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Discussion Starter · #1 ·
Unfortunately, I injured my back pretty severely and after waiting a week to see if the pain would get better, my partner and I have decided I need to see a doctor. I'm in France on a long stay visitor visa, and while I have health insurance in the US (Blue Cross Blue Shield PPO), I don't have health insurance here other than for emergencies (which in hindsight, I probably should have gone to the ER when I fell last week so the bill would have been covered).

Anyway, I'll be going to my partner's doctor tomorrow (he will be accompanying me as I don't speak French that well) - my question is, how do I pay for the doctor? My partner thinks I simply just go and pay the 23 euro fee that everyone in France pays, and that's it, but I think that's just his relaxed French way of thinking, and that because I'm not a citizen of France, I'll have to pay something more and then submit a claim to my insurance in the US. I'm sure this question has been asked before, I just cant seem to find any answer on this forum - any personal experiences would be greatly appreciated!
 

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You could try seeing an osteopath directly - they are not reimbursed by the French system, so everyone pays the bill. Expect around 60 € for a each session.

DejW
 

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If you are seeing the medécin traitant you pay €23 you will get in return a brown form called a feuille de soins which you may be able to claim back on your insurance.However a word of warning-check exactly what your insurance will cover you for as if you are sent off to the hospital for x rays etc you will be expected to pay up front if you cannot produce insurance
 

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You say you injured your back pretty severely and you are no better after a week, so I would definitely start by seeing the doctor.

It is highly likely, as has been said above, that he will want you to have some x-rays to see what damage if any you have done.

You will then have to return to the doctor with the x-rays and he will prescribe an appropriate treatment which may just be rest and painkillers but which may be physiotherapy/osteopathy or further investigations.

You will have to pay the doctor 23 euros at each visit, the rest is difficult to estimate but in any case you don't really have a choice.

Many doctors will wait before cashing cheques so that you might have time to be reimbursed by your insurance before your account is debited.
 

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sounds like you have done yourself an nasty injury somehow

personally I would go straight to urgence at the nearest hospital where they have all the facilities , what can the doctor do for you anyway ...give you an aspirin ?

cost ? often nothing for emergency treatment
 

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As VERITE says, if you go to a normal GP you should expect to pay just the 23 Euro fee, as your partner says. Make sure you get a feuille de soins to claim against your Blue Cross insurance.
I suspect that if you go to the emergency department as a US citizen you may well be asked to pay, or they will ask for evidence of your overseas insurance. They may possibly present you with a bill that you can pay by cheque in due course, or they may expect you to pay immediately, or there may just charge your insurer direct (much depends on where you are living, but France certainly does look to recoup emergency care for overseas visitors).
 

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sounds like you have done yourself an nasty injury somehow

personally I would go straight to urgence at the nearest hospital where they have all the facilities , what can the doctor do for you anyway ...give you an aspirin ?

cost ? often nothing for emergency treatment
It is of course possible to go to the emergency departement but expect to pay for treatment.

And be prepared to wait. The emergency services in the bigger cities are permanently congested. Three months ago I fell and broke my wrist, and although I was in a great deal of pain (had to have an operation) I waited over two hours in the waiting room of the urgences.
 

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Listen to your partner. The French medical system is something of a surprise to all of us anglo-saxons at first. You pay for your visits and services up front, insurance or no insurance. So yes, you'll pay the same 23€ (or whatever) as anyone else.

The doctor doesn't normally do any tests in the office - they will order them up on prescription forms. You then go to the lab, or the radiology service or wherever and again, you pay up front. (Not always these days, but that has been the general principle for so long that your have private insurance won't cause them to bat an eyelash.) For each visit, service, x-ray or whatever, you'll get a feuille de soin and that's what you need to send to your private insurer to see what, if any, reimbursement you can get. (Though if you have Blue Cross, check with them - they may have a list of doctors and hospitals here in France that they work with.)

If you're on a long-stay visa, you should have some form of private insurance that covers treatment here in France. Many Blue Cross plans (though not all) do have some provision for overseas cover that meets the visa requirements. Go get treated. Pay the fees (make sure anyone you see is "conventionnée" - which means they stick to the CPAM fee schedule) and then sort out the paperwork to claim back whatever you can.

The system here works much better than in the US. And, even if you're paying yourself, it's MUCH cheaper than in the US. (Which is why you should submit your claims in any event.)
Cheers,
Bev
 

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It is of course possible to go to the emergency departement but expect to pay for treatment.

And be prepared to wait. The emergency services in the bigger cities are permanently congested. Three months ago I fell and broke my wrist, and although I was in a great deal of pain (had to have an operation) I waited over two hours in the waiting room of the urgences.
well although people in the uk think it is only there that you wait for emergency treatment I think anyone who has travelled at all knows that it just ain't so !

but I have been in emergency 3 times in france in the last 20 years and the only time I paid was when I was kept in intensive care and had to pay for my food [ even though I refused the half bottle of wine ]

maybe you went to a private clinic where you have to pay and then claim a refund , or maybe things have changed !

and my local doctor doesn't do appointments ...you can spend a happy hour or two waiting there ...and the magazines are antedeluvian
 

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well although people in the uk think it is only there that you wait for emergency treatment I think anyone who has travelled at all knows that it just ain't so !

but I have been in emergency 3 times in france in the last 20 years and the only time I paid was when I was kept in intensive care and had to pay for my food [ even though I refused the half bottle of wine ]

maybe you went to a private clinic where you have to pay and then claim a refund , or maybe things have changed !
Emergency treatment in hospitals and clinics is covered 100% by the sécurité sociale most of the time so if you have a carte vitale you will not be asked to pay - which doesn't mean that the treatment is free.

If you don't have SS cover in France, you will usually be expected to pay.
 

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Discussion Starter · #11 ·
Thanks everyone for your responses - I'm honestly not 100% sure what to do at this point. Part of me wants to go to the ER as waiting at the doc tomorrow for 2 hours to be seen and then be told I need x-rays doesn't really sound too desirable, and the other part of me thinks that maybe it's not as serious as I may think it is. I know it's a bit naive, but I didn't really think about how much of a pain it will be to get an x-ray (I'm living in Brittany on the coast, so not exactly near anywhere that does x-rays)...that's why I'm leaning towards just going to the ER and getting everything done at once, regardless of the cost (and I suppose the wait, but the wait seems like it'll be long at the general practitioner too).
 

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Don't forget that if you find it too difficult and painful to get around, you can ask for a doctor to do a home visit. The cost is higher but your insurance should cover it. The pharmacy will also generally deliver medication if you can't get out.

Hope you'll soon be back to normal.
 

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Don't count on the ER being able to do everything at once. I went in for what turned out to be a broken bone in my shoulder. Sure, they did the x-rays there, but because it was the sort of break that would not be set in a plaster cast, I got a "prescription" for a sling to immobilize my arm. Still had to go to the pharmacy the next day to get the sling.

And then had to go see my regular doctor with the follow-up x-ray (which the guy in the ER recommended I get done at a radiology clinic because the wait for the appointment would be too long at the hospital). She then prescribed the follow up kiné (physical therapy) appointments.

If your partner has a local doctor he likes, go with that. It's definitely preferable to hanging around the ER for 2 or 3 hours - and then still having to go get prescriptions filled at the pharmacy, radiology lab, etc.
Cheers,
Bev
 

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...If your partner has a local doctor he likes, go with that. It's definitely preferable to hanging around the ER for 2 or 3 hours - and then still having to go get prescriptions filled at the pharmacy, radiology lab, etc.
Cheers,
Bev
Keith

I'm with Bev. Chances are it's affordable and a darn sight better than suffering.

My wife just had hip replacement surgery at a private 50-bed hospital with one of the best surgeons in the country. All in, including the cardiologist visit, multiple life-size xrays, the 2 pre-surgery visits with the surgeon, the pre-surgery visit with the anaesthesiologist, the surgery itself (including the surgeon, anaesthesiologist, and all of the supporting surgical staff), and 9 days in private room cost about 7,000 euro. I doubt we could have gotten the hospital stay alone for that in the USA.

A simple office visit with the doctor is 23 euro. Xrays (including a consulting session with doctor of radiology) begin at 23 euro and go up, depending on the number and size of the x-rays, and a doctor's visit to your house is 32 euro in our village. The kine is 20 euro.

Go, get treated. Your partner's doctor can likwly assist you with an appointment if it's critical that it happens soon. I'm guessing that if you were willing to come with only emergency medical insurance, this won't break your bank.

Best of luck.

Ray
 

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Discussion Starter · #15 ·
Thanks again for the reply. I'm going to go to my partner's doc tomorrow, and then assess the situation after that. It's not about the cost of everything per se, more just how to handle the cost of things with insurance at home / if I need to be prepared to pay up front at the doc. Thanks again for all the info, it's greatly appreciated - here's hoping I can report back with a fixed back :)
 

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If your US based insurance was adequate for your long stay visa, you just bundle up the feulles de soins that you get from the various doctors, clinics, labs and whatever, write a cover note explaining what happened and send them in to your insurer. (Keep copies for yourself.)

One thing you'll notice is that the doctors here do try to stick to a somewhat more "conservative" approach - they'll try a number of things before they recommend surgery or other "high tech" treatment. Works a little slower - but definitely keeps the costs down.
Cheers,
Bev
 

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I think all people coming over to live in France (or any country) should make finding a local doctor, and visiting them with a medical history, a priority. Regardless of your previous health, it appears to be a real issue on this forum and your health should not suffer because of a language fear or worry/misunderstanding about insurance etc. A 23 Euro fee for a visit to a doctor my tutor recommended has really given me peace of mind. At worst, she can contact my doctor in Australia (I've shared their information). At best, she can resolve a health issue I may have herself.
 

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...It's not about the cost of everything per se, more just how to handle the cost of things with insurance at home / if I need to be prepared to pay up front at the doc. ...
Keith

I understand that specific concern! We thought we were prepared (though we remained nervous) as our insurer had given us what seemed to be fairly simple instructions.

  • Translate the invoices from French into English
  • Translate the Euro to Dollars
  • Submit the insurance company Form, copies of the original invoices, and the translation of everything for reimbursement

I created a big spreadsheet that contained the French & English translation from each invoice, the vendor / doctor info (including address & contact info), the fee in Euro and Dollars, etc. After getting verbal approval to use the printed spreadsheet, I submitted everything. The insurance company reimbursed us for the medication costs within a month and told us that they would not reimburse us for a few of the costs (pretty minor ones, fortunately).

A few months later, the insurance company asked for the surgeon's notes. Somewhere around there, I wondered if it wouldn't simply be easier to pay for the whole thing myself. But I persevered and requested the notes, translated them (Google Translate is really useful), and submitted the notes. I heard nothing from the insurance company for 4 more months. Then, a check arrived just last week for the balance of the fees. My wife's first hip surgery was in June 2014.

Moral: When in France, you will often be asked for more than you were told originally and everything takes longer than one expects. Patience, patience, patience.

Best of luck.

Ray
 

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Discussion Starter · #19 ·
I just wanted to update everyone about my dr. experience...

I arrived at 2PM for the "first come first serve" portion of the day with the local doctor - my partner and I waited about 2.5 hours, and then he saw me. He was very nice (and joked about not wanting to serve Americans, haha)...anyway, I have an inflamed hematoma on my back, and he prescribed some meds (mostly homeopathic/herbal, which was interesting, but they seem to be working)...when it came to paying, he said, "I want to make a good impression on Americans, no need for you to pay." That was a really nice surprise! So all in all, a really nice and easy process that isn't found in the states...

One last quick question - I have a doctor appointment in Paris in early June with a specialist (for treating Cystic Fibrosis), and I was wondering if anyone knew the cost of seeing a "specialist" in France...he's a pulmonologist (a doctor of the lungs), not sure if the speciality matters or not...thanks in advance.
 

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Thank you for the update - apart from the excessively long wait, it sounds as though it went well.

For a consultation with a specialist, expect to pay at the least 23 €, probably more likely to be in the area of 40 €, but it will depend on whether any tests are carried out. When you make the appointment you can ask to know how much you are likely to be charged.

However be aware that a lot of specialists charge extra (dépassement d'honoraires) which your insurance may or may not cover. This is not covered by the SS and only partially by most mutuelles or complementary insurance schemes. It represents the difference between the amount paid by the SS and the amount the doctor considers correct given his expertise and experience. Can be expensive! This is tolerated at the moment but in view of the growing number of doctors charging over the top and the sometimes excessive amounts asked for, it is to be hoped that before long the govt will sort out this strange situation.
 
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