Carte Vitale, again....any faster under the new rules of Janvier dernier?

Hi all,

I'm in the middle of the process after 1 visit + 1 extended 'rendezvous' in Bergerac. I thought after reading up and preparing well (by getting things translated, photocopying it all myself so that I could hand over my pre-prepared 'dossier' on my 1st visit), that I had done a good job and 'cracked it' because M. Arnaud checked everyting off and seemed pleased that she had very little to do except send everything off to Perigieux....informing me that I should hear something in 10 days....

A letter came, returning my paperwork and asking to 'complet le dossier'...for an S1. which I am not eligible for , but I do have a letter in French and English from the DWP, that informs them that I am no longer covered by the UK system as I am now resident in France. Also, having read other posts re this, I obtained a 'Declaration' from my friend and close neighbour, the Maire, confirming that I had lived here to his knowledge for more than a year (not quite accurate as I returned from the UK, with the realisation that I must stay in France and get onto the French system at some point soon, in June of 2015)...

Having discovered on the first visit that my statement of prelevement of my Gaz consumption which straddled part of 2015 and the first part 2016..was considered inadequate.....I took along 6 months of Phonexpat statements as well, on the next visit. These were not considered necessary by the next interviewer in French and some English (who repeatedly, asked me to explain my circumstances, using my best Franglais) ans was definitely seeing if I would make an error over dates etc. So my 'dossier' will be sent off again to Perigieux, ..........this time, I have been told it could take 8 to 10 weeks to process !....'What is there to do ?'....The documentation has been checked...my Maire has backed me up...

A two month wait seems excessive...even if there are a lot of other applicants. What I feel is ridiculous is that my interviewer, was unable to confirm despite checklists, that I had submitted everything that I needed, despite my spending a hour and a half with her confirming my income from the Uk, converting it all to Euros and filling in yet more forms.....

Sacre-bleu....I am just keeping my fingers crossed but I'm having visions of 'Jarndice v Jarndice', ...is this unfair ? Have any of you done better, where this is concerned ?

Under CMU all applications from British inactifs were processed at a central processing unit in Nîmes, not sure if that's still the case under PUMA? If so then the people you've been dealing with in Bergerac and Périgueux aren't the decision makers (still less your mayor) so since it's not their decision, they can't make any promises. They do their best to make sure that everything is complete and Nîmes won't send it back, but as we all know, everyone has their own view on how the rules should be interpreted and applied. Now that they think it's complete, Nîmes need to receive it and process it, because they're the only ones who can make the final decision.

Unless PUMA applications don't go through Nîmes any more, but I've not read anywhere that it's changed.

Hi Anna,

They've told me it goes to Perigieux...and when you access the CPAM site...that is one of the places listed...Nobody mentioned Nimes.

The way the recent changes have been presented online, is that the old system has been scrapped...now everyone can sign up if they can prove that they have lived here, paid bills for 3 continuous months and receive the basic healthcare (and if one has a bit more income, pay the 8% over the limit of cotisations).....Just seems that, if that is the case, why is a decision strung out for weeks, when they have got you to produce the dossier for them. Why send all the documentation back after the 1st meeting and then have to resubmit it all again. I wonder if it's a technique (a degree of built in incompetance), to ensure that they all have plenty of work, the system can't cope with the 'supposed' volume and everyone stilll has a job...

I know in France that alot of people are employed as bureaucrats for the government, so I would not be, at all, surprised.....

"Bureaucrats for the government" ie fonctionnaires: that covers nurses, doctors, secrétaires de mairie, teachers, and all the other administration people. When EU lists of numbers of Bureaucrats are published, that's what you need to bear in mind, far more people here are employed by the state, either as fonctionnaires territoriaux or as fonctionnaires d'état- the latter means you get sent anywhere in France to work and can't refuse). Documents in France have to be under 3 months old to be valid for proof of residence etc and they are fairly picky about which documents count, that's just how it is - it's the same for us (French people). I wouldn' t be at all surprised if the administration for foreigners was in fact centralised somewhere else even if you are ultimately handled by Périgueux in the future. (For instance, ALL French people born abroad get their birth certificates from Nantes...)

Ok, thanks for the clarification, Veronique.....I will just have to try to be patient and focus on more immediate tasks...Have pencilled in a date in my diary to phone them by (or get the Maire to), if I hear nothing.

I believe Anna is right and Nimes is still doing the processing. It certainly was for us anyway. According to an article I was reading PUMA may take some time to filter through, but this shouldn't make any difference to your application. I have also read that there will be no cotisations to pay this year. 8-10 weeks is very optimistic I think(ours took months) and you may well get requests for additional info etc, but you will succeed.......eventually.

No cotisations ?.....did they give a reason for this......?

Just looked up PUMA....here, ..http://www.cleiss.fr/docs/regimes/regime_france/an_1.html

Not sure I understand this paragraph, which seems contradictory...or maybe it's just a bad translation...see italics, 2nd paragraph.....

1. Healthcare expenses

Scope of application:

Healthcare expenses cover medical and paramedical expenses as well as medicine, orthopedic appliances, and hospital costs.. Insured persons are entitled to such health benefits both for themselves and for beneficiaries not covered by any social security scheme.

"Carte Vitale"

The carte Vitale is a card with an embedded microchip that certifies entitlement to health insurance. It is issued to all persons aged 16 and over and contains all of the administrative information the patient's health insurance fund needs in order to reimburse their healthcare expenses. Depending on personal circumstances, it also contains the information needed to use the third-party payment system (meaning that the patient does not pay amounts upfront that will later be reimbursed either by the health insurance system or by his/her supplementary insurance, which kicks in once the patient has been reimbursed by the national system.
Parents can apply for a separate carte Vitale for children ages 12 and up.

Under the new Universal Healthcare Coverage system (Protection Universelle Maladie/ PUMA), which was rolled out on January 1st, 2016, adults can no longer be considered beneficiaries, even if they are not employed. Only minors continue to be considered beneficiaries up to September 30th of the year in which they reach the age of 18, whether or not they are enrolled in certain educational programs, and provided that they are not employed.

However, minors over the age of 16 can apply to be insured in their own right.

I'm sure I've read this somewhere Hilary but I don't remember where at the moment. Just before receiving our CVs we were notified that our cotisations would be X, but since receiving them a few months ago we've not been asked to pay anything.

I believe the reasons for "no cotisations" last year was due to a legal technicality - any cotisations levied at the end of 2015 would have been to pay for your cover under CMU during 2016, but in fact nobody was covered by CMU in 2016 because it changed on 1.1.2016. Or something daft like that, a hoist-with-your-own-petard kind of situation - I read about it and had a good chuckle but I've forgotten the details. However it does seem to be official.

Normally the bills are sent out in the December of each year, and from now on the bills will be based on the info you gave on your tax return because the impôts will pass this on to URSSAF, so you will no longer need to give income details to URSSAF yourself in a separate exercise.

Re your bit in italics Hilary, yes the translation is confusing isn't it! They are using "beneficiaries" to translate the French term "ayant droits" which I usually translate as "dependents" because I think it's clearer. So what they mean is that an inactif/inactive partner can no longer be covered as the "ayant droit"/"dependent beneficiary" of the working partner. Under CMU they could, an inactif/inactive partner could be automatically added to the working partner's cover for no extra cost, but under PUMA they can't; only children can be "ayant droits" and all adults, whether working or not, now apply for cover in their own right, e.g. on the grounds of residence. Hope this clears it up!

Sorry to harp on but

"now everyone can sign up if they can prove that they have lived here, paid bills for 3 continuous months and receive the basic healthcare (and if one has a bit more income, pay the 8% over the limit of cotisations)" - there is a bit more to it than that because to prove 'stable and legal residence' you also have to show that your income is above the minimum threshold. If your income isn't considered sufficient for you to support yourself, it's not accepted as "stable and legal residence" even if you have been here for 3 month.

A tiny point I know but people lurking on the forum might read that and get the wrong idea, and then be disappointed when they find they're not eligible after all.

Anna, A quick question - I am 64, retired and have been a dependent of my wife since she reached retirement age some years ago. I have a Carte Vitale and receive full benefit of the French Welfare System. Apart from reading this forum l have received no information from the Assurance Maladie nor read or seen anything in the news that directs me to apply for cover in my own right.

I will be 65 later in the year and will be expecting my State Pension and some documentation - A Form S1 - to present to the French Health Authority in order to obtain a Carte Vitale in my own right. Question 1) Should l expect to receive some kind of demand for my healthcare costs since the change in the Law on the 1st January this year? and Question 2) When can l expect my S1 and to whom do l send it?

No Dan, any adult who already had ayant droit status under CMU can continue being an ayant droit, if they wish, until the cut off date which I believe is 2018. After which they will be required to have separate cover. So in practical terms nothing has changed for you.

Also I'm not sure whether this would apply to the ayant droits of UK S1-holders. If the UK is happy to pay for them as dependents, maybe the French would accept that.

I believe you're entitled to your S1 as soon as you start receiving your UK state pension, and you take it to CPAM (it should tell you on the back). Are you sure your pension kicks in at 65? They've changed the ages for men too haven't they, I don't know the details but you must be quite near the borderline.

Thank you Anna for your help - it is very much appreciated.

Thanks from me also Anna, for your excellent contributions.....and to SFN site generally (Catherine & James)......

It is such good support !.. as it's great to be able to get such good quality feedback, so quickly and interact (albeit in a virtual way...sometimes I think, the best way), with such nice, well informed, sometimes cantankerous, sometimes very amusing people......

A bon weekend..a tout le monde ! (that's lurv, people...)

Anna.

I'm not sure if you can answer this but here goes (someone might know).

I am (was) ayant droit on my wife's CV (RSI) and recently received a request in the post to complete a form for my own CV with RSI providing a photo and a piece of identity. This was in a way not unexpected as a couple of months ago, I received a request from RSI to provide a court approved translator's version of my birth certificate them having already added me to my wife's CV some years ago and all had being going well. It seemed to me at the time that this would be a precurser to the issue of my own card.

I now have an S1 recently provided by the Pensions Service in UK (having reached 65 in March).

Do I sent the S1 to RSI or CPAM?

I don't know a categoric answer to that Graham, sorry. In theory, part of the point of PUMA is that people no longer need to change caisse every time their status changes (although they can if they want), so perhaps in theory you ought to be able to stay with RSI if you want. But I wouldn't be surprised if in practice you are told that this isn't possible when an S1 is involved. If it was me I certainly wouldn't send it to RSI, in case they don't know what to do with it, bury it at the bottom of a pile of papers and deny all knowledge. I would either take it in person to RSI and ask if they can deal with it, or take it to CPAM in the usual way, because CPAM are very familiar with S1s and what to do with them. If you do actually want to stay with RSI you could ask CPAM if it's possible. But given the choice, not many people would choose to stay with RSI if they didn't have to. Not that I've had any major problems with them myself, but they do get very bad press. All in all I think you would be better off going to CPAM.

Thanks anyway Anna.

The choice may have already been made of course in that RSI seem to be leading the way in issuing the new card. As I am currently in the middle of various medical interventions, it seems appropriate to 'go with the flow' to avoid any possible issues (there has already been one - at my last hospital appointment, my wife's card with me supposedly on it was refused because of the ayant droit issue; I had been summarily removed from it!) The hospital let it go through but I might be billed in the meantime until it is finally sorted. This might be less complicated because they already have me on their system of course...

9 plus years in France have taught me to be tolerant and not to panic over such things

the cut off date is 31 Dec 2019