, 2002, 2005, 2007 phpBB Group
greenmiles v1.1 designed by CodeMiles Team -TemplatesDragon-.