That very much depends on what medical cover is needed. Anybody on expensive medication, or requiring a stay in hospital could end up being unable to afford it.
As a matter of interest what is the standard % that the French healthcare system pays, or does it vary depending on the consultation/treatment? I’m asking as I seem to have only been reimbursed 6€ out of the 25€ I recently paid to the doctor, and will be having a shoulder scan shortly, so wondering if I will get that reimbursed (appears my booster jab was applied incorrectly ).
The standard reimbursement is 70%. The other 30% is up to the patient unless they have a top-up insurance.
Ummmmm, so now wondering why I only received what amounts to 25% it’s not the actual value but the principal - I’m wondering why there is a difference??
A condition that requires expensive medication on an ongoing basis will often be classed as an ALD and presumably those on S1s will continue to have their ALDs paid for in full since presumably that is covered by the UK.
Hospital-only mutuelle cover even for oldies does not need to be prohibitively expensive, and I believe emergency treatment is covered in full for everybody.
Sorry, I don’t know the answer. Perhaps ask the doctor? Was it your first visit?
Somewhere or another you should be able to see a breakdown of the payment you received.
I know that once when I grumbled, then checked, it showed that there were several small payments due from me to the State, which had been held in limbo until I was due to be paid something… then zap… the little bits got identified, added-up and deducted from the sum due to me… and I got what was left.
It’s something like that in my case… and perhaps something like that in yours…
Yes my first visit and hopefully the last for a very long time
Maybe it’s something to do with only recently receiving my care vitale The refunded amount was into my bank account so couldn’t see any breakdown unfortunately. Oh well, I’ll see what happens after the scan, then decide if I take it further.
if you go into your Ameli personal space you should be able to see the details…
Ok thanks - will take a look tmrw - very helpful:+1:
Was the doctor your registered medecin traitant? If not the reimbursement is always lower.
But I do not think there is is as much difference as all that.
You might well small amounts marked (1) and further down comes the explanation
those small amounts get added together and, as I’ve said, eventually get grabbed back from you.
It was a doctor I just registered with in the next village
Which departememt(s) was this in, SuKe?
btw did you manage to get a replacement tenant?
My OH had the same issue for a while and it seemed to be because he had no medecin traitant registered on the Ameli site. Check on your Ameli account whether under the “mes information” page you have the name of your doctor alongside “medecin traitant”. If not, go along to the surgery and ask them to register you.
Hopefully that’s why. If not, call their helpline. They are very helpful.
Did you have any medication prescribed? Theres always a (small) charge for every item
There is a 1,50€ charge non-refundable for each visit to the Doctor… so each patient has to pay that sum… regardless…
1,50€ + 6€ = 7,50€ which is the amount of the cheque I give our Doc for my visits these days… and we get 6€ back from our mutuelle
It might well be that not all Docs are so-linked-up… we certainly used to write cheques for the full 25€ (whatever) until 2 or 3 years ago…
You’ll possibly see that 6€ came from your mutuelle and the rest (less the 1,50€) will follow on… from Ameli… later
of course, if you don’t have a mutuelle… you’ve got me stumped…
You have registered with a doctor, but have either you or the the doctor registered with Ameli that he/she is your medecin traitant?
For every medical act there is a charge, and a percentage reimbursement. This percentage can be between 0% and 100%. There is a precise list on the Ameli website. The complication is that the social security only reimburses a % of their “base de remboursement” which can bear no relation to the change. For my insoles I am eligible for 100% reimbursement - great! But the base de remboursement is about €50, and the insoles cost €150! So I pay the €100.
You will have been reimbursed 30% of the €25 euro fee, less the franchise (you pay a franchise or forfait between €0.50 and €4 on every act too). If you have a mutuelle they will reimburse the rest. If not you pay it,
Great - just connected to Ameli for the first time, as the previous attempts failed as I wasn’t able to create an account. And as you suggest, there is no name next to my ‘medicin traitant’, so will pass by the surgery next time I’m nearby