Mutuelles santé

This is driving me mad! What do French medical top-up insurances actually provide. The websites happily talk about basic, enhanced, etc packages, additional cover for dental, optical but it is really difficult to see what each insurer is offering without ordering a "devis" which means being bombarded with phone calls and emails. And in any case, how do we know what cover we need, just to coiver the medical and medicine costs?

Thanks Roger,

Just made use of your medical insurance comparison site ...filled in the details and applied to have no obligation quotes email to me. Certainly the basic level of cover monthly tarifs seem quite reasonable.

I am so grateful for this as my previous googling attempts lead me to insurance companies that required several hundreds of Euros up front then a regular monthly payment.......

Thank you Chris, I really do hope it works for you as well as it has for me. Despite my great age, having young children did help, especially the agent's daughter being one of my youngest's best friends. Had he not said we should sit down with him and go through it all, I would probably never have thought of it and done the comparison web searches myself. The old thing isn't it: its not what you know but who you know.

In your case you know SFN!

I want to thank everyone who has contributed helpfully/thoughtfully/amusingly and helped me to understand and even reach a conclusion. Those of you who siad "ask an agent" were right and, in fact, the comparison websites didn't win - my existing Aviva agent seems to have come up with the best deal for the package which I believe we need! Who'd have thought that? Well done, everyone - SFN rules OK!

Every medical act/service has a cost which is available at the hospital depending on whether it is conventionee or not. General prices for doctors are here http://www.ameli.fr/professionnels-de-sante/medecins/votre-convention/tarifs/index.php

This is an interesting article about the variations in price

http://www.leparticulier.fr/jcms/p1_1510756/budget-sante-le-vrai-cout-des-operations-chirurgicales

We moved to Ociane in September and are saving over 40€ a month with a better level of reimbursement. As others have quite rightly said, it is all a matter of personal situation and priorities.

Karen,
Thanks for your comprehensive reply. Will certainly do more study on what the small peint says. I feel our mutuelle is very good value as not only have we already used it for both of us but I have been refunded for dental work and a decent amount paid towards new glasses. They do speak English & have helped me with problems in getting my carte. After 13 months I’m still on an attestation.
Incidentally, we had a steep learning curve as when my husband needed an ambulance I had no idea who to call so now keep numbers by the phone!
Regards
Miriam

I am 65 and have 100% for two things; lots of 'extras' like appointments with specialists, private ambulances, etc, are not covered by the CV, they add up to a small fortune too, anyway the €18 frais de sejour does not apply in any way when one has 100%. The RSI has paid out for MRI, EEG and nuclear scans 18 times in 23 months, that is a lot of money to begin with. Roger and I's sums probably work out along the same lines, similar proportions at least.

Mainly CV thus RSI as I said elsewhere, but a lot of things that are not covered by the CV make far, far more than paid in.

As I said earlier I use a price comparison site, Mutuel costs are a function of your age and the 'generosity' of the assurance co With Most the fraise de sejour are included and Chambre individuel are covered from 25€ per day mine offers somewhat more, you always have the option to top up as you would with dentures and spectacles. The 50€ is per person per month. As for the Knees op So far I've only got figures from the hospital that was 20,000€ remb 65%from the CV and then there was the extras as I said Ambulance transfers, Radiology and Kiné and the three weeks reeducation in an other clinique so I think the 12000€ estimate is close. The Kiné is ongoing.

Some of the companies I've seen suggested here, especially those offering face to face counselling are at the wrong end of the cost/benefit scale.

Thanks Tracy; you're quite right, it's not at all easy to find old threads. The "Search" option often does not take you to masses of useful stuff. I'll go look tomorrow.

Numbers, great thanks

My researches tell me that everyone has to pay 18€ frais de sejour, and a private room averages 61 apparently, say 80€ a day all in. How come you paid for surgery and how did it all get to 12000€ do you remember?

And how do you get a mutuelle which pays a private room for 50€ a month, sounds an absolute bargain!

Steve

Hi Catharine
Thanks for clearing that up. I followed the (long) discussion about satellite dishes, some of which was really helpful but if you look at it you can see a lot of advertising with prices, order dates, availability etc… I don’t have a problem with that but wasn’t sure of the rules regarding any self-promotion.
I’m glad I found you as it’s helped to see that others have the same bureaucratic problems as we do so keep up the good work.
Best wishes
miriam

Miriam I removed your reply (by accident) so apologies for that.

Tracy's comment was 100% correct - we rarely remove stuff and usually not without notifying the poster. I did remove the post that was a blatant plug for a member's business as we do not allow this. Your reply got caught in the crossfire so sorry about that!

I don't quite understand your comment about the satellite thread? SFN is a social network so people's opinions are never going to be 100% objective. As far as I know no one in the satellite thread has posted a link to their business - if they had it would have been removed - but perhaps I have missed something and if so, perhaps you can point me to the page in question? Thanks!

Steve, if you noticed the considerable sums mentioned earlier for orthopedic surgery you would be able to appreciate the contributions made by the mutuel, the contribution, in our case from the CV was half of the cost the mutuel allowed us a private room in addition to the surgery costs, covered the hospitals daily 'hotel' costs. and all for 50€ per month great value rather than having to find about 12,000€ which the mutuel paid out without quibble.

As for sports injuries our Kiné costs about 16€ per session CV covers 65% we have three per week so the mutuel pays out 3 x 4 x .35 x 16€= 67€ or a 17€ profit on our contribution :-)

I've participated on several of these threads, and I have never yet seen anybody posting actual figures of huge sums paid out by the mutuelle, (not by the carte vital).

I stopped our mutuelle this year, OH immediately started needing treatment for a sports injury, a dozen visits already this year - but despite all that we are still better off without the mutuelle!

Steve

Are you really sure the mutuelle paid out a fortune, or was it really the Carte Vitale?

Nja, nja. Basically yes, same goes for my cardiology stuff but the appointments with the specialists are still covered by the mutuelle, time in hospital, any emergency transport and umpteen other things. Ultimately though, one of the select list of 100% cover things though means that all treatment is free. So my ticker and gammy shoulder stuff, such as the weekly kinési are covered by (in my case because I am still a working AE) RSI within the state system. For my part I find it knocks spots off the NHS because I don't go on waiting lists, I am treated toute suite and sure I have appointments booked three months ahead but if anything gets bad I can see people next day. I am insured for that and it is bits like that people need to have in their policy.

What influenced us is how my better half sees it. In her Swiss system only children and the elderly get any state provided health care. From 16 to 68 (I think, it goes up to 70 soon too) there is only frighteningly expensive private cover, namely health insurance must be bought to suit. It costs more for existing and pre-existing conditions and goes up with new ones. So that is what she is used to and took out top cover with the insurer. Two years ago next month the benefit of doing that kicked in in a very big way and now I see exactly why. A lifetime of 'perfect' health deceives us into thinking as I did, that nothing can go wrong. Wrong Brian, oh so wrong. But with the fullest possible cover it meant no financial stress finding large amounts of money where a certain amount of private sector treatment helped.

Thanks Heather. I did realise that. I was just trying to out Brian, Brian ;-)

Mutuelles have been covered quite extensively in the past, the problem is that it's not easy to find old threads. Here's a few for starters

http://www.survivefrance.com/forum/topics/mutuelle-must-haves-what-...

http://www.survivefrance.com/forum/topics/so-you-re-still-wondering...

http://www.survivefrance.com/forum/topics/mutuelles

Then for info There's some stuff in the Useful Links page

With two kids, I'm a big fan of them. It's a bit like house insurance, I'm happy to pay and happy never to have to claim but if I do have to claim then it'd better cover everything.

Same with the (compulsory) mortgage payment life insurance, I hope I never have to claim but in the event of the death of either of us, the surviving one will have an easier life with no mortgage to pay.