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Healthcare limbo

3K views 31 replies 10 participants last post by  95995 
#1 ·
This pandemic has put me in an uncomfortable spot.

My husband and I first came into country on Februay 5th, to get an apartment and life set up in advance of getting the passport talent. We had been highly advised to get the apartment first, as it makes the visa more likely.

We landed an apartment for a 2/29 move in, so my husband went back to the US to have his visa appointment. We were going to have him go first, get the visa, then I would go to attend an appointment to get the spousal visa. He managed to get his visa the day the borders closed and by the grace of god made it back into France. I, however, was still here with a tourist visa.

(bonus point - he applied for a 14 month visa, but for some reason was only given a 6 month visa so I am not sure how that might impact any of this)

Fast forward a couple months, and I have gotten the prolongation de le droit de séjour through July from the government, but I still don't have the spousal visa. The borders are obviously still closed, and even if I wanted to risk going to the US to resolve the visa issue, the embassys and VFS are all closed.

The problem is that I am now in healthcare limbo. I have a chronic condition that requires medication that I ran out of 6 weeks ago. I also now have developed an infection under my tooth - I was able to pay out of pocket for a visit and antibiotics, but the tooth is going to have to be pulled in the next couple months.

The short is, I need healthcare - and I seriously doubt I can get on the Carte Vitale right now. I doubt I can do so in the next six months. I have the travelers insurance, but that only covers emergencies (with really low dental coverage). At this point I'd be happy to pay for a private insurance, but all the plans I have found are supplemental to l'Assurance Maladie.

Does anyone have any ideas or resources? Are there any stand alone health care options?
 
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#2 ·
You don't say where you are living (it's more expensive in Paris or other really big cities) but having a tooth taken out costs very little in general; though obviously it depends on the particular problem.

You will be able to pay the costs yourself .. you are on a holiday visa.

US costs are stupidly high. It's not usually like that in Europe.
 
#3 ·
Anyone who can prove that they reside in France in a "stable and regular manner" since at least 3 months has a right to health cover (PUMA - protection universelle maladie)

It's a difficult time to get things done quickly with the administration (Sécurité Sociale) but it's the only way forward.

You say: "I seriously doubt I can get on the Carte Vitale right now. I doubt I can do so in the next six months"
but you do qualify via more than 3 months residence.

Take your proof of ID, visa and residence to the Sécu and file your demand.

A miracle for dental infections is tea tree essential oil - one or two drops on a cotton bud applied every 2 to 4 hours.
Tastes like petrol but doesn't sting.

Links to webpages (in French) about health cover and residence requirements:

https://www.complementaire-sante-solidaire.gouv.fr/protection_universelle_maladie_puma.php

https://www.complementaire-sante-solidaire.gouv.fr/resider-en-france-stable-regulier.php
 
#6 ·
Anyone who can prove that they reside in France in a "stable and regular manner" since at least 3 months has a right to health cover (PUMA - protection universelle maladie)

It's a difficult time to get things done quickly with the administration (Sécurité Sociale) but it's the only way forward.

You say: "I seriously doubt I can get on the Carte Vitale right now. I doubt I can do so in the next six months"
but you do qualify via more than 3 months residence.

Take your proof of ID, visa and residence to the Sécu and file your demand.
When you say residence, is it a residence card? Because that's what I don't have yet because of the closures - I am still here on the droit de sejour (basically the tourist visa). Or do you mean proof of residing?
 
#4 ·
What kind of visa is your husband on? What's the basis of his and by extension your stay?
 
#5 ·
He received Passeport talent - VLS-TS. Entrepreneurial activity. The extension of my droit de sejour was justified on the basis that the borders and embassies are closed (so it wouldn't be possible to get the visa even if I could fly), and the chronic condition (which results in immunosuppression) makes this pandemic particularly dangerous for me - ergo, not able to fly to get my proper visa.
 
#10 ·
The Passeport Talent usually allows the spouse to reside in France, so entering on a tourist visa might not be an issue (albeit you entered before your husband received his Passeport Talent) and should be able to be formally fixed once the Prefectures re-open for such things. In the meantime, you should make the request to join the French health system and back it up with a copy of your husband's visa. All visas for those who are in France have been extended.
 
#12 ·
IIRC, we've had a few other folks here on the forum with these Passeport Talent visas and they seem to issue the initial visa for six months. During this time you are expected to register with some agency - possibly the OFII or maybe the préfecture - to validate the full term of your titre de séjour. (Up to 3 years, depending on what type of Passeport Talent you're on.)

If your husband hasn't done so yet, he should try to contact the OFII to ensure that he has properly registered his presence, and they should be able to advise you on your options - given the current travel bans and your health situation.

But as others have said, you should both go ahead and try to register for CPAM and see what they can tell you about obtaining a visa for yourself. One advantage of a centralized administration is that most offices do have contacts or connections with the other offices and can usually at least point you in the right direction.
 
#13 ·
Two points-Firstly private health insurance will not cover pre existing conditions or will load the premium to make it uneconomic
Secondly I do not know what you will be getting for 1900 euro but it must be the dental equivalent of a Rolls Royce All dentists are required by law to display their charges their charges so you can get an idea but do as others have said Start the CPAM process get treatment and keep the receipts
 
#14 ·
...Start the CPAM process get treatment and keep the receipts
Which brings up a question. Does the date from which claims can be filed start with the date the Demande d'ouverture des droits 􏰉a l'􏰈assurance maladie is received by the CPAM, or the date on which the numéro sécu is issued? I would assume the latter. But, I am not sure.
 
#17 ·
I don't know the exact dates for claims prior to the issue of a CV. We made doctor visits etc as soon as we arrived and did not get CVs until at least 6 months later. All was reimbursed by CPAM but only by the mutuelle from the start of the cover.
 
#22 ·
Alright! Thank you all so much. I appreciate the specificity you all brought - I am not sure I understand all of it yet, but I imagine as I work through the process, this conversation is going to be very helpful.

So my understanding, file for CPAM asap, go into OFII asap, and get a mutuelle just in case. Then just start getting receipts, correct?

Then pray things are covered. What happens with the mutuelle if I don't have l'assurance maladie at the same time?
 
#24 · (Edited)
... So my understanding, file for CPAM asap, go into OFII asap, and get a mutuelle just in case. Then just start getting receipts, correct?...
Almost. Since you have already been in France for more than 3 months, you can, and should, apply to the CPAM immediately. At the same time, keep receipts for any medical care you receive. They will give you a feuille de soins for each occasion, including drugs.

The OFII is independent. There is certainly no reason to delay that. But, it is not as urgent as the CPAM, and, in any case, it may still be a while before they start processing new requests.

And for the mutuelle. There is no point in buying one without having a Numéro Sécu - in fact, you probably can't even apply. So, you will just wait on that until you get your Numéro Sécu.
Then pray things are covered. What happens with the mutuelle if I don't have l'assurance maladie at the same time?
Nothing :eek: See above.

Also, check out this thread I started a while ago about our application for health coverage. https://www.expatforum.com/expats/f...ng-france/1494652-apostille-not-question.html

EDIT: I see David has already answered some of these questions while I was typing.
 
#23 ·
Ok, first get your prescription drugs sorted and dentist. Make sure you get the feuilles de soin. Apply for French health care via CPAM, when you have your social security number then apply for the mutuelle, you can't get the mutuelle until then. Then submit all the feuilles for reimbursement.

Good luck
 
#26 ·
One more thing, after you get your mutuelle you will get reimbursed for everything (almost 100 percent) but you will only get reimbursed by the mutuelle for expenses after the start of the policy. CPAM reimburse from the date of your attestation de droits
 
#29 ·
If you want to use your Tricare cover as a mutuelle, you'll need to send in your claims to Tricare as usual. I have heard that part of the claims process for Tricare is that they ask you if you have received reimbursement for part or all of the treatments. I don't know what (if any) proof they want of the reimbursements - but I guess they wind up reimbursing you for the part that Sécu doesn't reimburse (which is basically how a mutuelle works).

If you get a regular mutuelle, you notify CPAM who you are using for your mutuelle. That way, when your doctor or other care provider registers your treatment using your Carte Vitale, the "claim" goes in to CPAM and they forward it on to your mutuelle for reimbursement. Normally you'll have your reimbursement (in your bank account) within a day or two of when the CPAM reimbursement hits. (And all of that can often be within a week or 10 days of your appointment or treatment.)
 
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