Health cover

What I am about to write in part seeks advice and for the rest of it should be a warning for others. Let's not bore you with the whole story of the downfall of my health over the last 15 or so months, but skip up to last year and a diagnosis of apnoea. The specialist who diagnosed it prescribed a respirator for when I sleep, which I have had for seven months. A few weeks ago I somehow pulled it off during the night and had a bad turn. My wife rushed me off to hospital where I was entered. Next night, tranquillised I went to sleep. I had my respirator there and set up but medical staff forgot it, I had another bad turn which caused a heart attack. They rushed me off to a Bordeaux clinic where blocked arteries and a ruptured one were discovered and over two short stays there I have had stents put in to open the blocks and the 'leak' repaired.

At the end of the first stay they considered it necessary to send me home in an ambulance. Since then I have had a diagnosis of hypoxia. With the apnoea it raises the likelihood of me having heart problems.

Now the real bit begins. I have recently started to get bills for part of the rental of the respirator from the company who own it. I have been trying to get my mutuelle to tell me whether they are paying for it or not but apparently have just established in the last couple of days they have no agreement with the company who own the respirator, so won't pay up. Then a bill came for the ambulance home!

I contacted my doctor, at least his very helpful secretary who said that RSI should be paying. Plus, she added, my doctor has applied for 100% cover from them. So, on the phone today. One thing I have to avoid according to my cardiologist is stress. After watching me boil several times, my other half took over. She is now near explosion point. Firstly, RSI claimed the machine is not approved, but we know that it is, so gave them the details. Then my OH tried to extract from them exactly why the ambulance that was ordered by the hospital has also been refused by them. Basically, no answer to anything. The people either of us speak to tell us it is against the law to divulge the details of such decisions. After two of us blasting away on a phone each, my OH finally got somebody in a higher position to talk to. She went through the whole story.

What she got back was that person X at RSI will make a decision in mid-June and I will be informed in mid-July. So hang on to any bills and if they decide in my favour then they will pay. However, as all French bills they are deadlined and I shall have people on my back before they decide let alone inform me. This senior person said that in that case I would just have to pay up and perhaps return the machine. OH exploded at her and said that that could kill me. She asked what that woman would do in the same situation? No response, of course.

OH then asked for details of everything but was told it is against the law to divulge such information. So the question was raised as to exactly which law that was so that we could look it up and refer to it in my complaint to the commissioner. Wait for.... The jobsworth at the end of the line told my OH it is against the law to say which law that is! That will of course be quoted when the complaint goes in. The point of this post for all I have said, is that if it is actually true that these public servants are legally prevented from telling us which laws they base their decision making on then what we heard today is that we are living in a totalitarian state where law is only for those who administer it but does not offer protection to it subjects.

I just had to say this, my faith in the social state in France died today. RIP.

My thyroid medication is refunded 100% by the secu.

There is a link to a web site on the Useful Links page which lists what is covered by ALD (the 100% cover). Under Health, ALD.

If you have Graves, you get one drug to stop the thyroid from working (so you become artificially hypo), and then the synthetic thyroxin instead of your own.

What I meant was in the UK you can buy a prescriptions certificate, £104 for a year, and that covers all prescriptions. It's to do with cost full stop. (a lot cheaper than a mutuelle)

I think Graves disease is over you dont get it with hypothryoid. In the UK you get the passport if you have a chronic disease requiring treatment to keep you alive.... full stop...nothing to do with costs. That makes it much easier to understand...also, if you get the passport for you chronic illness...then all your other prescriptions are free as well. Much clearer system and easier to understand.

yes but Thyroxine costs us (the patient) something like 7€ a month less 70%, so it doesn't much matter. The principle in UK is that if your medicines start to get costly then you get the "passport" thingy.

Having said which, if he could attain Graves disease with opthalmopathy, then that's free.

Some fonctionnaire made an arbitrary decision yonks ago and nobody has bothered to review it!

I wonder how they choose which ones will be funded and which wont. Without insullin daily an insullin dependent diabetic will die...thats covered....but without Thyroxine daily a person who is hypo thyroid will die...and that isnt covered...I feel like I need to say.....interesting....but stupid......!

The same for osteoporosis and asthma!

My OH has cancer, was operated in October, EVERYTHING is 100%. Perhap sit is different as he is French and has paid in all his life?

We have a parallel with the UK as my sister is also being treated, she is now in a Macmillan hospice and being treated marvellously, despite being"difficult" ;It was however a very different tale to begin with. We had both diagnoses on the same day, Jp was operated 3 weeks later and is clear and recovering, my sister's notes were lost, she had to wait 3 months for an apointment, she only got that cos she pulled strings..........yes her cancer is different but she now has days to go whilst P is out in the garage clearing up!I am fully aware she would never have recovered but the incompetenc she encountered in the paperwork was just amazing.

It may not be as good but it has always been red hot for me! Where else can I see a dr in the morning tell him mys siter has cancer, and i am the only female in the family who hasnt, and seea semior oncologist in Bergonié in the afternoon?

Brother in law worried...his only remaining friends daughter...who is also my daughters friend...scared to death I expect...she is an editor of an underwear and swimwear fashion magazine...stunning girl....just been told they have found two tumours and her mastectomy on neither of them great at the are you and yours? ;-(

Nick requires Thyroxine for life....our GP emphatic no free scripts for that....

Annie, not everything is covered by the 100 per cent, but most of them.

Hi Carol, If you have a chronique or serious condition here you dont pay either, you are taken on at 100% and all your transport costs are paid! Yes there is paperwork, lots of it, but our DR did it and JP just signed in the right places! How is your brother in law? And your friend?

We have an excellent GP now who speaks excellent English as he has worked in the USA for several years.

What a story,it is frightful! MY OH is now on 100%, it took some time to come through, it was our medcin generalist who organised it all, the papers were done by him and he arranged atall the cover of our transport costs. Maybe you need to speak to you GP and get him to do the paperwork, it can be and frequently is post dated.

How are you now? Is the respirator helping? Dare I mention the shoulder??

you are of course right Jane. I think it helps if A. you have a good hospital B. you have good medical staff and C. you either have some knowledge of health matters or have looked up what ails you and can argue your corner. I always tend to remind people, doctors along with all the other medical staff are working for you....not the other way around. Doctors may suggest treatments, they may actively encourage treatments, but the patient is the one that decides and signs the consent forms. Have just read a very good little kindle book called 'Its Cancer'...the true account of a married couple who both have diagnosis of cancer the same month and the book follows the year they spend fighting their own cancer battles. Because medical cover in the US is very disconnected, there is no one person in charge of conducting the process...thus its beholden to the patient to read up, become the Expert Patient and choose their doctors with an eye to providing the treatment they require. In terms of medical treatment these days, the individual hands over responsibility for their care at their own peril!

Following my recent case against the CLEISS should anyone who is retired and living in France and needing treatment which is only available in UK, they should have no problem accessing this treatment.
I always look at the relevant charity site in UK and have rung the helpline of the British Lung Foundation, which put me in a much better position vis a vis my specialist here in France.
I have had terrible treatment in UK, food intolerance not diagnosed until by myself at forty, had to cancel a psychiatrists appointment because my GP could not diagnose my endometriosis, damaged my back during an operation and, of course, told I had not got cancer when I had.
We all have different experiences, although I do feel that some of the doctors here in France are as arrogant as they used to be in UK.

My friend was receiving the same treatment as you for sleep apnoea. His name also Brian, and he was a Uni Lecturer...or was till he took early retirement. He also taught rubgy and was always a big chap at 6ft 6.....but his sleep apnoea was caused by his weight, which got up to 27 stone... all of the equipment he was provided with is free, he has regular appointments at the sleep clinic....who have managed to get his weight down by 8 stones...he is now able to sleep without the mask.

er....dont agree Brian. I am working in the health service in the UK at present. Added to that my brother in law and a friends daughter both diagnosed with cancer last week. One is undergoing a type of surgery only available in the US and UK...the surgery takes place in 3 weeks at Kings College London with surgeons from around the country taking part. The other, a young woman of 40 (diagnosed the day before her 40th) has been allowed to go to Barcelona for her 4 day party...but is fixed in for surgery the day she comes back.

Ive been looking at the figures for treatment, waiting times, recovery numbers etc....and the UK according to many sites is on a par with France.....the health service in France Brian, isnt what it was, the same is said about the UK, but things are improving there at present and going down in France.

The other thing to remember is, in the UK you are not paying into a Mutuelle and not having to pay extras for ambulances, equipment etc. Also if you have a chronic condition where drugs are required to keep you dont pay prescription charges in the UK.