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Paying for hospital care

Posted by chanel-641946 - Created: 3 years ago
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10 replies (Showing replies: 1 to 10)

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Posted by LeParigot - 3 years ago

I am sending you a P. M ,  chanel

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Posted by chanel-641946 - 3 years ago

Thanks Parigot.  I haven't heard of an Assistante Sociale either, is she based in the actual hospital and do you speak really good French?  I try very hard with my French but I'm not speaking to anyone French on a social basis so it's never going to be that great.  Does the Assistante Sociale speak English usually do you know? 

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Posted by LeParigot - 3 years ago

Hi
I have been in that situation not long ago where I had to stay 5 days in hospital. I didn't have
a mutuelle and I panicked when I saw the daily price of the hospital on the door of the room. I asked to see the assistante sociale in the hospital
and she managed to give me a mutuelle phone number but she came only the third day, I called straight away and I was very lucky, I could subscribe even in the hospital.
As said before, C.P.A.M. pays 80 per cent. I have received the hospital bill 3 weeks later for the
2 days before I signed the mutuelle which was a lot of money. You really need to think about having a mutuelle.
Email me if you need more details.

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Posted by chanel-641946 - 3 years ago

Thank you Kanak for explaining the CPAM Charges etc.  I think we've got a bit more idea of what to expect now.  It's all been a bit daunting!

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Posted by chanel-641946 - 3 years ago

Thank you very much Janes.  I think what was worrying me slightly is if they just took the money straight out of our account but it sounds as if they always send you a bill and then you pay it, which we would prefer.  They didn't ask us to pay at the hospital so we just assume they will send us a bill.  All the information you gave us is really useful and we are very grateful.

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Posted by chanel-641946 - 3 years ago

Thank you Country Dweller for your help.  All duly noted. Thanks again.

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Posted by Kanak - 3 years ago

Hi Chanel,  sorry about your difficulties... the french system of reimbursement is confusing.. every acte has a 'tarif' or notional price against which the % is calculated, which will appear alongside  the dates on your account. Janes is right in that the hospital are the people to ask, because your husband's overnight stay could fall into the 100% reimbursed category, and here is not the place to discuss your case.  But without a mutuelle, any dépassement (french hospital doctors can sometimes charge more than the standard tarif), plus the 18euro food contribution will be payable anyway.  They are supposed to inform you by letter within 7 days, and not later than a month, of any charges due. Then you can think about a mutuelle, full, or a 'hospitalisation' only policy.

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Posted by janes-394036 - 3 years ago

Hi Chanel

The state pays 80% of your hospitalisation unless you are hopitalised because of an illness for which you receive 100% reimbursement such as cancer or  a heart condition. They will also reimburse all your hospitalisation 100% if you receive an 'acte medicale' that  costs more than 120 euros such as a general anaesthetic, which is why most operations are reimbursed 100%.

Before taking out a mutuelle in a panic, I would suggest you go back to the hospital and ask them how much your bill is going to be. They are normally very helpful and as they have a fixed tarif for most things, they should be able to give you a clear idea of the eventual costs. I am a little surprised that they didn't make you pay before you left the hospital which they would normally. Maybe you are covered 100%?

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Posted by janes-394036 - 3 years ago

Hi Chanel

The state pays 80% of your hospitalisation unless you are hopitalised because of an illness for which you receive 100% reimbursement such as cancer or  a heart condition. They will also reimburse all your hospitalisation 100% if you receive an 'acte medicale' that  costs more than 120 euros such as a general anaesthetic, which is why most operations are reimbursed 100%.

Before taking out a mutuelle in a panic, I would suggest you go back to the hospital and ask them how much your bill is going to be. They are normally very helpful and as they have a fixed tarif for most things, they should be able to give you a clear idea of the eventual costs. I am a little surprised that they didn't make you pay before you left the hospital which they would normally. Maybe you are covered 100%?

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Posted by countrydweller - 3 years ago

Basically CPAM pays approx 70% of the cost of hospitalisation medical care prescriptions GPs etc.There are times when CPAM pays for all of it eg long term chronic condtions and long term medication A mutuelle top up insurance will then pay the rest depending on what type of policy and the scope of coverage Why do  you not  have a mutuelle?  You will have to make up the difference between what CPAM pays and what the hospital/pharmacist/GP charges.Yu will probably get a large bill from the hospital for intensive care.I suggest YOU GET A MUTUELLE ASAP especially as your husband will have more medical treatment to come.They will not want to know about previous medical history.If you cannot afford one then you can help with payments or even a free mutuelle from CPAM if your income is low enough

In respect of prescriptions you are paying the chemist the difference between what CPAM pays and the cost of the drug.If you had a mutuelle you would not pay the chemist anything.BUT GET A MUTUELLE NOW