Thank you everyone for explaining. I don’t speak fluent French but I can read it better but nowhere on my policy did I see it was only 100% of what the social security pays, and if they do pay the few cents they need to then Swiss Life needn’t pay anything.
I was wondering though when the doctor said I would need leg lazur surgery and the social would not pay he said ask your Mutuelle as it would cost me 400 euros . When I did they just said NO. Not even a percentage of it.
Sorry I was going to say is this right?
Thanks again for all your help.
Unfortunately if the procedure you need is not covered by state healthcare, there would be no state tarif for it. Therefore if your policy only refunds up to the state tarif, it won’t refund anything for procedures not provided under state cover.
If you can wait a while before the op, why not look into changing to a policy with better cover? You could upgrade with the same company or change to a different company. You may have to wait a certain period of time (maybe up to 2 months, depends on the policy) before you can make a claim. But it could be worth it.
Hi Barbara, it seems weird that an operation isn’t refunded AT ALL by the social security. Is it like a plastic surgery? Because no mutuelle will cover plastic surgery and every operation is at least partially covered in France so that seems really unusual, I would appreciate some details to be able to better understand the situation and therefore enabling me to provide better insights (in private if some informations are ‘sensitive’).
Best,
Leg Lazar surgery is sometimes used for varicose veins and stuff…and sounds like something outside the Social remit…
Hi Fabian
Because I am so ill the surgeon doesn’t want to put me under. That he wants to do this under lazur
It is not plastic surgery - I have problems left undone would result in thrombosis
How awful for you… hope it gets sorted asap…
I do apologise for the crap spelling believe it or not I got an A in english lit etc,
But I’ve been crying that much I can’t think properly
Barbara… I’ve sent you a private message…
Aha… no, private message on this forum… look for bright blue at top-righthand side of the screen
In those circumstances, if it was me, and if I could afford it, I would pay the 400€, have the operation, and revisit the mutuelle question when I felt better.
Ok thanks for the details, the problem is that in France, laser treatment for varicose veins are considered as plastic surgery and therefore isn’t refunded at all by the social security and therefore won’t be refunded by a top-up insurance neither (whatever the mutuelle). Important fact, the average cost for that in France is between 100€ to 150€ so that remains ‘acceptable’… if you have extra costs then you might have been charged with additional costs (like the consultation, or some medicine) or maybe your doctor is a bit expensive.
If you need to be hospitalised a if you follow the ‘parcours de soin’ then the hospitalisation should be refunded so beware of the process you are following (the parcours de soin starting with a consultation with your local GP that should refers you to a specialist that can prescribe that operation).
It’s a bit confusing but it’s important to follow the parcours de soin and ask the doctor if it’s refunded BEFORE engaging any procedure otherwise the risk of not being refunded at all is real.
Hope this is helpful?
Best,
Thank you Fabian
I was charged 75 euros for the consultation and I didn’t get anything back.
The 400 euros is for the operation and if anything goes wrong I wouldn’t have to pay anything further seemingly
If the problem is VV’s but the anaesthetic risk is deemed too high could the standard procedure not be done under epidural?
Regarding the price of the consultation and the fact that that kind of operation is considered plastic surgery I suspect you went to see a plastic surgeon which is not refunded at all by the social security (not the consultation nor the operation).
Otherwise you would have at least be refunded for the consultation.
The only to be sure you follow the ‘refunded’ way is to go through the ‘parcours de soin’ which means basically to start with your local GP and see where he sends you.
Sorry you have to experience these dreadful French administrative dullness.
Hi Fabian
I did go and see my GP and he sent me to a leg doctor who tested me with a dopple machine. (I think that’s right) then I took the results back to the doctor who then sent me to this doctor. He did say he could do the operation the convential way but with my other health problems he wouldn’t recommend it.
To me it’s not cosmetic surgery I am in terrible pain. He said if I didn’t have this operation my legs would only get much worse.
Hi Paul
He didn’t give me that option.
I completely understand your situation and sincerely empathised but the issue here lies with how the social security see the matter and why isn’t that doctor’s consultation fee refunded? Without seing any document I cannot answer for sure, just an educated guess that if no refund then it’s probably considered as plastic surgery (even if it clearly isn’t in your case)… I’m sorry I cannot help more…
Paul’s option is on the other a pretty good alternative, to be considered 