French health insurance


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 Know your "Carte Vitale"     l     How to use your "Carte Vitale" & "Top-Up"     l     How to use "Feuille de Soins" or "Factures"

how to use feuille de soins


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 Know your number.o. alt='search this word'>r.o./a>ff by heart !


In the event that you are taken ill without you per.o. alt='search this word'>r.o./a>nal
belongings, just by telling you "numéro de Sécurité Sociale"
the medical services will have enough information to get started.


The first number designates your sex, 1 for men and 2 for women.
For temporary numbers starting with 5, 6, 7 or 8 this logic does not apply.
The next four numbers indicate your year and month of birth.
Your "insee" number will probably be followed by 99 for foreigners.
This number is replaced by the department code if you were born in France.
e.g.: 24 if you were born in the Dor.o. alt='search this word'>r.o./a>gne.
Finally, a series of 8 numbers show what “CPAM” office treats your dossiers.





"How to use your "Carte Vitale" & "Top-Up"


When you have medical treatment in France, you are usually asked for your “CARTE VITALE” (from CPAM or RSI) and the slip of paper called “Tiers payant complémentaire or Mutuelle" (from your Top-Up).  Usually no money is asked for.  The bill will be sent to “CPAM” (Caisse Primaire d’Assurance Maladie or.o. alt='search this word'>r.o./a>ther if selfemployed) and your TOP-UP.

When only your Carte Vitale is asked for this is usually because there is the possibility of using the “Télétransmission” (automatic payment and reimbursement system). You will have to pay either the total amount (eg: GP, Dentist) or just the “Ticket Modérateur” difference between the CPAM allowance and the “Tarif de Convention” (100% base rate (what the state says your treatment is worth).

CPAM will proceed with their partial reimbursement and send the information(normally) to your Top-Up by Télétransmission.

Your Top-Up will in turn reimburse the difference depending on your chosen level of cover.

In some cases you will have to pay for excess charges that the “Médecin Spécialiste” has over the state convention rate. These are called in French “Dépassements d’honoraires”.

These charges can be claimed from your Top-up by sending the an acquitted  bill.  (! If your level of guarantee covers  such charges).

If the CPAM does not reimburse medical treatment then the Top-up will not either, unless otherwise stated by annual flat rate.
(eg: Private room, glasses, spa, flu injection, etc.)





How to use "Feuille de Soins" or "Factures"


When your “Carte Vitale” is not used, papers called “FEUILLES DE SOINS” are given to you.

The information on these papers is identical to the information given by your “Carte Vitale”.

These forms have to be filled in and sent to the CPAM office dealing with your reimbursements.

! Please make sure you fill in your Social security number (also called numéro d’immatriculation) and sign the paper.o. alt='search this word'>r.o./a>rk at the bottom.

If for whatever reason the Top-up takes time reimbuRSIng their part on  reception of the CPAM statement itemising your last reimbursements, send these to your Top-up.
(This replaces the Télétransmission should CPAM not have sent the information in the first place).

As soon as your Top-up has the correct information they too can reimburse their part.

N.B: If you send your paper.o. alt='search this word'>r.o./a>rk directly to your insurance company, then the reimbursements will be a lot quicker than if you send them to your brokers, “SOFICA’s”. Please, do not forget to indicate your contract number.