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Seeking objective info on Mutelles

Posted by Sevendaver-252003 - Created: 5 years ago
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10 replies (Showing replies: 1 to 10)

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Posted by house for rent-318030 - 5 years ago

My husband had an AVC last year, taken to hospital by helicopter and stayed there for a week, mutuelle paid out over €3000, thank goodness we had the it. You have to know that the social security will pay out 100% if you have an operation over quotation 50, it's mainly if you go to hospital for medical reasons that the social security only pay out 70% and a day in hospital cost over €200 if not more. Mutuelle is important for these reasons but know that you often pay more than what you get out of it. 

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Posted by crumblies - 5 years ago

I am curious to know why your 'insurance person in Paris' can't help you, and why you are asking us. Maybe he/she doesn't do health.

There is a question similar to yours in the Health, Fitness and Beauty discussion. You may find additional suggestions there.

Mrs C 

 

 

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Posted by Sevendaver-252003 - 5 years ago

Forums such as Ango Info were created so that people can share informationa and experiences.  I appreciate all of the comments, suggestions and diversity of thought on this very important topic.  I have been doing other research while waiting for the wisdom to pour in.  Check it  out, 3 pages of comments ranging from real life examples of serious injury to no Mutuelle at all.  My insurance person in Paris explained to me that most French people have Mutuelles however English people are less like to buy a Mutuelle.  English people buy less cover and have fewer medical appointments.  This is good info.

 

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Posted by Squeaky-882728 - 5 years ago

jules_d - did you ask the glasses shop to show you the stand of reimbursable glasses? These are widely available and are reimbursed by the CPAM in accordance with the tarrif on their website and there are some stylish ones.  Very practical for children who need them changing them regularly.

Sevendaver - "And finally can someone give me a specific example of a situation where owning a Mutuelle paid off.  What was the nature of the claim, what was the base charge payable by CPAM and how much did the Mutuelle pay."

Why don't you do your own research across all the other forums as you are clearly not happy with the advice you're receiving on here, from those of us who've lived here a long time and know what it's like to have accidents and require payment from a mutuelle.  There are loads of examples across various ex-pat forums where you can find out how much various operations cost, what the CPAM reimburse and what the shortfall is.  Bearing in mind the thousands of possible unexpected treatment plans and operations, do you really think we can come up with a list for all the costs implicated??

OK, for starters, collarbone smashed, operation needed. CPAM paid 70% of 10k, mutuelle paid 3.3k.  Broken arm, operation requiring plate and restructure. CPAM paid 70% of 13k, mutuelle paid the remainder.  Hospital stay following serious car accident. Various stitches, broken leg, torn shoulder. Week in hospital. 15000 euros, mutuelle paid 5k.

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Posted by jules_d - 5 years ago

hi I have to agree with N.  I have 4 young kids who are fortunately heathly.  We've been here 4 years and decided to effectively self insure.  A basic insurance would have been around 2.5k per year and we certainly have not spent 10k so far.  Even when we've had a hospital visit it was pretty cheap (in the low hundreds).   I looked again recently (the children are getting to the age of orthodontics) and unless you are on a really top mutuelle you don't get enough repaid to make it worthwhile.

I find glasses are the only rip off - our local glasses shop wanted over 200 euros for a pair of kids glasses.  I now buy online from the uk/states - about 20 euros a pair...

J

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Posted by Sevendaver-252003 - 5 years ago

And finally can someone give me a specific example of a situation where owning a Mutuelle paid off.  What was the nature of the claim, what was the base charge payable by CPAM and how much did the Mutuelle pay. 

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Posted by Squeaky-882728 - 5 years ago

Here, here, LB!

nissalabella - your doctor clearly had the financial means to pay for any unexpected medical bills and maybe you do too. I don't, which is why I simply couldn't risk being not covered - fully - for myself and my son. That's the way to weigh it up.

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Posted by laughingboy-409220 - 5 years ago

Sevendaver - I think what most people are trying to say to you, in the nicest possible way, is that we're not experts and we don't feel it's appropriate to advise someone else on such an important and personal issue. All we did is, we read lots of infomation on google, we picked out the bits that  seemed relevant to our own particular circumstances, and then we took what seemed the best decision for us. There doesn't seem much point in us trying to remember all the info we found out and repeating it in this thread - no doubt with a few inaccuracies where we can't quite remember, or maybe we misunderstood it in the first place - when you can easily google exactly the same information yourself and read it all first hand. If you want expert advice beyond what google throws up, you need to talk to the professionals. And then - please come back and tell us all what you've found out :)

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Posted by Sevendaver-252003 - 5 years ago

Thank you for that Nissa.  In my past professional life I learned to ask a lot of questions and get a lot of answers before making decisions that would effect the lives of others (and help me live with my more difficult cases).  If I did all of the research myself or did not defer to the process of discovery by asking those who know more than me I would be destined to a life of drudgery and costly mistakes.  Thanks to everyone including the less than complimentary responses.

Please keep the responses coming but there really is no need for bitterness.

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Posted by nissalabella - 5 years ago

Hi Sevendaver,  you may have reasons to disagree with what I'm going to suggest, but, after some calculations and comparisons etc,  pros and cons, what we spend, what is refund, different premiums, we decided, some years ago, to opt out of a mutuelle and, so far, we have found it was the best decision.

In case you have a major health problem in France, or in case of a recognised long sickness requiring medicines, heavy treatments - dialysis, heart surgery, etc - national french health system will pay 100% of your spending.  More and more medicines, X-rays, oncology treatment, etc, and, of course, optical and glasses spending are on a reduced refund by both SS and mutuelles, whatever they can advertise on tele..

A lot of people will probably disagree with us, but I can guarantee that we've drastically reduced our medical spendings by just not having a mutuelle.  In fact, it was after talking with a doctor - married with 3 young children - that we become convinced that he was right and decided to get rid of our mutuelle. 

I can understand if people disagree,

Hope this helps,

N.