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Moving to France: L’Assurance Maladie – #4

Moving to France: L’Assurance Maladie
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“While I do what I can to maintain good health, there are inevitably times in which I have needed – and will need – medical care. France has an incredible health system that, while not perfect (what is?), will allow me to receive high quality health care at a much lower cost than I had in the United States.”

L’Assurance Maladie: what is it?

In a nutshell, this is France’s universal health insurance program that covers everyone residing here. The Assurance Maladie is what compensates the healthcare professional for their services.

Who is eligible for l’Assurance Maladie?

“France’s universal healthcare system (PUMa) guarantees coverage of healthcare expenses for all individuals who:

  • are working, or
  • have been residing on a stable and ongoing basis for at least 3 months in France (including Guadeloupe, French Guiana, Martinique, Reunion Island, Saint Barthelemy and Saint Martin) .

Healthcare expenses cover medical and paramedical expenses as well as medications, orthopedic appliances, and hospital costs. Insured persons are entitled to such health benefits both for themselves and for beneficiaries not covered by any social security scheme in their own right. ” as stated on the Cleiss website.

Why is it Important?

A month or so after I arrived in France, I made an appointment with a local general physician to establish myself as a patient. We met for approximately 45 minutes, during which she asked in-depth questions about my health background followed a brief exam. I paid 25 euros for the appointment.

Since that time, I have been back to her office for an eye issue and blood work. I do not yet have my carte Vitale but was able to get an appointment without issue.

Unlike the medical visit, I did not pay for the bloodwork the day the blood is taken, but rather when I picked up the results. (For reference, a full blood workup was about 45 euros.)

The doctor was kind enough to call me personally, from her home, on a Saturday, to discuss the results and treatment plan for my ever-changing thyroid issues. She has left the prescription at the office and I will pick it up to take to my preferred pharmacy. While I do not yet know the cost of the prescription, I do know the majority will be reimbursed:

  • The general rule for medication is that 100 per cent of the cost is reimbursed if the drug is “irreplaceable”, such as drugs to treat diabetes, AIDS, cancer and other chronic diseases.
  • If the medication is determined to be “a major or important medical service”, such as antibiotics, then you get 65 percent back. 
  • Drugs with only “moderate” medical benefits & homeopathic remedies 30% reimbursed. While drugs that have only “low” medical value are reimbursed at 15 percent.
L'Assurance Maladie
Walking in France to stay healthy

What is the Carte Vitale?

“The carte Vitale is a card with an embedded microchip that certifies entitlement to health insurance. It is issued to all persons aged 16 and over and contains all of the administrative information the patient’s health insurance fund needs in order to reimburse their healthcare expenses.

Depending on personal circumstances, it also contains the information needed to use the third-party payment system (meaning that the patient does not pay amounts upfront that will later be reimbursed either by the health insurance system or by his/her supplementary insurance, which kicks in once the patient has been reimbursed by the national system.”

Once I was in France for three consecutive months, I was eligible for the carte Vitale.

I began the process of getting my health insurance card in February, 2022.

As of April, it is still in progress. The process can take several months to complete therefore I have kept the health insurance policy that I purchased when applying for my visa. The carte Vitale contains a great deal of information about the holder, but interestingly no medical information.

Once I have the carte Vitale, it will be necessary to keep the card with me and take to any medical appointments.

My experience with l’Assurance Maladie paperwork

When I registered with Unions de Recouvrement des Cotisations de Sécurité Sociale et d’Allocations Familiales (URSSAF), my information was forwarded directly to my departmental l’Assurance Maladie office. Just over three months after I declared my business, I received a letter stating that I needed to provide the following for my file:

  • A copy of my passport
  • My visa
  • Birth certificate
  • My bank account number (for future reimbursements)

I went to the local post office to make copies of the requested documents and paid a little more to have
tracking and extra peace of mind. Some weeks later, I received a second letter requesting additional
information. This time, I needed to submit:

  • L’Office français de l’immigration et de l’intégration (OFII) validation page PDF
  • Marriage license and divorce decree
  • Copy of my passport (note: have several of these on hand)
  • Copy of my visa (ditto)

Most recently, I received a letter requesting that I provide the following:

  • Photo (with specific dimensions and requirements)
  • Piece of identification (copy of passport … again)

I also received a letter indicating that I am eligible to log in to the French healthcare network but when I attempted to do so, I was not able to access it. With the last paperwork I submitted, a friend wrote a note asking what I should do in order to gain access.

Moving to France: L’Assurance Maladie

Reflection

Having lived permanently in France for a little over 5 months, I already appreciate the ease in which to get in for a general medical appointment. I understand that to get into a specialist, such as a dermatologist, the wait time is significantly longer.

Like everything, there are pros and cons.

From my end, I am thankful that residents are able to seek medical help regardless of their age or current economic status. Coming from the United States where insurance costs are prohibitive to many, and one visit to the Emergency Room can be catastrophic financially, I feel blessed to be living in a country in which that would not be the case.

I am proud and happy to contribute to this system, working hard and doing what I can to support my fellow residents.

4 key TIPS for moving and living in France

  • Keep a paper copy of every document that comes in the mail. Electronic copies are good to have for backup purposes, but one needs originals to show at appointments.
  • Checking and double checking that all requested documents have been submitted and understand that even if they have been submitted, they may be requested again.
  • Keep any and all medical and pharmaceutical receipts. In my case, I will be reimbursed from the day that my Auto Entrepreneur status started.
  • Keep practicing/improving French skills. It is not easy, but it is 100% necessary. Everytime I meet with a banker, a medical professional, the veterinarian, etc. I remind myself that I chose to live in France and need to improve to integrate.

I hope that this is helpful information please save it for future reference – To be continued … Be sure not to miss my moving to France story which will continue in episode #5 coming soon.


Where to go for additional information?

  1. Helpful information on French healthcare
  2. Health insurance in France explained
  3. Source for above information: Ameli
  4. Source for above The French Social Security System information
  5. Source for the above Reimbursement information
  6. Sources for the above Carte Vitale information

Follow this mini-series Moving to France
1. Taking the plunge #1
2. The first month #2
3. Buying a car #3
4. L’Assurance Maladie #4

 



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