[Miss Brodie]

What exactly will they do for me?

I am aware that one can claim for medical fees if you have a problem, but do they cover you to help you out on sick pay or the first three days of illness before the social securuty kicks in. Are they worth it if you dont have any major illnesses and no dependants? Should I get a basic one, or one at all? Who does the best/cheapest et'c?

 

[Bevdeforges]

A basic mutuelle reimburses the difference between the sécu portion of your health care bills (usually about 60 - 70% of the standard fee schedule) and what you actually paid. It will often allow you to visit a non-agréé doctor (i.e. one that charges more than the fee schedule) and still receive full reimbursement.

Your mutuelle affiliation is registered with the sécu, so that "claims" are automatically passed to your mutuelle once they have been accepted by the sécu.

IIRC, the mutuelle doesn't get involved in sick pay. That's normally between your employer and the sécu. But a good mutuelle can make up for the fact that sécu reimbursement for dental and eyeglass care is pretty poor. (And eyeglasses are expensive in France.)

If your employer has a mutuelle, you probably won't have a choice. But the benefit of a mutuelle isn't really for major stuff, it's for the day to day things.
Cheers,
Bev

 

[Miss Brodie]

Thanks,


Does that mean there is no back up in case you get sick apart from 50% of your pay from the 4th day?

 

[Bevdeforges]

Thanks,


Does that mean there is no back up in case you get sick apart from 50% of your pay from the 4th day?

Depends on your employer. Some employers will keep you on the regular payroll and then you sign over your sécu payments (I guess this is the 50% of pay you're talking about - I'm not sure how the benefit is calculated) to the employer.
Cheers,
Bev

 

[GALLUS]

insurance

Mutuelles are private insurance companies with a difference, they claim not to be profit oriented.

For you they can insure everything just as a private firm does.
They are well known in the medicare industry because some of them offer additional advantages or benefits, or some have joined efforts for specialised diagnostic or treatment centers in large towns (where it is all for free if you are insured).

For medical health insurance, they would just cover you securite sociale share, and add a few benefits (reimburse the difference between state sponsored scheme price and real costs, or at hopistal cover just everything, or cover more for dentistry of reading glasses costs, ...) service are endless. You can also cover funeral costs, or what ever

Their advantages is that some a really serious in reinvesting their profit in diagnositc centers or providing more services for customers

do your market

 

[Californiagirl]

So I just received my first paystub and they take out all this stuff but how do I know if I've got insurance? I can't ask my company cause they don't respond to my questions since it's a virtual office type of thing. Also, anyone know what I need to do to get a carte vital? HELP

 

[Bevdeforges]

Look at the pay slip you've received.

If there are a bunch of lines that start with "URSSAF" then you're covered for the national health. "ASSEDIC" means unemployment coverage. And there should be something for "retraite" in some form, which means retirement.

If you have a mutuelle through your employer, there's normally a line that says "mutuelle" or has the name of the insurance company.

Your employer should have put in the forms for your carte vitale on your first day of work. If you haven't heard anything, try checking the website for "Ameli" (the health agency).
Cheers,
Bev

 

[Californiagirl]

Thanks Bev, I'll check out that website. I do have all those things listed on my pay stub plus about 15 others! I would hope that I'll be receiving my carte vital but you never know!

 

[Californiagirl]

Hmmm I don't seem to be in their system so I'll have to check with my work and see if they respond.

 

[Bevdeforges]

Thanks Bev, I'll check out that website. I do have all those things listed on my pay stub plus about 15 others! I would hope that I'll be receiving my carte vital but you never know!

Your pay slip should have a sécu number for you somewhere on it. If you've got that, you're enrolled. (Though they issue a "temporary" number for a while before the permanent number is assigned.)

You may have to pay a visit to the local URSSAF office. But check first to see if your local mairie has a regular visit from the URSSAF representative (usually weekly). It's often easier to go there to find out what your next step should be.
Cheers,
Bev