Mutuelle abroad

I’m worried.
The mutuelles only top up things that the French CPAM pay for.
I’m in the French state system because of my German pension. I gave them an E121 (I think it’s the same as a British S1) and they accepted me.
What they won’t give me is a European Health Insurance Card. They said I have to get it from my German State Insurance, which I have done. So far so good.
They also said that if the EHIC is not accepted by the Doctor abroad (which it never is!), I would have to reclaim the expenses not from the French, but from the Germans.
If I were French the mutuelle would top up my expenses.
But if the German Health pays, would the mutuelle top it up? I don’t think so.
Any thoughts on this?

HI James and welcome to the Forum.

Germany “pays” France for your French State health cover (via E121/S1) and a French Mutuelle will top-up what the French State health cover does not pay (depending on the level of Mutuelle you pay for).

you need to ask your mutuelle, according to an email recieved a few days ago, mine will pay towards teeth implants here in France but won’t if I have them done in Hungary even though the French state will pay their tiny part.

Hi Stella

" a French Mutuelle will top-up what the French State health cover does not pay"

That’s just what I mean.
In the case of expenses outside of France, the French State health would not pay for it, but the Germans.

Would the Mutuelle top-up what the Germans pay?

I’m talking about emergency costs, for instance on holiday in Spain, not about travelling to another country specially because the treatment is cheaper there.

That’s what I thought and I too would like to know the answer.

The way an ehic/ceam works is that it covers your costs to the same level that a resident of that country is covered by the health system of that country.
So, in the uk, residents get “free” healthcare so your German ehic would cover 100 per cent of the cost. Same as my French ceam or a Spanish resident’s equivalent.
In another eu country where residents pay part of the cost, visitors using ehics do likewise.
AFAIK a French mutuelle would have nothing to do medical costs incurred outside of France. Regardless of your nationality.
Most people take out travel insurance. :wink:

Hope this helps
(please see blue links below)
With your French Mutuelle some contracts provide the additional part when the costs are covered by the CEAM. Check your contract before you leave to see if this is possible.

If you do not have this clause in your mutual contract, there are short-term contracts that cover you satisfactorily to make you feel calm during all your holidays: And that’s the most important thing!

I suggest you ask your Mutuelle - I would certainly try and offload any unpaid costs onto them… but I know French neighbours who do take out Travel Insurance when they go outside of France…:thinking:

I found this in my contract:

Le bénéficiaire est garanti pour le remboursement de ses frais médicaux et d’hospitalisation consécutifs à une atteinte corporelle survenue et constatée à l’étranger pendant la durée de validité des garanties, et restant à sa charge après intervention de la caisse d’assurance maladie, de sa mutuelle et/ou de tout autre organisme de prévoyance habituelle ou collective dont il bénéficie.

Dans le cas où ces organismes payeurs ne prendraient pas en charge les frais médicaux engagés, IPA rembourse au bénéficiaire ces frais dans la limite du plafond garanti à condition qu’il communique :

• les factures originales des frais médicaux et chirurgicaux,

• l’attestation de refus de prise en charge émise par l’organisme payeur.

So I think I’m in the clear.

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Does atteinte corporelle cover illness as well as injury?

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Best as suggested earlier to clarify with your Mutuelle and ask directly. But it looks promising, get them to confirm the finer details.

Depends what you call “in the clear”. :thinking:

It’s very easy to think a document/whatever means something - only to find it does not mean that at all or, at best, find it means rather less than one had thought. :wink::roll_eyes:

Why not have a word with someone at wherever your Contract comes from… be clear in your questions and make sure you all understand one another.


Will do.

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« Atteinte corporelle » : Accident corporel ou Maladie dont la nature risque de porter atteinte à la vie d’ l’Assuré ou
d’engendrer, à brève échéance, une aggravation majeure de son état de santé si des soins adéquats ne lui sont pas
prodigués immédiatement.
Par Accident corporel, on entend toute atteinte corporelle provenant de l’action soudaine et violente d’une cause
extérieure, imprévisible et indépendante de la volonté de l’Assuré.
Par Maladie, on entend toute altération soudaine et imprévisible de la santé de l’Assuré constatée par une
Autorité médicale.

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That is great, but our EHICS are issued by the UK and if we leave the EU, what then?
Another loss of privelege.

Yes, it is like living with the Sword of Damocles constantly hanging over us with all this uncertainity.

Possibly, who knows?.. that’s the problem :woman_shrugging:t3:

UK are suggesting folk will need to join the French system “properly” after Brexit and then France will issue us with EHIC I suppose…

And then pay for it when we have, like the UK citizens still living in the UK, paid our contributions.
We could have put our Winter Fuel Payment towards it, but that was stolen by IDS.

Found that the Mutuelle has a limit of 10.000 (on top of what the EHIC pays), or 70.000 for the USA, which is woefully inadequate. So there is no alternative to travel insurance.
Did some research and found some international insurers with websites in English who insure expats living in France.
Half of them are not interested if you’re over 65, which I find ridiculous as they don’t cover existing conditions anyway, and the rest just charge more.
We live near Spain, and the temptation to pop over the border often is great, so I checked out the annual multi-trip policies. There are big differences in price.
For those who are interested, europesecure, staysure, globelink and chapka are worth checking out. Cancellation insurance is included, which is good, some reimburse you if your airline goes bust (very topical), and one even pays you for a delay caused by your flight being hijacked!
If anybody can recommend any others, let me know.