Doctor's Fees

With a Carte Vitale is the 22 euro fee for a visit to the doctor normally reimbursed, less 1 euro?

I recently had to go to the docs, paid my fee, and then had quite a hefty bill at the pharmacie. The pharmaciste warned me that quite a lot of the stuff wouldn’t be reimbursed.

I’ve just received a cheque/summary from RAM/RSI which seems to cover doctor/pharmacie but refunded only E5,60. Is it possible they’ve made an error, or might I receive another cheque to cover the doc bit?

We looked into Top Up Insurance too & whilst it looked pricey at first when we realised it included Dentistry, Optical & most pharmacy items we realised we couldn’t do without it. We were used to paying for private insurance in the UK & the Top Up was a lot less (however our income has also considerably dropped since we started our family so it still seems a large part of our income). We are with AXA.

Our daughter needed to go into the day hospital last year & the bill was 1080 euro, her recent upset stomach was around 200 euro for repeat Dr Visits & pharmacy items. My maternity scans, dr visits, lab tests & medicines was easily 1000 euros last year (ignoring the hospital fees which UK EHIC paid for).

Another thing to be aware of with Top Up/Mutuelle is the 100% coverage is not actually 100% it only covers 100% of the conventional tarif, there are deplacements (think extra fees!) which certain dr’s/surgeons add on top which can be 300% or 400% of the conventional tarif. So even if your top up says it covers 100% of hospital fees you can still end up with a bill for the difference if the Dr’s are non-conventionne. Same applies to dentists & specialists too I believe. Mostly this depends on your area - I imagine Paris & Provence are where the big fees exist.

But I still believe it is far better to have even the minimum cover you can afford that to take all the risk on yourself.

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Sorry Ameli is the website for CPAM, if you pay RSI it will be RamGamex, I think.

Just checked my statement from CPAM. You pay the medecin traitant 22 euros and get 70% refunded less 1 euro which is a refund of 14.40 euros

Thank you, Tracy… and to Christa as well.

I’m not sure where Ameli fits in but I’ve just set up an online account with RamGamex, the organisation to which I pay my cotisations. The joke is that I have to wait for them to POST my password!

I hear what you say about mutuelle/house insurance. I’ll dig out the quote I received and check what hospital cover only would be.

It could be an error but there is also a euro or so to pay for the pharmacy stuff as well, have you had a look at your account on, as I belive all details of reimbursements are on your account there.
As for not having a mutuelle - do you have house insurance? It’s the same kind of gamble and could cost you the same - if you really can’t afford it, then look at taking out just hospital cover. Medical charges over here have to be seen to be believed, my short sejours in Maternity cost over 800€ a night, without complications.

Hi Tracy

Yes, I’m registered with medecin traitant so it looks as if I should be getting 70% of E21 back, non?
I don’t have a mutuelle though as a) can’t afford it, and b) I am (fingers tightly crossed and touching every piece of wood within reach!) very rarely unwell - recent visit was first for two years - so the annual outlay just isn’t worth it. We also have a very good pharmacist so, for any minor ailments, she’s my first port of call.

Have you registered with a GP - medecin traitant/ there is no obligation to but if you haven’t you will only be reimbursed 30% of the fee, instead of the usual 70%.
The amount you are reimbursed for pharmacy has also been reduced (very recently) by a huge amount and many items, are no longer reimbursable at all.
You need a medecin traitant to be referred to most specialist these days, otherwise the reimbursement will also be limited to 30%.
If you want the whole amount reimbursing then you must purchase a mutuelle.