Mutuelle - I seriously think it is money for old rope as far I am concerned. If I remember correctly the hospital expected that I pay them something like 25 Euros per day, so even if I was in for 10 days it would have been 250 Euros. A lot less than they take annually. The rainy day fund could have coped. Serious hospital treatments are covered by the CV. I am satisfied with NI specs and dental so it really is a question what is the purpose of the Mutuelle? When we arrived in France we were under the impression it was a MUST, not it is a DOUBT. I am sure the salesmen (oops salespersons) out there will say otherwise…
fair enough… you’re giving it some thought and you’ll make your choices.
Indeed, some folk go through life and never have the need for mutuelles…
Should it become necessary, ie if you/your family do run up medical-debts you can’t pay… I think they can be offset against any property you own…
I’ve seen that happen here. The empty house was auctioned to settle years of medical bills, for a chap who died after being in hospital care for a long, long time…
his family couldn’t afford to pay the debts so this was the best way forward
there’s nearly always a way round things…
Might this help settle your fears about health cover?
As for mutuelles it is not correct to say that hospital costs max out at €25 a day! You can end up with huge bills which is why we have a hospital policy. But we don’t have the full mutuelle cover as similar to you decided it wasn’t benefitting us. The other advantage of havimg a hospital policy is that we can increase the cover at a moment’s notice should we need to.
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Indeed, isn’t that only for food? My wife, fully covered by S1 and ALD, still had bills for hospital stays of €10 per day, and lately €20.
The daily hospital fee has just gone up to €20, and even for those covered by ALD any acts carried out by secteur 2 on non-conventioné doctors can be in 4 figures.
So why bother with a Mutuelle if the hospital visit/stay is for ‘standard’ treatment? I am not talking about a long term stay for Dimentia which we already know is ‘specialist’ care.
I am really trying to justify what we gain from paying this money for years and never getting a return and when we do it is less than what we have input.
Also the standard reply at the Pharmacie “not covered by the mutuelle”…
I am also more confused now about my retirement and what will happen to my health CV staus than I was before I asked.
I assume that I should ask CPAM directly about it. Although I prefer to not stir the wasps nest! I am considering just carrying on as being registered as an AE as long as possible and getting my UK and German pensions in tandem.
have you never queried why certain things are not covered at the time ???
I’ve just filled a long prescription after a bad fall… only one item wasn’t covered by my mutuelle and the pharmacist told me and we discussed whether or not I really needed it. it was for an icepack thingy… which she suggested I might already have at home…
anyway, I decided it might be useful so paid the 7 euro…
perhaps your Mutuelle policy needs to be inspected to find out what is and is not covered!!! and adjusted as you think fit.
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It’s in the nature of insurance that most people lose most of the time - because the insurance companies pay for all their admin etc costs - and profits if they’re not mutuals - out of our contributions. But most people take the view that it’s worth paying as - literally - an ‘insurance policy’, should the worst happen - eg. complicated accident injury that is not ALD but nevertheless involves lots of treatment.
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OK as I said these enquiries usually go off topic and what was originally asked. Possibly my fault. This said I still ask.
What actually is a complicated accident that is not covered by the ‘normal’ hospital service and one which requires the Mutuelle (or another third party) to pay instead? What is ALD? Are we talking about a broken leg that will not heal or worse spine or coma? Schumacher type injuries…? Well if these are not covered and no Mutuealle what happens??? The family unless they have the wealth of Schumacher would surely refuse to pay. I also think that such treatments would even bankrupt the Mutuelles and never be sanctioned.
Ah… perhaps we need to find you a link in English.
(the link which jane jones offered does explain things… but is in French)
can anyone give us the translation, please ???
as folk on the forum know… it cost £4,000 to get a Brit back yo uk in a medical ambulance, as the bills were mounting and there was no insurance in place to pay the bills. that was about 2 years ago… after a terrible fall from a height with resulting fractures and injuries… a simple accident !
friends and family clubbed together… to get the lady back to UK for free treatment…
Stella - So this person did not pay for a Mutuelle, can I assume that in this case they would have been covered for treatment at the hospital OR again would it have still been dependant on what cover they had actually signed up for. I rightly/wrongly assume that a standard accident is treated by the French NHS equivalent under normal treatment policies. Was this a ‘special’ case? Was it more related to after care treatment which needed the Mutuelle cover?
Can I assume that this person just chanced their luck and until something went wrong they were happy to stick their head in the sand. When the worst happened they relied on the good nature of others to get them out of the Sh!t. I wonder what they spent the money on instead of paying the Mutuelle…? On top of that they got shipped back to the UK to get ‘free’ treatment (free for them as they did not contribute there either). A burden on the overstretched UK NHS. I would use the words ‘Selfish’ and ‘Parasite’ amongst others.
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it’s totally unfair to assume anything … when you don’t know the facts. I merely offered that case (of which I have full knowledge) to show how the unexpected can seriously turn one’s life upside down… if one does not have mutuelle/insurance cover.
I shall step back and let you make whatever decision you deem fit.
Perhaps it is worth checking your insurance policy, they all differ and even if a tiny bit can change the whole outcome as to whether they will pay or not. As with any insurance, you have to check the policy detail. If in doubt call the insurance provider and ask. You have to ask them as all insurance companies are there to make sure their risks are covered
Two personal examples One of our very good elderly friends went into the local clinic for a routine op to remove a stomach cyst via keyhole surgery Three days later he contracted MRSA and was transferred to the public hospital reanimation ward where he was kept under sedation for the next three weeks as the infection took its toll because the clinic did not have enough beds. I took his wife several times, we had to wear protective clothing it was that bad. Anyhow he did not make it unfortunately due to his age more than anything else. Several weeks after the funeral, his widow received a bill from both the clinic and the hospital amounting to over €40,000 for the costs. They had insurance and were covered by the CPAM and she only ended up paying around €350 but it did show where the costs come in for those not covered. My OH died in hospital and had an ALD exemption for diabetes 2,but he had a major stroke. We had not bothered with a top up insurance for several years as the kids were covered by their uni studies etc and after his death I got a bill totalling thousands of euros for his week’s hospital treatment in reanimation. Luckily though I only paid a few hundred for the daily bed rate as it was deemed covered. What the authorities will do and have done to brits in the past that needed hospital treatment is make them sign cheques running into hundreds/thousands of euros to cover treatment if they are not fully covered. Don’t think it can never happen to you, it can and in a few minutes you could lose everything.
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Thank you for sharing your experiences with us.
take care…
I wasn’t going to write those examples but I think people should realise this is not NHS country and that most people pay in during their working lives so the health system continues to function maybe not for free but certainly not over the top like the US. I am covered by the state due to my circumstances and personal contributions over the years but have been thinking more and more about just a hospital only policy, so will get the info sooner than later. Another point to make is that supposing you are the innocent victim of a bad accident or crime which leaves you needing lifelong treatment. Who will fund that if you have no cover, the carte vitale is only your recognition of being in the social security system,not covered 100% for medical matters.
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Well not sure if I ever do the right thing but I try.
When we came here 15 years ago we insured the car, the property and took out a mutuel.
On arrival in France we had no ailments or problems with our health.
But things changed dramaticly and my surgery and hospital bills must have come to
thousands and thousands.
I am sure that the health cover over and above carte vital was imperative.
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