Help! Information regarding health charges please?

It’s great that you are so upbeat Sandra and doing so well. So many friends of mine have comtracted (is that the right term) cancer over the last five years that I think it is something we should almost plan for. Best wishes for your continuing recovery.

Sorry John, your advice doesn't apply to every lady. My qualification for disagreeing ?

My late missus found she had colon cancer at 49 years of age - she had operations, radio therapy and chemo and the rest for the secondaries which eventually killed her. She never felt sorry for herself either but she flatly refused to wear a wig because she was a proud woman who didn't want to be seen as anyone other than herself. It wasn't a question of vanity, just honesty, being honest with herself. She didn't care what people thought of her as the people who cared for her didn't give a toss either.

Every day was a new challenge for her, she never complained and remained proud until her last breath. She lost her battle at the age of 56, seven years after the diagnosis and made the most of every day. It's almost three years to the day of her passing and I remain proud of her strength and of the example she gave to the rest of us.

Cancer is one of those illnesses - actually its a bit queer, because it is your own body that may kill you; you don't "catch" it; that falls under the aegis of universal free care. Sounds like you have the costs sorted; now just get better / cope as best you can: to knock out the cancer cells, they need to blitz the system completely - the good along with the bad; so crap times ahead. Feeling shit**y and it brings on early menopause too..........

Just don't forget the sun will shine again, and stay as positive as you can: I went to more funerals of the "why me" / self-pity brigade than the "OK, so I'm in a hole, now lets get out of it" bunch. And get a wig cut to your usual style; losing a primary sexual characterisitic is lot more diffilcult for ladies than it is for men.

Qualifications for this advice? I had bowel cancer (with surgical complications) aged 40; my darling wife had breast cancer aged 47 - we've both been there and done it... French officialdom is a doddle in comparison; so ya-boo to all the whiners and whingers. Fight for your life, and enjoy every morning - precious gift. And don't be proud; find someone to talk to, and get good clinical advice - IF the game is "up" choose your exit with care, and dignity.

Wishing you courage and strength - you'll need them both. This is not the time to worry about money: it'll be around long after we are all forgotten dust.


Thank you. I hope you are continuing to progress too.

Hi Karen

Sorry to hear about your diagnosis ! Having had primary and two lots of secondary cancers here, I can say the treatment is superb ....and everything should be covered 100% by CPAM ....I had TEP scans in Poitiers, three ops in Bordeaux at CHU ...public hospitals all, but University teaching hospitals and care could not have been better ......It is surprising that for cancer treatment you have been sent to a Clinique rather than a public hospital ......why don't you ask your GP why he/she referred you to a clinic ?? My OH was referred to a clinique and paid 700 euros each leg for vasculaire surgery (mostly refunded by his Mutuelle) although the hospital I went to in Bordeaux (Haute Leveque) has a specialist vasculaire department which is highly regarded ! ....CPAM usually have a presence locally to whereever you live if you do not wish to travel to the main office, and if you ask the Mairie they will know when CPAM is likely to be available in your locality (you may also find, on details of when and where this will be. also gives the current rates of charges and refunds, and you can view your 'account' with them to see what they have paid out for you by registering online (beware of scam e mails, though ....check the logo !) As has been said on here before, CSF may have some knowledge of current charges - or have someone you can communicate with who has had the same treatment. They have an online forum. Also, McMillan nurses in the UK have a website, and you can 'chat' about various things if you wish. Also, I have heard refund rates for certain drugs and treatments have recently changed on CPAM - so if you check with their website you can find out if any of yours are affected.

Good luck with the treatment - and try not to worry too much ! I think a positive attitude gets you through !

At our local hospital they have certain days when you are considered a private rather than public patient, even if you are seeing the same consultant. I was given one of these private appointments without asking for it, despite having seen the same consultant several times on ‘public’ days. It sounds unlikely in your case but worth checking just the same. All the best.

I've used the Chenieux several times Roger, three times for orthopaedic operations and once for the eye dept for a relation and each time we were fully reimbursed by the GAN and I have to say the healthcare has always been exemplary.

My wife has had cancer treatment. everything, including taxis and even my mileage if I take her to hospital is refunded or not charged directly to us. All cancer treatment is free here. The problem might be using the Clinique. I am guessing, but perhaps the charges there are above the schedules for your mutuelle. All my wife's treatment has been at the CHU Poitiers. Faultless service.

Some Brits think Polyclinics are 'private' as in UK, but it is not quite like that.

Karen, I think it depends on the area you are in, and whether or not the Clinique is part of the health system. Our first doctor was in Chalus, and she always sent us to the Clinque Chenieux in Limoges. Yes, we paid the specialist an honoraires, but it was fully reimbursed within a couple of days. Our doctor now is in Ladignac and he sends us to the general hospital in Saint Yrieix. Our impression is that different Hospitals and Cliniques service different geographic areas within the national health system.

Thank you. Confusing though it is, I am beginning to understand it all a bit better. I think you are right about my GP's choice of surgeon too because the specialist has taken great care to make sure I haven't lost any unnecessary breast or lymph tissue by using 'state of the art' medical techniques.

I will phone the mutuelle too and discuss the situation for the future with them too as you suggest. It wasn't so much the actual paying but sorting out why I was being reimbursed sometimes and not others that confused me!

your doctor obviously wanted you to see this specialist as he his good at his job. The other approach is not necessarily to request the public service, but when your mutuelle is coming up for renewal to look for cover of dépassement des honoraires. It is faily common to include 200eu of dépassement. It is not necessarily true that if you are in the public that you won't have dépassement - although you have the choice. I had an ear operation a few years ago in the public, but to see the consultant more quickly I saw him privately - his consulsation fee alone was 70 eur (not the 28 the secu base themselves on). I could've gone back to the public for the operation but when I asked what the difference was she explained that as it was a teaching hospital if I was public I could not guarantee it was him that actually did the operation - he would supervise of course but it may be another doctor actually operating. If I was private I was guaranteed it was his "hands" and expertise that would operate on me. The first year we were caught out a bit, like you on the honoraires as our mutuelle changed its policy between us taking out the policy and it coming into effect!! The second year (as I had to have the other ear done) it was totally planned, a different mutuelle and adapted cover, and I was fully reimbursed. I do this a lot - I plan for when my husband needs glasses, there was a discussion with our dentist regarding orthodontic work for my son - so I can adapt the level of cover of our mutuelle accordingly. I wish you a speedy and full recovery

Sounds like you need to speak with your insurance company Karen. Check your level of guarantees etc. I went to my agent (GAN) on tuesday to increase my guarantees for such things when I realised certain guarantees on things like Optique & Dentaire were out of date.

Good luck with the treatment.

Yes, and make sure you double check as most of the time you are paying for something you could get free of charge. Take care!

Hi Karen, I had my thyroid removed last year because of suspicious cells in the tissue. Which is interpreted as thyroid cancer. My GP filled out a form for CPAM asking for me to be covered by an ALD (think the translation is an ailment of long duration) I.e, life threatening. This was approved and I received an atteststion which gives me 100% cover for any treatment for anything related to my thyroid for the next five years, this includes Visits to the GP, consultants or any medication. When CPAM approved it I was asked to update my carte vitalle in the machine thingy at the pharmacy and now it’s recorded, May I suggest you check your GP has done the referral for an ALD?

Thank you. Its all becoming much clearer. As I now understand it I must ask my GP to send me to specialists at the hospital not the clinique.

Thank you. I have already got the 100% from the CPAM because my doctor's secretary applied for it but it was the depassement I had to pay after the op which confused me. However,now I have Katie's reply I can see I must have seen a more expensive doctor without realising. This time it doesn't matter because he obviously is very good at his job, and I have had very efficient and well organised treatments so that the cancer has already been removed and my chances of recovery will be good but I can't go on paying nearly 400€ depassments for everything in future so I may need to request a change of specialist.

Karen, it depends on the clinic and the doctor you choose. If you go to a private clinic, you will pay more and won't necessarily be reimbursed, if you go to a State-run hospital, you won't pay anything as everything will be processed directly.

When making appointments, simply ask about the "dépassement d'honoraires" and then check with your mutuelle, sometimes they will cover it, other times they won't. If you want to make sure you don't pay for anything, simply make appointments with specialists in hospitals.

Eminent specialists work in public and private hospitals, even when they have their private practices too, so there is no need to fear treatment in State-run places, they might, however, offer a lower level of comfort and the doctors' bedside manner might be a little less soothing.

Let your friend know that it simply isn't possible not to be able to afford treatment for serious illness in France (for the moment, at least!)

Good luck and speedy recovery!

Thank you. I didn't realise doctor's could charge different rates. So if I want a specialist who is this Secteur 1, do I ask my GP before any treatment is arranged? Obviously too late for the current treatment but just what I need to know for the future.

to explain every "acte" that you have has a predetermined rate by the securité sociale which is called the ticket moderateur. For example you go to your GP - you pay 23 eur - you will be reimbursed 22 split approximately 60% by the secu and 40% by your mutuelle - that is 100% in total. You have paid x amout and between the secu and your mutuelle you will be reimbursed 100% of the Ticket Moderateur - not what the Doctor has charged. If you don't want any more dépassements you need a doctor that is Secteur 1 conventionné - he will only charge the TM rates.

Hi Karen. It is confusing but rest assured there is no problem. My wife had Leukaemia and all the treatment was free except the food in the hospital which is paid for by your mutual assurance. I had a heart by-pass and that was also free and am on medicine every day all of which is free. CPAM will tell you which illnesses qualify for free treatment but it is mostly life threatening illnesses. Hope this helps you and get well soon.