Lot-et-Garonne CPAM cancelling category S1 Cartes Vitales 31/12/20. Other depts likely to follow

Health Care & Carte Vitale
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@Davidpmackintosh The AMELI website is where you find information about your healthcare rights.

One of the things you will need from time to time is an attestation which is a piece of paper that confirms that you and your wife have cover under the French National Health scheme.

Do you have someone who could sit down with you and show you what you have to do to set up an account and access your information? The person who did is for us was the Generali agent who sold us our top-up health insurance when we first moved here. She spoke good English, which helped as the website is all in French of course.

It can be daunting and is helpful if someone can guide you through it face to face. If not David, come back to this thread and between us here we’ll talk you through it and show you with pictures what to look for.

Just off to make supper. Happy to help further later on if you need it.

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Don’t have self doubt, it just takes time to get things lined up correctly. I think it is more than likely that your wife is registered correctly, they just won’t bother to send out separate documents as she is effectively you. I imagine they would only do so if two separate accounts.

It is well worth setting up your online access to ameli as that was payments and so on are sone automatically and you can see what is going on very clearly.

This is the starting point and needs yiu to have bank details to hand

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Hello, Since my last post I have tried the Ameli helpline numerous times. Originally left on hold but now there is just a recorded message and then it cuts you off. Message on our account still says ‘cards are being cancelled soon’ and we must send supporting documents ‘within 10 days’.
The ten days never reduces!

I have no idea what the ‘supporting documents’ are, we have been on S1 since we arrived years ago.

Suggestions please.

Thanks

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@Toovey27 New S1s?

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The situation of S1 not covering both people in a couple seems to be based back to 2016 when PUMA was launched. This article explains that from 2020 people are considered individual and not entitled from the others entitlement - ayant droits

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@Toovey27 Hello Beth, sorry you had problems getting through to the English speaking helpline. I’ve just called them now and was attended to in less than 5 minutes. In fact they gave me the estimated wait time.

I used this number: 09 74 75 36 46

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@PeterJ Thanks Peter. That looks like it - it’s been frustrating to be given the run around over these last weeks, starting with Brexit, and carrying on through a variety of other excuses!

Also, I don’t know how we were supposed to know this since neither CPAM nor Newcastle informed us.

Having been in the system since we came in 2007 it’s frustrating to suddenly find his card doesn’t work. Our first bill to pay the full amount in the post from the GP this morning. GRRR . It’s all very well to be told we’ll be reimbursed. What if we don’t have the money to pay now?

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Guess that can only be the wonderfull Lydie in Callac
agent to many Brits in the area and beyond !

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I found getting into the health care system, carte V and using online AMELI reasonably OK
with some language help
BUT understanding the actual repayment amounts is something else
eg go to doc’ pay €25, some time we get €15 back other times €11
 blood test, get a bill from lab’ got 65% back one visit next one didn’t even appear on our Cpam next time got about €5
 each time they had our CV
so its all a mystery, but what I do know is that health care including top up is costing lot more and neither wife or I have any big health care issues. Had a minor op’ day case in hospital
 just handed over my CV and got no bills for anything.
All seems to work efficiently but incomprehensible regarding refunds !

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That is the big positive of having an online Ameli account. You can then see exactly what things are costing you and why.

The basic principle is that everyone has to pay a contribution for every medical act. But it varies according to the act from nothing to 100% (which you can look up if you want). The most common is that the state pays 65% or 75% and you pay the rest.

However! Not so simple because

For many acts you also have to pay a franchise or a forfait of 50 centimes or so. And if all your bills are being paid automatically through the tiers payant system these tiny amount build up and the next time you actually pay something with real money they will be deducted from the refund you get.

The other complexity is that the state only pays a basic set cost for each act, so if you go to a more expensive specialist (secteur 2) they will only refund the cost of secteur 1 doctor. Or if you get something where big gap between actual cost and state reimbursement. (The insoles for my shoes cost 150€, and I am refunded 100%
except that the state cost is only 50€ so I am refunded 100% of 50€, not 100% of 150€!

The other thing you might want to consider is changing your mutuelle to a hospital only policy. We used to have an all singing mutuelle with 150% cover that cost a huge amount and now we have a hospital policy with 300% cover that is a fraction of the cost.

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Finally got through to Amali. Told that our cards are being cancelled on the 31/12/2020 because of Brexit. Then told we had to get new S1’s. So tomorrow phoning UK!

Regards

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Autoimmune stuff is not my bag but there are some conditions where only a short course is needed and others where it is given on an ongoing basis - probably closer to ÂŁ2.5k per treatment though.

However you can check if you like whether you would normally get ongoing treatment - the commissioning guidelines are here: https://www.england.nhs.uk/wp-content/uploads/2019/03/PSS9-Immunoglobulin-Commissioning-Guidance-CQUIN-1920.pdf

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Hi I worked out the cost on €35 per kg body weight and I am on 2g per kg so about €6000. I have undergone a 6 month monthly course of perfusions (IVIG drip) and then two more at six weekly intervals. My body strength and blood CPK were then back to normal (in fact they were back to normal after the first three months) so I decided to stop however my condition NM came back and I was back on IVIG, again it has gone away but so has my relationship with my French Consultant, who seems unable to accept input from her patient. I am meeting a new Consultant in January with help from my MT, ( he is great and did warn me that she is a very difficult woman)

I will be sourcing an S1 when I am entitled to one a year in December and then the UK can pay for my treatment.

Another interesting fact is my wife is also diabetic (type 2 drug controlled) in the UK she was prescribed a drug called Forxiga. She had good blood sugar control but in France Forxiga is not prescribed. However it is an EU licensed drug, I do not understand how this system works. She has found she can get it in Andorra and can buy it by ordering it on a credit card from a Pharmacy in Andorra and they courier it to her here in France

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Seems to be available?

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More Fun!!

Today I phoned the number supplied to me by Ameli to obtain the new S1’s. Held on for a long time & then told that this was not the number for ‘overseas’ & given a new number!!

Phoned ‘new’ number, held on even longer. Got through to a chap who looked at my records & said ‘you don’t need a new Si as the old one does not have an expiry date’. He said, however that he would send me copies of the originals.

I’ve also found an old photocopy so can I send this??

Turning even more grey now! Any ideas or a direct phone number would be good!

Many thanks

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@Toovey27 Hi Beth, fun isn’t it!

The Overseas Healthcare Services, NHS Business Services Authority is the one dealing with all this. +44 (0) 191 218 1999

Glad he agreed to send a copy. Some are being helpful and some not. This is the letter I wrote at the beginning of October 


Alison Newell,
Deputy CEO,
NHS Business Services Authority,
Stella House, Goldcrest Way,
Newburn Riverside
Newcastle upon Tyne, NE15 8NY

Dear Ms Newell,

Conflicting Information Provided by Overseas Healthcare Services to Retirees living in France

I am writing to you as someone who may be able to help with a challenging situation those of us who are retired and living in France are facing in our dealings with the helpline of NHS Overseas Healthcare Services.

Whilst the UK Government is insisting that all is well with healthcare provision in the context of the Withdrawal Agreement, that is no longer the case so far as retirees living in France are concerned.

On moving to France we continue to obtain our national health cover in France via a “carte vitale” which normally is valid for a full year ahead. Those of us who are retired originally obtained our cartes vitales by virtue of holding an S1 form issued by the UK. We are now finding that our cards are expiring on 31st December 2020. The rationale in France for their expiry is the perception of uncertainty around Brexit and the honouring (or not) of the Withdrawal Agreement. This perspective of uncertainty is emanating from the highest levels of French government.

Getting this misunderstanding resolved is being taken up within France itself but there is a knock on effect for those of us who are having dealings with the Overseas Healthcare Services helpline.

The health service within France is, in some instances, asking retirees to update their applications for their cartes vitales, in other words to provide a NEW S1. It may well be, come December 31st, all of us will need to reapply for our cards. In this context we are receiving conflicting information from the helpline.

Some have met with sympathy and a willingness to issue a new S1 – this has been my experience and for that I am very grateful because it means there is one less thing for me to worry about during these stressful times. Other, however, have found a blank refusal and an insistence that a new S1 is not necessary and will not be provided. This arbitrariness of the helpline response – ie “if you are lucky you will find someone who helps” - is deeply distressing when it may well be that the future of our healthcare provision in France is at stake.

Hence my appeal to you that the Overseas Healthcare Services helpline provides a consistent and proactive approach in its dealings with those of us calling for help from France and that (despite the perception that “all is well” in the UK) new S1s are, in fact, provided to those of us who say we need them. Such a response will be much appreciated.

Thank you for your kind attention during what must be difficult times.

If through this all Beth you have the energy to complain I recommend you do so. Sadly Newcastle really has little comprehension of what we are going through right now.

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Many thanks Sue for your reply. The number is the one that I used this morning and that is when I was told that I do not need a new S1. If I do receive the copy ones they promised to send they will obviously have the original issue date on them so do you think they will be accepted?

Do you have a link for who I could complain too? Thanks again for your help.
regards

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Aren’t the UK government now issuing new S1’s with a start date of the 1st of January 2021?

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not heard about that Tim, why would they need to if there is no expiry date on the existing :thinking:

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That number is the correct one:
S1 Overseas Healthcare Service on +44 191 218 1999