Type of mutuelle query (I don't have one yet)

Health Care & Carte Vitale
1

Β·
Hi all,

Up until now I have not had a mutuelle as I rarely need to see a doctor.

I am now looking at taking out a mutuelle and have approached an insurance company (FAB) for quotes. I got an email back asking
π·π‘œ π‘¦π‘œπ‘’ 𝑛𝑒𝑒𝑑 π‘Ž β„Žπ‘–π‘”β„Ž π‘π‘œπ‘£π‘’π‘Ÿ π‘œπ‘› 𝑠𝑝𝑒𝑐𝑖𝑓𝑖𝑐 𝑑𝑦𝑝𝑒𝑠 π‘œπ‘“ π‘šπ‘’π‘‘π‘–π‘π‘Žπ‘™ 𝑒π‘₯𝑝𝑒𝑛𝑠𝑒𝑠 : π»π‘œπ‘ π‘π‘–π‘‘π‘Žπ‘™π‘–π‘ π‘Žπ‘‘π‘–π‘œπ‘›, πΆπ‘œπ‘›π‘ π‘’π‘™π‘‘π‘Žπ‘‘π‘–π‘œπ‘›π‘ , 𝑑𝑒𝑠𝑑𝑠, π‘‘π‘’π‘›π‘‘π‘Žπ‘™? (π‘“π‘œπ‘Ÿ 𝑒π‘₯π‘Žπ‘šπ‘π‘™π‘’ π‘π‘’π‘Ÿπ‘‘π‘Žπ‘–π‘› π‘β„Žπ‘Ÿπ‘œπ‘›π‘–π‘ π‘π‘œπ‘›π‘‘π‘–π‘‘π‘–π‘œπ‘›π‘  π‘šπ‘Žπ‘¦ π‘Ÿπ‘’π‘žπ‘’π‘–π‘Ÿπ‘’ π‘“π‘œπ‘™π‘™π‘œπ‘€ 𝑒𝑝 π‘ π‘π‘’π‘π‘–π‘Žπ‘™π‘–π‘ π‘‘π‘ β€™ π‘π‘œπ‘›π‘ π‘’π‘™π‘‘π‘Žπ‘‘π‘–π‘œπ‘›π‘  π‘Žπ‘›π‘‘ 𝑑𝑒𝑠𝑑𝑠 π‘œπ‘› π‘Ž π‘Ÿπ‘’π‘”π‘’π‘™π‘Žπ‘Ÿ π‘π‘Žπ‘ π‘–π‘ )

I am not sure how to respond as the situation I am in is:
1. I see a doctor only once a year for hypothyroidism, and have a blood test.
2. This is the first time I’ve seen a specialist - a gynaecologist (π‘€β„Žπ‘–π‘β„Ž 𝑀𝑒 π‘π‘œπ‘£π‘’π‘Ÿπ‘’π‘‘ π‘Žπ‘‘ π‘œπ‘’π‘Ÿ π‘œπ‘€π‘› 𝑒π‘₯𝑝𝑒𝑛𝑠𝑒, π‘Žπ‘›π‘‘ 𝐼 𝑏𝑒𝑙𝑖𝑒𝑣𝑒 β„Žπ‘’ 𝑖𝑠 π‘Ž 𝑙𝑒𝑣𝑒𝑙 2 -?- π‘ π‘π‘’π‘π‘–π‘Žπ‘™π‘–π‘ π‘‘) after having pain in an ovary.
3. He has advised me that I need to have a hysterectomy after seeing the results of an ultrasound scan (π‘Žπ‘”π‘Žπ‘–π‘› π‘‘β„Žπ‘–π‘  π‘€π‘Žπ‘  π‘Žπ‘‘ π‘œπ‘’π‘Ÿ π‘œπ‘€π‘› 𝑒π‘₯𝑝𝑒𝑛𝑠𝑒) of my abdomen which revealed a fibroid.

What cover would you suggest in this case (high or low cover)?
(π‘Žπ‘  𝐼 π‘ π‘Žπ‘¦, 𝐼 𝑠𝑒𝑒 π‘Ž π‘‘π‘œπ‘π‘‘π‘œπ‘Ÿ π‘œπ‘›π‘π‘’ π‘Ž π‘¦π‘’π‘Žπ‘Ÿ π‘Žπ‘›π‘‘ π‘‘β„Žπ‘–π‘  𝑖𝑠 π‘‘β„Žπ‘’ π‘“π‘–π‘Ÿπ‘ π‘‘ π‘‘π‘–π‘šπ‘’ 𝐼 β„Žπ‘Žπ‘£π‘’ 𝑠𝑒𝑒𝑛 π‘Ž π‘ π‘π‘’π‘π‘–π‘Žπ‘™π‘–π‘ π‘‘ π‘Žπ‘›π‘‘ 𝑀𝑖𝑙𝑙 𝑛𝑒𝑒𝑑 π‘ π‘’π‘Ÿπ‘”π‘’π‘Ÿπ‘¦ π‘Žπ‘›π‘‘ 𝐼 π‘‘π‘œπ‘›β€™π‘‘ π‘“π‘œπ‘Ÿπ‘’π‘ π‘’π‘’ π‘Žπ‘›π‘¦ π‘“π‘’π‘Ÿπ‘‘β„Žπ‘’π‘Ÿ π‘ π‘’π‘Ÿπ‘”π‘’π‘Ÿπ‘¦ π‘Žπ‘“π‘‘π‘’π‘Ÿ π‘‘β„Žπ‘Žπ‘‘)

Thanks for your thoughts.

2

I would explain all of the above to your broker. That’s what they’re for. They’ll explain the advantages and disadvantages of different policies, and give you details of what’s included - and at what rate. Ask them for multiple quotes so you can compare.

For now, I’d personally be focusing less on things like dental cover or hearing aids, and instead making sure the hospital cover is as comprehensive as it can be. I’d hate, for example, to find out my cover didn’t include a single room… I hate sharing at the best of times, but definitely not after surgery.

As well as β€œhospitalisation”, I’d also look for decent coverage for β€œsoins courants”.

I’m with these guys (via my work), they explain what each section on the quote means in this article…

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Before going into complexities of mutuelles are you convinced by the explanation of why a fibroid/fibroids needs a hysterectomy rather than simple excision?

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Private health cover (for that is what a mutual is) is a quagmire. Some people go for minimum top up insurance, some go for maximum. Between those two extremes one can choose different levels for different disciplines, medical, teeth, eyes, ears, etc. all with subsections and different reimbursement levels. Plus the comparison between providers is as complicated and difficult as are their offerings. Therefore I recommend getting a professional’s advice and @fabien is a good, independent and trustworthy port of call (I’m a client too).

You need to look at the different offerings and decide what you want. I guess it’s all down to risk tolerance and affordability.

However in your case now, I think pre existing conditions may be the most important factor. Since you have not been contributing to a Mutuel I doubt (happy to be corrected) that they would cover a pre existing condition immediately.

Otherwise why would anybody have mutuel until they needed it? The whole point is that our collective contributions over time help those who need it - hence mutuel.

It would be like being able to take out car insurance after you’ve had a crash.

There’s probably a waiting period before you can claim for pre existing conditions so I would urge haste on you part to decide.

Good luck with your surgery and best wishes for a speedy recovery :slightly_smiling_face:

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Ohhh, we move on from insurance to medical advice :scream: My daughter wouldn’t approve.

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With the more expensive range of coverage I think that it’s a good idea to identify what the actual benefit is.
For example, my mutuelle cost would increase by €50 a month (€600 a year) to cover spectacles which I can buy for substantially less than that at the optician’s shop. So I don’t bother with that particular coverage.
I find that my basic policy works just fine and covers most day to day stuff at an acceptable level.
Also, don’t forget that if you were to become seriously long term unwell, then it may well be that the ALD system would kick in so that you have 100% coverage from the Assurance Maladie without having to resort to calling upon the Mutuelle.

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7

Good advice. My wife and I are probably making the glasses mistake. We buy them in Specsavers anyway :face_with_hand_over_mouth:

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Actually John I’m pretty sure I’ve seen on here that specific pre existing conditions are not taken into account. Mutelles being the private-ish part ofvthe blended public/private system but still to a large extent very tightly circumscribed by the French Health Dept.

So unlike the more standalone private health coverage policies we recall from UK/US, I am absolutely certain there’s been a comment on here that some people do indeed take a mutielle when they discover they need coverage for something specific that has come up. One was @JaneJones , she’s a bit busy right now I believe so unsure how soon she would see this.

The waiting period - from a Que Choisir report ISTR reading about 3 years ago - may occur on newly taken out mutuelles but not specifically due to pre-existing. Though I had the strong impression from the report it was a lot more likely to be a standard part of policy terms for seniors. So there may be an underlying link statistically in that they expect more claims.

Speculating, it may also be that the French Health Dept has told mutuelles to cover people in workers’ mutielle schemes immediately, to keep people working. Or large employers mght demand that for their employees. Leaving not many in the population out (by the time young families are covered ehich would also be a priority I would guess), except the very old :slight_smile: So non-working seniors have no one to tell the mutielles not to mpose a waiting period. So they do. Que Choisir noted a worsening trend in the number of mutielles imposing them.

So I wouldn’t worry about pre existing as an issue I’m pretty sure it’s age and gender mostly and then some other non- personal demographic factors like in which Departement you live, that drive price smd to an extent, conditions.

I agree with John best to get stuck in and sort something because I’d be surprisef if you find a policy that doesn’t have a waiting period - but not driven by pre-existing.

I’ll welcome it if someone comes and corrects me and also recommend Fabien, hopefully he can give you some options between different providers. Reports are that unlike some other brokers he is around to help if needed after you’ve been sold the policy and for insurance of any type Fabien would be my first call.

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I found Fabian and co very helpful in searching insurance cover but on all my policies they were unable to better them by a country mile. I was told that it was because I had been with my current insurers for many years so got excellent ratesπŸ€”
Perhaps will try them again when next renewal due.

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Just on the single hospital room point, neither I nor my wife have ever been in a French hospital without having a single room. I have no idea if this is unusual but I have never wittingly applied for such cover.

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That is NOT medical advice, merely life experience from someone who used to have fibroids.

Mutuelles are contrats solidaire which are tightly regulated and don’t exclude pre-existing conditions. I presume that the policies sold by profit making insurance companies, rather than classic mutuelle companies, are similar.

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All I can suggest is our experience. We didn’t have a mutuelle for many years as the figures didn’t stack up - it would have cost us more than we got back as we are basically healthy people (apart from my ALD). However, time changes things and after exploring the high and low options we have opted for a hospital only policy that only pays for treatment in hospital (including ambulatoire). It doesn’t include consultations and investigative tests/imaging.

That works for us, and having unexpectedly had 7 hospitalisations in last 9 months between us has proven to be a good decision. The amount we have had to pay for the non-hospital elements remains less than the cost of a higher level mutuelle.

But you need to do your own sums and consider your own appetite for risk, and ability to summon up extra cash if needed.

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Thank you so much for your continued trust and support John, I really appreciate this and feel lucky to have you as a client :pray:

And yes, of course, Fab French Insurance is the place to go for all things insurance and you have no excuse as we have both a Biritsh, an American and a French insurance advisor so whatever your preference we got you :joy:

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I am delighted to hear it Jane. Lolly needs all the support she can muster.

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That wasn’t my question.

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I know, but having been through operations for fibroids here in France I just thought I’d check.

I replied on the actual question later on, and with a hystΓ©rectomie costing around €10,000 a hospital policy as a minimum would be sensible. You can increase or decrease cover each year.

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Up until now, it hasn’t been worth my while taking out a mutuelle as I’m relatively healthy, and seeing a doc once a year for a thyroid blood test is far lower than a monthly premium :slight_smile: I’m hoping the hysterectomy is the first and last thing that I need for a long time to come. So probably a low cover mutuelle?

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Thanks Jane. By the time he’s taken out the bulky fibroid and it’s extension into my abdomen, there wouldn’t be much uterus left - I’m a very petite woman. :no_mouth:

Thanks for the information you gave earlier, and a hospital policy as a minimum.

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That was not the question so not helpfull at all. If you are happy doubting the reasons for doctors advice, that is up to you, good luck, and you are going to need it.

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I am.

I wrote a post called β€œshould I complain” last month about a botched diagnosis. Finally got the doctor to say they made a mistake.

Doctors are not gods, they make mistakes like anyone else, and to me it is right to question them - politely of course.

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