Hi Jane, thanks for querying this. The paperwork is not clear. It’s been sent to us, we’ve assumed for us to pay . I’ve been in such a tizz, I haven’t looked at this very carefully. I’d be grateful if you (or ANother) can confirm what this part of the facture means and how you would interpret it. Thanks (If you click on it , it enlarges and is just about readable.)
According to what I see
70€ remains for the Assured to pay…
I read this as you will be charged €70.
and, as it doesn’t mention the Mutuelle… it’s quite possible that the Mutuelle will be up for paying the 70€… it surely depends on your contract …(?)
And the 491.76??? What’s this “régime obligatoire”?
The crazy thing is the 70€ is the one bit of this we have already paid. OH paid before we went to the room.
If your mutuelle will pay for the room… then you should claim it from them… it depends on the wording of your contract…
I suspect your OH is registered as ALD (?) certainly my OH is and gets anything to do with his Heart for Free (except single room at hospital, which IS covered by our Mutuelle)
We really don’t have a problem with the small amounts Stella - and who pays we can sort out next week once I’ve stopped making sure I’ve removed every last spiders web from the cottage.
It’s only this 491.76 which is giving me the heebie jeebies
Not as simple as that Stella - heart, yes. I am ALD for heart and I never see a bill. For OH he has a different condition and although he is ALD the French government in its infinite wisdom does not rate his condition as being worthy of the same level of refund. Yes he gets 100%, BUT, based on lower amounts - it’s appalling since his condition is just as life threatening as mine.
Frankly… I wouldn’t worry … get on with the housework
You can investigate further, once the Gite is gleaming. Depending on who you know and chat with… for me, I’d ask at my pharmacy as he’s almost a friend… or next time I saw my Doc…
Or… you could ask when OH goes into Hospital for whatever he’s having done…
and then you can let us all know what on earth this is all about…
The régime obligatoire is your caisse, as everyone must have one. In your case will be CPAM.
Hospitals have to get paid for what they do (and a €50 consultation doesn’t cover it!) so there is a system by which hospitals can account for what they do and so be compensated.
So I read this as being your hospital carried out a standard set of checks on your OH, for which you (or mutuelle) pay €70 and CPAM pay the rest.
The ALD will cover 100% of things up to the level of the base de remboursement. So some of my checks the base de remboursement is less than the cost, so I pay the rest. And one of my specialists is secteur 2, and the ALD only covers 100% of secteur 1 professionals. So I have to pay the dépassement.
In general public hospitals stick to secteur 1 costs, but private clinics are often above.
Thanks very much Jane. Your explanation is much appreciated - I can stop worrying. Now all we have to do is get them to acknowledge that OH has already paid the 70 € for the room.
I think I am right, but when you get an explanation from hospital do tell!
did he pay by bankcard or cheque??? either way you should have “proof”…
(I’m only thinking that getting any sense out of any Health Office is a longshot in these busy times…)
I am sure Jane is right with that one - the end column is the only one which is your liability @SuePJ
Since you have actually paid the 70 euros, is it possibly that this is just a confirmation invoice? I know I’ve had one of those to show to my mutuelle for them to contribute to the amount I’d paid…
Just reading this, and hopefully there will a surprisingly pleasant outcome, but doesn’t the hospital have a duty to set out the costs clearly for any treatment that needs to be paid, prior to any expense being incurred? I know it’s quite different, but when I went to the dentist they gave me a devis to decide if I wanted them to do the work, which made complete sense, and allows you to make a clear decision before committing. If the hospital go ahead and treat someone, and then it later transpires that the person is unable to pay for whatever reason, how does that work I ask myself, or if the person has limited means to pay at that time. It does raise many questions.
I couldn’t agree more @letsmile
I find it extraordinary (in hindsight) even if CPAM IS picking up this 400€+ that all of this wasn’t explained to us BEFORE we went into the whole process.
We’ve come slam up against the French cultural tendency not to volunteer information. It happened a lot in our early days, more rarely now. Why? Because we’ve been through a process already and know what to expect, or know what questions to ask.
We’ve both been wondering what quality questions to ask when we find ourselves in a new situation so that we are better informed. Anyone any thoughts?
Is this compulsory / obligatory?
Will there be a charge / payment for this … ?
Who will pay?
Do I have to decide now?
To help me decide is there anything else I need to know? (Probably too broad to be workable)
I also think we need to be more hard-nosed about all of this and less humbly grateful that we are being so well looked after by the French health service.
Fortunately we’re back there this coming week and I’ll pop into the pre-admission office and ask them about the paperwork and show them OH’s bank statement. We’re certainly learning that we MUST keep every invoice / receipt from now onwards. OH tends not to because he puts everything in an excel spreadsheet and then chucks the bits of paper - not any more!
The situation might arise after a serious accident… the patient is rushed to hospital and treated as may be necessary… eg: no-one stops to ask “who pays” in an emergency.
The situation where a Visitor or a Resident finds themselves without sufficient Medical Cover… has been thrashed about already on the forum…
The standard advice is to have a Carte Vitale + Mutuelle or (for visitors) EHIC plus Travel Insurance with Medical Cover inc Repatriation…
(and before anyone queries this… yes, I have come across Brits who’ve never bothered to get the CVitale…aaargh… once they’ve met me they’ve now bitten the bullet and got themselves into the System… hurrah. but there might be others who have escaped my beady gaze )
those who travel abroad without Medic Ins etc… are crazy in my view…
Yes if the treatment is an emergency e.g. a serious accident where someone may be totally incapacitated, but this must be an exceptional case and not the norm.
It must always be the recipients choice as to whether they want to go ahead or not, armed with the full knowledge and facts beforehand. Brazenly blustering along and expecting to someone to foot a large bill at the end isn’t acceptable in my opinion. Fortunately I’m in a position to pay, and also have a CV, but regardless, this is a matter of principle. The medical system shouldn’t have ‘carte blanche’ to throw out bills of any value without prior knowledge and consent. If I’m in the unfortunate situation of needing any medical treatment, I will certainly be very direct with my questions before any treatment go ahead, but obviously remain extremely polite in doing so
I think this thread certainly raises awareness, which I see very positively, so thanks @SuePJ for sharing - much appreciated, and hope it all ends well for you.