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Thanks to EverHopeful who gave me some great advice, I've succeeded in getting a Carte Vitale and have begun searching for a French Health Insurance to replace my more costly International Health Insurance. So thanks to EverHopeful for that.

As I search though, I'm finding that the French Government health system and the private mutelles, seem so different to what I am used to in Australia, UK and US. These are some things I've been told by conseillers and some French people and it just seems to good to be true. If anyone could confirm or deny, that would be awesome:

1. GMF tells me there is no such thing as pre-existing conditions. No need to declare anything, just sign up and if you need any treatment for anything, you're covered. This seems crazy to me, as if you discovered you had a non-urgent disease or heart condition for example, you could be uninsured, then literally walk into a mutuelle, insure yourself and start treatment the next day?

2. GMF also tell me there's no need to declare and/or pay extra for certain activities. With my last insurance they considered surfing, martial arts, even trekking as hazardous activities and if you hurt yourself doing them, you're not covered. Apparently here you can do what you want and if you hurt yourself, you're covered?

3. In Australia and the US, it seems to me like there is a huge gulf between private health insurance and simply being covered by social security. It seems like in Australia if you have a non life threatening condition and you don't have private health insurance, then you could be waiting for a ridiculous amount of time for treatment, you have much less choice in who your doctor is, what hospital you go to, etc. Which is to say that if you don't have private health insurance in Australia and something big happens to you, there is a huge difference between the quality of treatment you would get (as opposed to if you have private health insurance). But in France, it seems the difference is pretty little and is really only concerning the payment that you make yourself on top of what the government pays. Have a misunderstood here?

Anyway, thanks for any input, the help is always appreciated.
 

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Actually, all that GMF has told you is absolutely true. Enjoy!

You pay for your national coverage (the sécu) by whatever means - whether you're registered under PUMA and pay an annual assessment based on your income, or employed and paying in (along with your employer's contribution) or on a French pension and it's considered already bought and paid for. Then, you select a mutuelle that covers at the level you are willing to pay for. And some mutuelles pay for extra stuff.

But there is no "pre-existing conditions" - and basically, the mutuelle pays their share as long as the sécu has paid what they're supposed to. There is no approval process (and in fact, the sécu has no right to know what you went in for, nor what the ultimate diagnosis is/was). If it's prescribed/performed by a registered doctor or health care professional and it's on the list of covered treatments, procedures or drugs, then everyone pays according to their contract.

In fact, for certain serious or long-term conditions, the sécu takes over and pays 100%. (My husband had heart surgery last year, and now the sécu pays for everything related to that condition.)

The only real "gotcha" is dental and eyeglasses. The sécu rates are pretty pathetic for most things in those realms, so you need to find a good mutuelle if you think you'll need things like dental crowns or eyeglasses - especially on a regular basis.
Cheers,
Bev
 

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Discussion Starter #3
Wow thanks Bev, concise, straight to the point and very helpful. Ok, when I read that the French health system costs 11% of their GDP I was wondering if I mis-read, but it makes sense now. Thanks.
 

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Hi Narcissus - glad you got into the French system.

Yes, mutuelles in France are entirely different to private health insurers in Oz - and thank heaven for that :D Don't know if you've read about the shenanigans with private insurers in Oz, but it seems things there have become even worse.

I don't think you'll find much difference with dental compared to Australia, but optometry is very different here and you will potentially have higher out-of-pocket if you make a claim - that's essentially because they don't go in so much for the ultra cheap frames here. Overall, though, you will find French mutuelles wonderful. That's essentially because of the regulations they have to follow :)

There are something like 500 mutuelles in France, which can make finding one that suits you somewhat difficult - even for the French. However, I have heard good things about GMF and, from what you say, it seems they offer some extras that others don't. So, as long as you're happy with the premiums, I would definitely say go for it :)

Interestingly, I have seen lots of media about Australia having one of the best health systems in the world - obviously the criteria for that are somewhat spurious :D
 

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Interesting thread! I'd advise going for one of the 'big name" mutuelles. It is very difficult to compare mutuelles...so stay safe for a year or so. To compare you need good understanding of the complex medical /legal French vocabulary used, and you need an experienced view of how the system works. For example my wife's mutuelle is more costly than mine, but she gets 10 days home help after a serious operation.

DejW
 

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Interesting thread! I'd advise going for one of the 'big name" mutuelles. It is very difficult to compare mutuelles...so stay safe for a year or so. To compare you need good understanding of the complex medical /legal French vocabulary used, and you need an experienced view of how the system works. For example my wife's mutuelle is more costly than mine, but she gets 10 days home help after a serious operation.

DejW
GMF is a well-known mutuelle that primarily covers public servants in France. But you're right about the home help thing DejW - it can be extremely useful :)
 

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Discussion Starter #7
Thanks to everyone for their input. This is all so new me, I think I'm going to go for a fairly basic level of cover. I can afford to cover small-medium expenses myself, like optical, dental, etc (I realize that these things are crazy expensive in France and can go up to 2,000 - 5,000 Euros for some things) in the even that I need them *touch wood*.

Where my biggest worries come in is in the event of major conditions that run into the tens of thousands or even more. But based on what Bev has said (and what I've learnt from GMF), almost all of that is covered by the Sécu, and the mutuelle should cover most of the rest. So I think a 40 Euro policy a month should suffice as I'm also under 40 which helps.

Thanks again all!
 

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Thanks to everyone for their input. This is all so new me, I think I'm going to go for a fairly basic level of cover. I can afford to cover small-medium expenses myself, like optical, dental, etc (I realize that these things are crazy expensive in France and can go up to 2,000 - 5,000 Euros for some things) in the even that I need them *touch wood*.

Where my biggest worries come in is in the event of major conditions that run into the tens of thousands or even more. But based on what Bev has said (and what I've learnt from GMF), almost all of that is covered by the Sécu, and the mutuelle should cover most of the rest. So I think a 40 Euro policy a month should suffice as I'm also under 40 which helps.

Thanks again all!
Just make sure you read the policy and understand what it covers, and get them to explain to you what 100%, 150% actually means (it's not what you might well think it means). And remember, even young, very fit people have accidents that can require surgery and post-surgery treatment - in fact they very often do. :)
 

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Discussion Starter #9
Thanks EH. I've got the terms and conditions and got some reading to do on my next flight back to Australia. I do understand that 100% and 150% is only of the government "recommended" amount, so there is often additional costs on top of that to be paid by the individual.

I am also painfully aware of that anything can happen at anytime to anyone no matter what age. In my twenties I had a theory that I wouldn't take out private health insurance over the next 10 years and if something happened to me, as long as it cost less than $10,000 I would be able to use the money I had saved on private health insurance to pay for it. Got bitten by a shark in Indonesia while surfing, almost lost my thumb. 5 surgeries over 2 years to reattach different parts of my hand, hundreds of hours of rehab in learning to use my thumb again and lets say the costs spiked well well well over $10K. Luckily I was in a position to pay for everything myself, but it taught me a good lesson.

Cheers again.
 
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