S1 form, residency and health insurance

I understood that long term illnesses were covered 100% by our carte vitale. Is that correct? And if so, what constitutes a long term illness? Cancer? Heart disease? Diabetes?
If this is the case, it further questions the need for additional levels of mutuelle other than the basic costs of hospitalisation which is where the expense is as others have said.

When I went to see a different doctor as an urgent case, she was horrified to see that my MT had not put me down ALD for my asthma.

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There are 30 diseases that count as affections longue durée. Your doctor has to submit a form to the health authority for your application be approved. Diabetes Type 1, severe heart disease etc etc, the list is on the Ameli website.

And yes you have 100% cover but only up to the social security base de remboursement. And several items cost more (like my specialists who are all secteur 2). They have cracked down on ALDs lately, so high blood pressure no longer included.

Here’s list. https://www.ameli.fr/jura/medecin/exercice-liberal/presciption-prise-charge/situation-patient-ald-affection-longue-duree/definition-ald

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Interesting as this ties in with what the private ORL surgeon in Perigueux said.

So what would you have paid out over the year if you’d just paid the difference? So what did you get back from the mutuelle?

I agree - I’m a bit confused how a private hospital only cost me €18 / day when I was paying out and how that adds up with needing a mutuelle costing heaps to cover that??? As someone else said ADLs are 100% covered by secu so what actually does the mutuelle cover than could cost loads???

Yes, all three of those are covered.

  • accident vasculaire cĂ©rĂ©bral invalidant ;
  • insuffisances mĂ©dullaires et autres cytopĂ©nies chroniques ;
  • artĂ©riopathies chroniques avec manifestations ischĂ©miques ;
  • bilharziose compliquĂ©e ;
  • insuffisance cardiaque grave, troubles du rythme graves, cardiopathies valvulaires graves, cardiopathies congĂ©nitales graves ;
  • maladies chroniques actives du foie et cirrhoses ;
  • primitif grave nĂ©cessitant un traitement prolongĂ©, infection par le virus de l’immuno-dĂ©ficience humaine (VIH) ;
  • diabĂšte de type 1 et diabĂšte de type 2 ;
  • formes graves des affections neurologiques et musculaires (dont myopathie), Ă©pilepsie grave ;
  • hĂ©moglobinopathies, hĂ©molyses, chroniques constitutionnelles et acquises sĂ©vĂšres ;
  • hĂ©mophilies et affections constitutionnelles de l’hĂ©mostase graves ;
  • maladie coronaire ;
  • insuffisance respiratoire chronique grave ;
  • maladie d’Alzheimer et autres dĂ©mences ;
  • maladie de Parkinson ;
  • maladies mĂ©taboliques hĂ©rĂ©ditaires nĂ©cessitant un traitement prolongĂ© spĂ©cialisĂ© ;
  • mucoviscidose ;
  • nĂ©phropathie chronique grave et syndrome nĂ©phrotique primitif ;
  • paraplĂ©gie ;
  • vascularites, lupus Ă©rythĂ©mateux systĂ©mique, sclĂ©rodermie systĂ©mique ;
  • rhumatoĂŻde Ă©volutive ;
  • affections psychiatriques de longue durĂ©e ;
  • rectocolite hĂ©morragique et maladie de Crohn Ă©volutives ;
  • sclĂ©rose en plaques ;
  • scoliose
  • structurale Ă©volutive ;
  • spondylarthrite grave ;
  • suites de transplantation d’organe ;
  • tuberculose active, lĂšpre ;
    , affection maligne du tissu lymphatique ou hématopoïétique.
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When I was wrongly diagnosed with cancer here, we didn’t have to pay for anything, even though I was hospitalised and had a lung puncture.
I also spent two weeks in hospital with pancreatitis and then having my gall bladder removed.
Another night in hospital in Lyon for another procedure to check that I didn’t have cancer around the bile duct into my stomach, as that was too cloudy to see properly the first time round.
I would not like to have paid for all the treatments out of my own pocket.

If you go to a public hospital using secteur 1 doctors you will just be charged the daily hospital fee (now 20€). However if you need, say, a specialist spine or heart operation you may want to go to a specialist clinic with highly qualified specialists. This can cost a huge amount, figures way over 10,000 are not unusual. Which is why we have hospital cover.

With a 150% mutuelle you will get a bit back, but even with 300% cover it can still cost you

Cancer treatments are always free.

No of course not but how much was covered by the secu v mutuelle?

Aahhhh OK, thanks for the explanation Jane. Once my finances improve (please!!) and I no longer have CSS I’ll definitely look at hospital cover.

Ho John or anyone, which Mutuelles accept attestations as proof of being in the system?

Threads have been really useful thanks all!

All mutuelles, an attestation is just that :wink:

Mine’s MAAF.

S1 is still sufficient to get you into the French system and thus a Carte Vitale.

With a Carte Vitale you have proof of cover .

I recently reached UK retirement age, having lived in France for 20 plus years) and the UK provided me with an S1.

I sent my S1 to the local CPAM and they flipped my existing Carte Vitale (I was an “ayant droit” on my wife’s Carte Vitale) to the S1. All done on-line and quite painlessly.

If you are coming to live in France permanently you don’t have to wait, you can apply immediately. Broadly speaking a EHIC is only valid for temporary stays in an EU state and the future of the EHIC is very doubtful because of Brexit.

just the ride home to 33890 from Bordeaux teaching hospitals was approx 500 euros.

Every thing you do has to backed up with paperwork and you must think clearly, Getting older is not for the weak or fain hearted,

We cross referenced everything when we applied for our C de S, but the same principle applies.