Warning if you think you are completely covered in France

As many here know my wife Fran went into a care home for a week’s respite back in June while I, after much toing and froing on the decision, went to England for a reunion.

With the help of Gill one of our health carers, I filled in an extensive form one of the questions on which was ‘who pays?’ We put down APA, the organisation which supplies some of our health visitors and which charges us around €70 a month but, which always comes back in the form of a reimbursement from the Departement, in the form of APA.

When I took her in I was required to sign multiple forms one of which contained our bank account number. I asked if there was anything for us to pay and was told ‘no’.
The same question and answer when I collected her 8 days later.

When I got her home I was very concerned for her health, I began to get an inkling that became a conviction that she had spent most of her time in bed, or at least in a wheelchair because she had totally lost the ability to walk with assistance, as she had been able to before. So the Pompiers came and whisked her off to hospital where she spent the next 9 days, very definitely all in bed.

Ever since she came back she has been in bed and only now, today, 6 weeks or so later have we, the aide and I gingerly got her upright to sit on the edge of the bed for her wash and to see if she can stand. She can, just about and we will attempt to walk her a very short distance tomorrow.

But, all that aside, on the 20th of July we got a bill which I thought was from the hospital because it mentioned Perigueux Hospitals at the top, for €538.86. The very kind and concerned Karine at the pharmacy was outraged by this and had a long conversation on the telephone the result of which was that we had failed to notice the panel further down the document which said Nontron. The hospital was free (a surprise because in the past we had paid a small ‘journalier’ charge for stays) and this charge was for the care home at Nontron. Furthermore it was taken directly from our account.

That was that we thought, until a month later, on the 21st of August, another bill for the same thing for €153.96. Again taken out of the account, the total of which was now €538.86.

Not at all pleased but then I accepted it as I thought a distinction was made between health charges, for which Fran should be covered by both ALD and her S1, and what was in effect simply a one week ‘holiday’ in a care home.

Imagine my horror this morning when I opened yet another bill, this time referring to the hospital stay, for €600. In fact the 9 day stay cost €10,117.71 of which our contribution, so far unpaid, was the €600 and must be paid immediately.

So, a total of € 1,138.86 for a person who is not supposed to pay anything, which is the reason why she does not need a mutuelle. In fact, the cost of a mutuelle for everything for the whole year would not have come to much more than that.

The next step, a discussion with Gill this evening, another with Karine tomorrow, and then I suspect a third with the Assistante Sociales the next time they come around.

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I hope you get this sorted out quickly.
Perhaps they have not taken into account the ALD?

Thank you Jane, yes, I wondered that too, but I am also thinking, will we expect a further charge another month down the line?
What a terrible decision we made back in June, the various reunions were nice, but was it worth it? Definitely not, and won’t be doing it again.

This is certainly an area which needs clarification… as too many folk don’t realize the full implications…

OH has an ALD… which (on the face of it) means everything is covered… only it certainly isn’t… not everything.

Thankfully we do have a Mutuelle (cheers Fabien…) :+1:

this general link explains some of the figures/expenses…

ALD : faut-il une mutuelle pour une Affection Longue Durée ?.

It’s certainly an issue in the UK - needing care because of dementia is not covered by the NHS, the logic is exactly as above - i.e that only board and lodging is involved and not “medical” care.

the fact that the board and lodging probably would not be needed were it not for a medical condition seems to escape the authorities.

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I do know that our Asst Sociale will pull out all the stops to help folk who find themselves in expensive hospital/aftercare situations and who have no Mutuelle… and I’m talking about locals not Brits…

Medical Care is never withheld…
and there is every opportunity for folk to take out Mutuelle cover. If personal funds are low, help is at hand… even free Mutuelle… so there really is no need for folk to worry… they simply need to get themselves organized…

There are so many people with this condition that they cannot cover it, so they ignore all the problems it causes for the sufferers and their families.

The ALD should cover everything associated with that condition, but it is qualified, My ALD covers all the things listed in the protocol de soins that my MT submitted (thankfully quite a lot ). Anything outside that doesn’t get covered 100%, but a lower level or just at standard rates,

So question 1 is whether her stay in the care home was registered as ALD, and

Question 2 us whether the specific protocol for her includes this as a legitimate item.

And question 3 , why not!

Would the SSIAD Aides Soigantes, who organised it with the care home have knowledge of her ALD (pretty sure they would have because there is no charge for their services) and have passed that information on I wonder?

She has certainly been in that hospital as an in patient twice before and all we have ever had to pay is the daily ‘journalier’ charge which on those occasions has been €10 and €20 so might be as much as €40 or €50 today, but I wouldn’t have thought as much as the €66.66/day being demanded here. In any case I don’t think that what is demanded here is a journalier charge. The total cost of €1,124.19/day seems to indicate that this is a separate charge for treatment, rather than ‘living expenses’. But their records should certainly know that she is ALD.

Although I can’t prove anything, to my mind whatever went on in that care home is at the root of what followed. She certainly came out worse than she went in.

On a bright note, over the last week or so efforts have been in place to get Fran out of bed and habituated where she used to be, walking with assistance to the bathroom and back and living in the kitchen day to day.

For a week now the aides soignantes of SSIAD have been coming in a little earlier to do the necessary washing etc. but then to get her out of bed and into the new reclining chair in the kitchen.

Just for an hour or so while they go away to do their next customer, but returning then to put her back in bed.

Tomorrow is another step forward in this rehabillitation. Instead of coming back after an hour she will remain in the chair until the scheduled evening visits around 5pm.

At the same time, as she has got over her long struggle with diaorrhea, she has been taking more solid food, finely mashed (they still have not replaced her teeth, I gave up on that some time ago but will start pressing them again from next week) and feeding herself from the bed tray which has had several lives in the past, justification for me never throwing anything which might be useful away, bath tray and laptop tray amongst them…

As a new wheeled walker arrived at the same time as the new chair, neither of which have been used till now, I can see the time when she might be able to do more for herself given the hoped for increase in muscle with the extra and more varied food intake.

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I hope I am not intruding when I say I have followed your journey with your dear Fran in the thread on this forum, with admiration of your efforts and your grit. Nice to hear some good news. Very best wishes.

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Thank you Mike, very kind, though I think my last post should have been in the other thread really but no matter, everybody who is interested has seen it nevertheless.

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