HOW DOES IT WORK

---

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

 Know your number off by heart !

In the event that you are taken ill without you personal
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 Dordogne.
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 other 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 paperwork 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 paperwork 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.

HOW DOES IT WORK

---

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

 Know your number off by heart !

In the event that you are taken ill without you personal
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 Dordogne.
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 other 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 paperwork 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 paperwork 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.

ASAF/AFPS/GIEPS

950 route des Colles

Les Templiers
06410 - BIOT

 

ASAF (Association Santé et Action Familiale)
AFPS (Action Familiale de Prévoyence Sociale)

Established in 1974 with the objective of making accessible, Top-Up health covers to everyone, whatever their age, their personal situation or their particular health needs.

 Top-Up, Régime Complémentaire or Mutuelle.  

Most medical treatments are only partially covered by the régime obligatoire and some not at all.  It is French way of life to take out an additional insurance that works hand-in-glove with the French regime obligatoires to reduce or eliminate such shortfalls. 

Different levels of cover, adapted to different needs and especially for different budgets.  It is important to understand that French Top-Ups are designed to cover expensive unplanned medical bills incurred during treatment and not just to get a new set of dentures.  Unlike any other insurance, it is not because one person makes a claim that their premiums will increase.  Effectively in comparison, you could say that people in good health pay for people in need of treatment.  The Top-Up system is based on “solidarity” like the CPAM.  To stop your premiums shooting through the roof should you fall seriously ill, the costs will spread out annually to all clients, thus making Top-Up insurance accessible to everyone.  Those that are unable to afford Top-Up are granted help from the government called ACS to contribute towards a Top-Up proving how important it is to take out such insurance. 

Top-Ups starts at 100% of the base de convention and can go up to 600% or more depending on your needs and especially what area you live in. 

SOFICAS recommends middle of the range cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for other medical treatment as some base rates are very low.

HOW DOES IT WORK

---

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

 Know your number off by heart !

In the event that you are taken ill without you personal
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 Dordogne.
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 other 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 paperwork 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 paperwork 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.

ASAF/AFPS/GIEPS

950 route des Colles

Les Templiers
06410 - BIOT

 

ASAF (Association Santé et Action Familiale)
AFPS (Action Familiale de Prévoyence Sociale)

Established in 1974 with the objective of making accessible, Top-Up health covers to everyone, whatever their age, their personal situation or their particular health needs.

 Top-Up, Régime Complémentaire or Mutuelle.  

Most medical treatments are only partially covered by the régime obligatoire and some not at all.  It is French way of life to take out an additional insurance that works hand-in-glove with the French regime obligatoires to reduce or eliminate such shortfalls. 

Different levels of cover, adapted to different needs and especially for different budgets.  It is important to understand that French Top-Ups are designed to cover expensive unplanned medical bills incurred during treatment and not just to get a new set of dentures.  Unlike any other insurance, it is not because one person makes a claim that their premiums will increase.  Effectively in comparison, you could say that people in good health pay for people in need of treatment.  The Top-Up system is based on “solidarity” like the CPAM.  To stop your premiums shooting through the roof should you fall seriously ill, the costs will spread out annually to all clients, thus making Top-Up insurance accessible to everyone.  Those that are unable to afford Top-Up are granted help from the government called ACS to contribute towards a Top-Up proving how important it is to take out such insurance. 

Top-Ups starts at 100% of the base de convention and can go up to 600% or more depending on your needs and especially what area you live in. 

SOFICAS recommends middle of the range cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for other medical treatment as some base rates are very low.

CLICK TO VISIT

Furley Page Solicitors 39 St Margaret's Street Canterbury Kent CT12TX

Sarah Bogard: 0044 (0) 1227 763 939 Florence Richards: 0044 (0) 1227 763 939 Anna Berry :0044 (0) 1227 763 939

 The Basics of Buying French Property

CLICK TO VISIT
Your French Matters 17 rte. du Grallet 17920 - BREUILLET	Laura MORLEY Telephone: 06 79 14 21 03  yourfrenchmatters@gmail.com

Help and Advice for all your Professional and Personal Administrative Matters

I have lived with my family in France for eight years.  We began our adventure in the Charente area of France but relocated to the Charente Maritime and the coast in 2006.  In the UK, I was a primary school teacher and upon moving to France studied and gained a diploma with honours to Teach English as a Foreign Language (TEFL).
As well as giving English lessons to French individuals, I had my own retail enterprise and have spent 4 years in a chartered Accountancy firm as head of the foreign section, completing over 200 income tax declarations annually and dealing with all administrative issues encountered by the UK expatriate in France.

Local Taxes:  I have studied local tax impositions and verification of the French Tax Foncière and Tax d’Habitation in order to check that the tax impositions  are based on realistic information and requesting recalculation when appropriate.

Business Setup:  I give help and advice on grants and financial help available for business set up and personal situations with the CAF (social security and family allowance organisation in France).
I help people to understand, register and run their business under the micro regime and auto entrepreneur regime and help deal with the social organisations such as RSI and URSSAF.

Sworn Translations:  I am a sworn translator via the TRIBUNAL DE GRANDE INSTANCE de SAINTES and have recently been awarded accreditation to complete and certify Capital gains declarations.

Tax Reimbursement:  I also deal with obtaining reimbursement of tax paid twice for clients that relocate to France from the UK or other European countries and dealing with pension forecasts and other administrative issues involving the relocation from one country to another.

Works Undertaken:  Annual French Income Tax returns (residents and non residents),  Completion of UK administrative forms (P85, R105, France Individual etc),  Help understanding Social charges and Social Contributions,  Business registration and advice under the Micro regime or the Auto entrepreneur scheme,  Issues surrounding local taxes such as Taxe Foncière & Taxe d'Habitation,  Help with planning permissions,  Certified and Sworn Translations (registration via the Tribunal in Saintes) 

CLICK TO VISIT
Anglo-French Communication La Basse Rivière, 22630 - EVRAN, BRITTANY	Rachel Gallard Telephone: (0033) 2 96 27 43 16 Mobile: (0033) 6 26 10 99 08 info@anglofrenchcommunication.com

No matter how many books one reads or how much advice one seeks from others who have made the move to France sadly there are always pitfalls.

My customers save a great deal of time and stress by using my service, that's what they tell me, and I can see the relief on their faces. I am Rachel Gallard, a French National and I am tri-lingual; I also speak German fluently. Having lived and worked in the Channel Islands for many years I can understand the frustrations felt by my UK clients trying to deal with another culture, in particular - the French way.

The French approach to business and service can be hard to comprehend even for the French, so I have developed an accurate and up-to-date knowledge of the system, I spend my time ensuring the answers are in place before the questions arise.

Anglo‑French Communication is registered with the French authorities and as such is legally required to meet their standards in providing a legitimate and accurate service to customers.

Through Anglo‑French Communication my clients have easy access to other professionals who I trust and work with, here in Brittany. Even if your problem is utterly unique, you have our combined experience to draw on for a fast and effective solution to any headache.

The stories are true, every branch of the French civil service adores red tape and paperwork, let us handle the administration while you enjoy your new life in France!

We provide high quality services to individuals and all types of businesses paying close attention to the needs of each client. 

HOW DOES IT WORK

---

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

 Know your number off by heart !

In the event that you are taken ill without you personal
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 Dordogne.
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 other 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 paperwork 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 paperwork 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.

ASAF/AFPS/GIEPS

950 route des Colles

Les Templiers
06410 - BIOT

 

ASAF (Association Santé et Action Familiale)
AFPS (Action Familiale de Prévoyence Sociale)

Established in 1974 with the objective of making accessible, Top-Up health covers to everyone, whatever their age, their personal situation or their particular health needs.

 Top-Up, Régime Complémentaire or Mutuelle.  

Most medical treatments are only partially covered by the régime obligatoire and some not at all.  It is French way of life to take out an additional insurance that works hand-in-glove with the French regime obligatoires to reduce or eliminate such shortfalls. 

Different levels of cover, adapted to different needs and especially for different budgets.  It is important to understand that French Top-Ups are designed to cover expensive unplanned medical bills incurred during treatment and not just to get a new set of dentures.  Unlike any other insurance, it is not because one person makes a claim that their premiums will increase.  Effectively in comparison, you could say that people in good health pay for people in need of treatment.  The Top-Up system is based on “solidarity” like the CPAM.  To stop your premiums shooting through the roof should you fall seriously ill, the costs will spread out annually to all clients, thus making Top-Up insurance accessible to everyone.  Those that are unable to afford Top-Up are granted help from the government called ACS to contribute towards a Top-Up proving how important it is to take out such insurance. 

Top-Ups starts at 100% of the base de convention and can go up to 600% or more depending on your needs and especially what area you live in. 

SOFICAS recommends middle of the range cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for other medical treatment as some base rates are very low.

CLICK TO VISIT

Furley Page Solicitors 39 St Margaret's Street Canterbury Kent CT12TX

Sarah Bogard: 0044 (0) 1227 763 939 Florence Richards: 0044 (0) 1227 763 939 Anna Berry :0044 (0) 1227 763 939

 The Basics of Buying French Property

CLICK TO VISIT
Your French Matters 17 rte. du Grallet 17920 - BREUILLET	Laura MORLEY Telephone: 06 79 14 21 03  yourfrenchmatters@gmail.com

Help and Advice for all your Professional and Personal Administrative Matters

I have lived with my family in France for eight years.  We began our adventure in the Charente area of France but relocated to the Charente Maritime and the coast in 2006.  In the UK, I was a primary school teacher and upon moving to France studied and gained a diploma with honours to Teach English as a Foreign Language (TEFL).
As well as giving English lessons to French individuals, I had my own retail enterprise and have spent 4 years in a chartered Accountancy firm as head of the foreign section, completing over 200 income tax declarations annually and dealing with all administrative issues encountered by the UK expatriate in France.

Local Taxes:  I have studied local tax impositions and verification of the French Tax Foncière and Tax d’Habitation in order to check that the tax impositions  are based on realistic information and requesting recalculation when appropriate.

Business Setup:  I give help and advice on grants and financial help available for business set up and personal situations with the CAF (social security and family allowance organisation in France).
I help people to understand, register and run their business under the micro regime and auto entrepreneur regime and help deal with the social organisations such as RSI and URSSAF.

Sworn Translations:  I am a sworn translator via the TRIBUNAL DE GRANDE INSTANCE de SAINTES and have recently been awarded accreditation to complete and certify Capital gains declarations.

Tax Reimbursement:  I also deal with obtaining reimbursement of tax paid twice for clients that relocate to France from the UK or other European countries and dealing with pension forecasts and other administrative issues involving the relocation from one country to another.

Works Undertaken:  Annual French Income Tax returns (residents and non residents),  Completion of UK administrative forms (P85, R105, France Individual etc),  Help understanding Social charges and Social Contributions,  Business registration and advice under the Micro regime or the Auto entrepreneur scheme,  Issues surrounding local taxes such as Taxe Foncière & Taxe d'Habitation,  Help with planning permissions,  Certified and Sworn Translations (registration via the Tribunal in Saintes) 

CLICK TO VISIT
Anglo-French Communication La Basse Rivière, 22630 - EVRAN, BRITTANY	Rachel Gallard Telephone: (0033) 2 96 27 43 16 Mobile: (0033) 6 26 10 99 08 info@anglofrenchcommunication.com

No matter how many books one reads or how much advice one seeks from others who have made the move to France sadly there are always pitfalls.

My customers save a great deal of time and stress by using my service, that's what they tell me, and I can see the relief on their faces. I am Rachel Gallard, a French National and I am tri-lingual; I also speak German fluently. Having lived and worked in the Channel Islands for many years I can understand the frustrations felt by my UK clients trying to deal with another culture, in particular - the French way.

The French approach to business and service can be hard to comprehend even for the French, so I have developed an accurate and up-to-date knowledge of the system, I spend my time ensuring the answers are in place before the questions arise.

Anglo‑French Communication is registered with the French authorities and as such is legally required to meet their standards in providing a legitimate and accurate service to customers.

Through Anglo‑French Communication my clients have easy access to other professionals who I trust and work with, here in Brittany. Even if your problem is utterly unique, you have our combined experience to draw on for a fast and effective solution to any headache.

The stories are true, every branch of the French civil service adores red tape and paperwork, let us handle the administration while you enjoy your new life in France!

We provide high quality services to individuals and all types of businesses paying close attention to the needs of each client. 

HOW DOES IT WORK

---

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

 Know your number off by heart !

In the event that you are taken ill without you personal
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 Dordogne.
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 other 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 paperwork 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 paperwork 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.

ASAF/AFPS/GIEPS

950 route des Colles

Les Templiers
06410 - BIOT

 

ASAF (Association Santé et Action Familiale)
AFPS (Action Familiale de Prévoyence Sociale)

Established in 1974 with the objective of making accessible, Top-Up health covers to everyone, whatever their age, their personal situation or their particular health needs.

 Top-Up, Régime Complémentaire or Mutuelle.  

Most medical treatments are only partially covered by the régime obligatoire and some not at all.  It is French way of life to take out an additional insurance that works hand-in-glove with the French regime obligatoires to reduce or eliminate such shortfalls. 

Different levels of cover, adapted to different needs and especially for different budgets.  It is important to understand that French Top-Ups are designed to cover expensive unplanned medical bills incurred during treatment and not just to get a new set of dentures.  Unlike any other insurance, it is not because one person makes a claim that their premiums will increase.  Effectively in comparison, you could say that people in good health pay for people in need of treatment.  The Top-Up system is based on “solidarity” like the CPAM.  To stop your premiums shooting through the roof should you fall seriously ill, the costs will spread out annually to all clients, thus making Top-Up insurance accessible to everyone.  Those that are unable to afford Top-Up are granted help from the government called ACS to contribute towards a Top-Up proving how important it is to take out such insurance. 

Top-Ups starts at 100% of the base de convention and can go up to 600% or more depending on your needs and especially what area you live in. 

SOFICAS recommends middle of the range cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for other medical treatment as some base rates are very low.

CLICK TO VISIT

Furley Page Solicitors 39 St Margaret's Street Canterbury Kent CT12TX

Sarah Bogard: 0044 (0) 1227 763 939 Florence Richards: 0044 (0) 1227 763 939 Anna Berry :0044 (0) 1227 763 939

 The Basics of Buying French Property

CLICK TO VISIT
Your French Matters 17 rte. du Grallet 17920 - BREUILLET	Laura MORLEY Telephone: 06 79 14 21 03  yourfrenchmatters@gmail.com

Help and Advice for all your Professional and Personal Administrative Matters

I have lived with my family in France for eight years.  We began our adventure in the Charente area of France but relocated to the Charente Maritime and the coast in 2006.  In the UK, I was a primary school teacher and upon moving to France studied and gained a diploma with honours to Teach English as a Foreign Language (TEFL).
As well as giving English lessons to French individuals, I had my own retail enterprise and have spent 4 years in a chartered Accountancy firm as head of the foreign section, completing over 200 income tax declarations annually and dealing with all administrative issues encountered by the UK expatriate in France.

Local Taxes:  I have studied local tax impositions and verification of the French Tax Foncière and Tax d’Habitation in order to check that the tax impositions  are based on realistic information and requesting recalculation when appropriate.

Business Setup:  I give help and advice on grants and financial help available for business set up and personal situations with the CAF (social security and family allowance organisation in France).
I help people to understand, register and run their business under the micro regime and auto entrepreneur regime and help deal with the social organisations such as RSI and URSSAF.

Sworn Translations:  I am a sworn translator via the TRIBUNAL DE GRANDE INSTANCE de SAINTES and have recently been awarded accreditation to complete and certify Capital gains declarations.

Tax Reimbursement:  I also deal with obtaining reimbursement of tax paid twice for clients that relocate to France from the UK or other European countries and dealing with pension forecasts and other administrative issues involving the relocation from one country to another.

Works Undertaken:  Annual French Income Tax returns (residents and non residents),  Completion of UK administrative forms (P85, R105, France Individual etc),  Help understanding Social charges and Social Contributions,  Business registration and advice under the Micro regime or the Auto entrepreneur scheme,  Issues surrounding local taxes such as Taxe Foncière & Taxe d'Habitation,  Help with planning permissions,  Certified and Sworn Translations (registration via the Tribunal in Saintes) 

CLICK TO VISIT
Anglo-French Communication La Basse Rivière, 22630 - EVRAN, BRITTANY	Rachel Gallard Telephone: (0033) 2 96 27 43 16 Mobile: (0033) 6 26 10 99 08 info@anglofrenchcommunication.com

No matter how many books one reads or how much advice one seeks from others who have made the move to France sadly there are always pitfalls.

My customers save a great deal of time and stress by using my service, that's what they tell me, and I can see the relief on their faces. I am Rachel Gallard, a French National and I am tri-lingual; I also speak German fluently. Having lived and worked in the Channel Islands for many years I can understand the frustrations felt by my UK clients trying to deal with another culture, in particular - the French way.

The French approach to business and service can be hard to comprehend even for the French, so I have developed an accurate and up-to-date knowledge of the system, I spend my time ensuring the answers are in place before the questions arise.

Anglo‑French Communication is registered with the French authorities and as such is legally required to meet their standards in providing a legitimate and accurate service to customers.

Through Anglo‑French Communication my clients have easy access to other professionals who I trust and work with, here in Brittany. Even if your problem is utterly unique, you have our combined experience to draw on for a fast and effective solution to any headache.

The stories are true, every branch of the French civil service adores red tape and paperwork, let us handle the administration while you enjoy your new life in France!

We provide high quality services to individuals and all types of businesses paying close attention to the needs of each client. 

Expats in French Health Cover Lottery

Tuesday 15 June 2010

Our recent exclusive on the EU investigation of French health rules provoked an interesting reaction from both readers and health insurance professionals.

One of the widely made comments concerned the difficulties faced by those with a pre-existing medical condition, both amongst those hoping to relocate to France and already resident.

Chris from Worcester wrote to us advising that he is planning to relocate to France, but due a recent stomach operation was concerned that he might not be able to find private health insurance.

‘When we do relocate we will have a modest income, so we cannot afford to pay large sums each year for health insurance,’ he stated.

Some of you had also applied for to get private health insurance, and had been turned down.

Adrian Metcalfe stated that he suffers from high blood pressure, for which he is undertaking medical treatment to keep it under control, but that was enough for the private insurer to whom he made application to turn down his request for health cover.

‘The result is that we fear we may actually have to return to the UK, as there is no way we can stay in France without having some form of health cover.’
However, it does seem all is not lost for those with a pre-existing medical condition.

Tony Mason of Soficas insurance brokers in Bordeaux states that for those with a medical condition there is a route of entry into the French system.

'If someone makes an application to us for insurance, and we refuse due to a pre-existing medical condition, we will provide the applicant with a letter that they can use to make application for entry into the CMU', he stated.

'Under the rules of entry, those who are resident in France through an E form, can make application to join the CMU when their cover expires, provided they have been refused private health insurance.

''Indeed, we have numerous applicants who have taken precisely this route and they have been successful.

''The only downside is that it is unlikely in the future you would be able to obtain a mortgage or secured credit in France, as your application for life insurance would probably be refused', he stated.

Strictly speaking, admission to the Couverture Maladie Universelle (CMU) because of the refusal of private health insurance only applies to those who developed a medical condition after they relocated to France, although it is clear the local health authorities are not necessarily applying this interpretation of the rules.

Given the unclear position, Peter Owen of Expathealthdirect.co.uk says people need to act with caution: 'If you are affiliated via E106 and during this period you have an illness and subsequent claims relating to this condition were excluded by a private insurer, then on expiry of the E106 it is possible, even probable, affiliation via the CMU would be granted, as a CPAM would judge this an accident de vie.'

'But', he continued, 'it is less certain if affiliation via CMU would be extended on expiry of E106 if you arrive in France with a pre-existing condition. A CPAM office could well argue this is no accident de vie at all, and may (harshly) judge this as somebody engaged in medical tourism, which the new rules intended to extinguish.'

In his view: 'Individual CPAM offices have always varied in their interpretation of regulations; it is a fact of life. As a result I would never advise a client that once an E106 has expired, affiliation via CMU would be automatically extended because of a pre-existing condition being excluded by a private insurer.'

Lack of Consistency in Rules

The differences in intrepretation of the rules was also commented on by a number of readers.

Thus, several months ago we heard from Jane Stewart in the Dordogne who told us that she was unable to obtain private health insurance as a result of an illness developed in France, but she received a blank refusal from her local CPAM for health cover.

At the time, we advised her to appeal against that decision, as is her right.

Following our article, she wrote to us last week to say: 'My application did not even go to the appeal panel, as the local CPAM director simply decided to sign off the application for me to be admitted to the Couverture Maladie Universelle (CMU)!'

A similar picture emerged from a conversation with Ron Wright of Exclusive Healthcare who pointed out to us that, in his experience several expats he had come across had actually been admitted to the CMU, even though they did not qualify under the rules of the French government circular of 23 November, 2007.

‘I know of three cases in three different health authority areas where the local CPAM have decided to admit them into the CMU, purely on the basis that they had been resident in France for more than 3 months in a stable and regular manner and had no other health cover', he stated.

‘There seems not rhythm or reason why this should have happened, and it all seems a bit of a post-code lottery. CPAMs seem to be making up their own rules, with some taking a hard line and others willing to admit you.'

David Yeates, Editor at www.french-property.com/news

HOW DOES IT WORK

---

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

 Know your number off by heart !

In the event that you are taken ill without you personal
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 Dordogne.
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 other 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 paperwork 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 paperwork 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.

ASAF/AFPS/GIEPS

950 route des Colles

Les Templiers
06410 - BIOT

 

ASAF (Association Santé et Action Familiale)
AFPS (Action Familiale de Prévoyence Sociale)

Established in 1974 with the objective of making accessible, Top-Up health covers to everyone, whatever their age, their personal situation or their particular health needs.

 Top-Up, Régime Complémentaire or Mutuelle.  

Most medical treatments are only partially covered by the régime obligatoire and some not at all.  It is French way of life to take out an additional insurance that works hand-in-glove with the French regime obligatoires to reduce or eliminate such shortfalls. 

Different levels of cover, adapted to different needs and especially for different budgets.  It is important to understand that French Top-Ups are designed to cover expensive unplanned medical bills incurred during treatment and not just to get a new set of dentures.  Unlike any other insurance, it is not because one person makes a claim that their premiums will increase.  Effectively in comparison, you could say that people in good health pay for people in need of treatment.  The Top-Up system is based on “solidarity” like the CPAM.  To stop your premiums shooting through the roof should you fall seriously ill, the costs will spread out annually to all clients, thus making Top-Up insurance accessible to everyone.  Those that are unable to afford Top-Up are granted help from the government called ACS to contribute towards a Top-Up proving how important it is to take out such insurance. 

Top-Ups starts at 100% of the base de convention and can go up to 600% or more depending on your needs and especially what area you live in. 

SOFICAS recommends middle of the range cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for other medical treatment as some base rates are very low.

CLICK TO VISIT

Furley Page Solicitors 39 St Margaret's Street Canterbury Kent CT12TX

Sarah Bogard: 0044 (0) 1227 763 939 Florence Richards: 0044 (0) 1227 763 939 Anna Berry :0044 (0) 1227 763 939

 The Basics of Buying French Property

CLICK TO VISIT
Your French Matters 17 rte. du Grallet 17920 - BREUILLET	Laura MORLEY Telephone: 06 79 14 21 03  yourfrenchmatters@gmail.com

Help and Advice for all your Professional and Personal Administrative Matters

I have lived with my family in France for eight years.  We began our adventure in the Charente area of France but relocated to the Charente Maritime and the coast in 2006.  In the UK, I was a primary school teacher and upon moving to France studied and gained a diploma with honours to Teach English as a Foreign Language (TEFL).
As well as giving English lessons to French individuals, I had my own retail enterprise and have spent 4 years in a chartered Accountancy firm as head of the foreign section, completing over 200 income tax declarations annually and dealing with all administrative issues encountered by the UK expatriate in France.

Local Taxes:  I have studied local tax impositions and verification of the French Tax Foncière and Tax d’Habitation in order to check that the tax impositions  are based on realistic information and requesting recalculation when appropriate.

Business Setup:  I give help and advice on grants and financial help available for business set up and personal situations with the CAF (social security and family allowance organisation in France).
I help people to understand, register and run their business under the micro regime and auto entrepreneur regime and help deal with the social organisations such as RSI and URSSAF.

Sworn Translations:  I am a sworn translator via the TRIBUNAL DE GRANDE INSTANCE de SAINTES and have recently been awarded accreditation to complete and certify Capital gains declarations.

Tax Reimbursement:  I also deal with obtaining reimbursement of tax paid twice for clients that relocate to France from the UK or other European countries and dealing with pension forecasts and other administrative issues involving the relocation from one country to another.

Works Undertaken:  Annual French Income Tax returns (residents and non residents),  Completion of UK administrative forms (P85, R105, France Individual etc),  Help understanding Social charges and Social Contributions,  Business registration and advice under the Micro regime or the Auto entrepreneur scheme,  Issues surrounding local taxes such as Taxe Foncière & Taxe d'Habitation,  Help with planning permissions,  Certified and Sworn Translations (registration via the Tribunal in Saintes) 

CLICK TO VISIT
Anglo-French Communication La Basse Rivière, 22630 - EVRAN, BRITTANY	Rachel Gallard Telephone: (0033) 2 96 27 43 16 Mobile: (0033) 6 26 10 99 08 info@anglofrenchcommunication.com

No matter how many books one reads or how much advice one seeks from others who have made the move to France sadly there are always pitfalls.

My customers save a great deal of time and stress by using my service, that's what they tell me, and I can see the relief on their faces. I am Rachel Gallard, a French National and I am tri-lingual; I also speak German fluently. Having lived and worked in the Channel Islands for many years I can understand the frustrations felt by my UK clients trying to deal with another culture, in particular - the French way.

The French approach to business and service can be hard to comprehend even for the French, so I have developed an accurate and up-to-date knowledge of the system, I spend my time ensuring the answers are in place before the questions arise.

Anglo‑French Communication is registered with the French authorities and as such is legally required to meet their standards in providing a legitimate and accurate service to customers.

Through Anglo‑French Communication my clients have easy access to other professionals who I trust and work with, here in Brittany. Even if your problem is utterly unique, you have our combined experience to draw on for a fast and effective solution to any headache.

The stories are true, every branch of the French civil service adores red tape and paperwork, let us handle the administration while you enjoy your new life in France!

We provide high quality services to individuals and all types of businesses paying close attention to the needs of each client. 

Expats in French Health Cover Lottery

Tuesday 15 June 2010

Our recent exclusive on the EU investigation of French health rules provoked an interesting reaction from both readers and health insurance professionals.

One of the widely made comments concerned the difficulties faced by those with a pre-existing medical condition, both amongst those hoping to relocate to France and already resident.

Chris from Worcester wrote to us advising that he is planning to relocate to France, but due a recent stomach operation was concerned that he might not be able to find private health insurance.

‘When we do relocate we will have a modest income, so we cannot afford to pay large sums each year for health insurance,’ he stated.

Some of you had also applied for to get private health insurance, and had been turned down.

Adrian Metcalfe stated that he suffers from high blood pressure, for which he is undertaking medical treatment to keep it under control, but that was enough for the private insurer to whom he made application to turn down his request for health cover.

‘The result is that we fear we may actually have to return to the UK, as there is no way we can stay in France without having some form of health cover.’
However, it does seem all is not lost for those with a pre-existing medical condition.

Tony Mason of Soficas insurance brokers in Bordeaux states that for those with a medical condition there is a route of entry into the French system.

'If someone makes an application to us for insurance, and we refuse due to a pre-existing medical condition, we will provide the applicant with a letter that they can use to make application for entry into the CMU', he stated.

'Under the rules of entry, those who are resident in France through an E form, can make application to join the CMU when their cover expires, provided they have been refused private health insurance.

''Indeed, we have numerous applicants who have taken precisely this route and they have been successful.

''The only downside is that it is unlikely in the future you would be able to obtain a mortgage or secured credit in France, as your application for life insurance would probably be refused', he stated.

Strictly speaking, admission to the Couverture Maladie Universelle (CMU) because of the refusal of private health insurance only applies to those who developed a medical condition after they relocated to France, although it is clear the local health authorities are not necessarily applying this interpretation of the rules.

Given the unclear position, Peter Owen of Expathealthdirect.co.uk says people need to act with caution: 'If you are affiliated via E106 and during this period you have an illness and subsequent claims relating to this condition were excluded by a private insurer, then on expiry of the E106 it is possible, even probable, affiliation via the CMU would be granted, as a CPAM would judge this an accident de vie.'

'But', he continued, 'it is less certain if affiliation via CMU would be extended on expiry of E106 if you arrive in France with a pre-existing condition. A CPAM office could well argue this is no accident de vie at all, and may (harshly) judge this as somebody engaged in medical tourism, which the new rules intended to extinguish.'

In his view: 'Individual CPAM offices have always varied in their interpretation of regulations; it is a fact of life. As a result I would never advise a client that once an E106 has expired, affiliation via CMU would be automatically extended because of a pre-existing condition being excluded by a private insurer.'

Lack of Consistency in Rules

The differences in intrepretation of the rules was also commented on by a number of readers.

Thus, several months ago we heard from Jane Stewart in the Dordogne who told us that she was unable to obtain private health insurance as a result of an illness developed in France, but she received a blank refusal from her local CPAM for health cover.

At the time, we advised her to appeal against that decision, as is her right.

Following our article, she wrote to us last week to say: 'My application did not even go to the appeal panel, as the local CPAM director simply decided to sign off the application for me to be admitted to the Couverture Maladie Universelle (CMU)!'

A similar picture emerged from a conversation with Ron Wright of Exclusive Healthcare who pointed out to us that, in his experience several expats he had come across had actually been admitted to the CMU, even though they did not qualify under the rules of the French government circular of 23 November, 2007.

‘I know of three cases in three different health authority areas where the local CPAM have decided to admit them into the CMU, purely on the basis that they had been resident in France for more than 3 months in a stable and regular manner and had no other health cover', he stated.

‘There seems not rhythm or reason why this should have happened, and it all seems a bit of a post-code lottery. CPAMs seem to be making up their own rules, with some taking a hard line and others willing to admit you.'

David Yeates, Editor at www.french-property.com/news

Health Cover - Plus Ça Change...?

Thursday 01 September 2011

The recent Circular on health cover for early retirees may well be obtuse, but despite the cryptic language the rules really have changed.

Prior to the summer break we broke the news that the EU Commission had forced France to change the rules on granting early retirees access into the health system.

The new regulations are contained in a Circular issued in early July by the French health and social security authorities.

The Circulaire Nº DSS/DACI/2011/225 is a classic piece of French obscurification, leading a number of you who have read it to write to us seeking clarification on your own position.

The lack of clarity has not been helped by reports elsewhere, stating that, despite the initial euphoria, there has been ‘no change’ in the rules.

In order to try and shed more light we wrote to the EU, who provided us with the following statement:

'Habitually Resident'

As the EU statement confirms, the formal legal position is actually a very clear one.

If an early retiree from within the EU is 'habitually resident' in France then they are entitled to be treated in the same way as a French national. This implies an equal right to access the health system.

In order to be considered ‘habitually resident’ you must be resident in France for at least three months, with health insurance cover and the minimum level of income.

Health insurance cover provided via an E106/S1 would meet the first criteria. At the expiry of the E106/S1 (up to 2 years) you would have obtained the status of being ‘habitually resident’, and so would be entitled to access the health system, subject to the test of minimum income.

Indeed, you need continuing health cover in order to remain legally resident.

All of this is actually stated in the new Circular, despite the convoluted manner in which it is expressed, particularly the so-called 'case by case' examination of all applications.

Thus, the guarantee of continuing health cover for those who are 'habitually resident' in France is confirmed in the Circular, where it states: 'l’application des règles européennes de coordination permettant d’assurer à une partie des personnes ayant établi leur résidence en France de bénéficier d’une continuité de leurs droits en matière de maladie-maternité, acquis dans un autre Etat membre, par le bénéfice des prestations de l’assurance maladie française.'

It goes on to say: 'Si l’intéressé «n'a droit à aucun autre titre aux prestations en nature d'un régime d'assurance maladie et maternité», français ou européen, l’article L.380-1 et l’article L.861-1 du code de la sécurité sociale ouvrent l’accès à la couverture maladie universelle (CMU) et complémentaire (CMU-C) aux personnes qui justifient d’une «résidence stable et régulière en France».'

Local Interpretation

Now we have no doubt that despite what the Circular may say, some early retirees who meet the criteria will continue to be refused entry into the system by their local health authority, the Caisse Primaire de l'Assurance Maladie (CPAM).

The capricious nature of local public officialdom is an indelible feature of life in France.

Ever since the original Circular of November 2007, which ostensibly excluded early retirees from the health system, there has been wide variation in the way the Circular has been interpreted by local health authorities.

Despite the many reports of health authorities taking an inflexible and narrow approach, there have also been a large number of CPAMs who have simply ignored the Circular and carried on in the same old way, granting entry to early retirees at the expiry of their E106/S1.

So we fully expect that the same lack of consistency in policy implementation will continue and some of you will be denied access into the system, despite the fact that you may be eligible.

The current uneven application of policy is inevitable, particularly when the guidance from the centre is not spelt out clearly.

Appeal Procedure

If you are unreasonably refused access into the system, what should you do?

Do not accept the decision as irrevocable is what you must do.

You need to challenge it, for there is a reasonable chance you will be successful, and only by determined action against local intransigence will this issue ever be put to rest.

Your local CPAM are required by law to justify their decision to you, which they must do so in writing. You should not be put off by a verbal refusal from a local official. Insist on a letter of explanation.

If they are not prepared to give you a letter explaining their reasons, then you should make a written complaint to the Conciliateur of the CPAM. The CPAM will have their contact details, which is normally the local CPAM office. Send the letter by recorded delivery.

If you do have a letter of refusal, you have an automatic right of appeal to a local board, called the Commission de Recours Amiable (CRA).

The appeal procedure is very simple. A recorded delivery letter must be sent to the CRA within two months of the (written) decision you contest. You are not required to attend a hearing. The absence of a response from the CRA with one month implies a rejection of your appeal.

If the CRA do reject your appeal, then within two months you can take the matter to the social security and health tribunal - the Tribunal des affaires de sécurité sociale(TASS).

If you are refused health cover, you should also make a complaint to the EU Commission, which you can do at EU Citizens Complaints. We urge you to make use of this complaints procedure.

We would be most interested to continue to hear from you on this issue, as it is of fundamental importance to many who seek to relocate to France and, indeed, to many who are currently resident. E Mail: editor@french-property.com

HOW DOES IT WORK

---

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

 Know your number off by heart !

In the event that you are taken ill without you personal
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 Dordogne.
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 other 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 paperwork 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 paperwork 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.

ASAF/AFPS/GIEPS

950 route des Colles

Les Templiers
06410 - BIOT

 

ASAF (Association Santé et Action Familiale)
AFPS (Action Familiale de Prévoyence Sociale)

Established in 1974 with the objective of making accessible, Top-Up health covers to everyone, whatever their age, their personal situation or their particular health needs.

 Top-Up, Régime Complémentaire or Mutuelle.  

Most medical treatments are only partially covered by the régime obligatoire and some not at all.  It is French way of life to take out an additional insurance that works hand-in-glove with the French regime obligatoires to reduce or eliminate such shortfalls. 

Different levels of cover, adapted to different needs and especially for different budgets.  It is important to understand that French Top-Ups are designed to cover expensive unplanned medical bills incurred during treatment and not just to get a new set of dentures.  Unlike any other insurance, it is not because one person makes a claim that their premiums will increase.  Effectively in comparison, you could say that people in good health pay for people in need of treatment.  The Top-Up system is based on “solidarity” like the CPAM.  To stop your premiums shooting through the roof should you fall seriously ill, the costs will spread out annually to all clients, thus making Top-Up insurance accessible to everyone.  Those that are unable to afford Top-Up are granted help from the government called ACS to contribute towards a Top-Up proving how important it is to take out such insurance. 

Top-Ups starts at 100% of the base de convention and can go up to 600% or more depending on your needs and especially what area you live in. 

SOFICAS recommends middle of the range cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for other medical treatment as some base rates are very low.

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Furley Page Solicitors 39 St Margaret's Street Canterbury Kent CT12TX

Sarah Bogard: 0044 (0) 1227 763 939 Florence Richards: 0044 (0) 1227 763 939 Anna Berry :0044 (0) 1227 763 939

 The Basics of Buying French Property

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Your French Matters 17 rte. du Grallet 17920 - BREUILLET	Laura MORLEY Telephone: 06 79 14 21 03  yourfrenchmatters@gmail.com

Help and Advice for all your Professional and Personal Administrative Matters

I have lived with my family in France for eight years.  We began our adventure in the Charente area of France but relocated to the Charente Maritime and the coast in 2006.  In the UK, I was a primary school teacher and upon moving to France studied and gained a diploma with honours to Teach English as a Foreign Language (TEFL).
As well as giving English lessons to French individuals, I had my own retail enterprise and have spent 4 years in a chartered Accountancy firm as head of the foreign section, completing over 200 income tax declarations annually and dealing with all administrative issues encountered by the UK expatriate in France.

Local Taxes:  I have studied local tax impositions and verification of the French Tax Foncière and Tax d’Habitation in order to check that the tax impositions  are based on realistic information and requesting recalculation when appropriate.

Business Setup:  I give help and advice on grants and financial help available for business set up and personal situations with the CAF (social security and family allowance organisation in France).
I help people to understand, register and run their business under the micro regime and auto entrepreneur regime and help deal with the social organisations such as RSI and URSSAF.

Sworn Translations:  I am a sworn translator via the TRIBUNAL DE GRANDE INSTANCE de SAINTES and have recently been awarded accreditation to complete and certify Capital gains declarations.

Tax Reimbursement:  I also deal with obtaining reimbursement of tax paid twice for clients that relocate to France from the UK or other European countries and dealing with pension forecasts and other administrative issues involving the relocation from one country to another.

Works Undertaken:  Annual French Income Tax returns (residents and non residents),  Completion of UK administrative forms (P85, R105, France Individual etc),  Help understanding Social charges and Social Contributions,  Business registration and advice under the Micro regime or the Auto entrepreneur scheme,  Issues surrounding local taxes such as Taxe Foncière & Taxe d'Habitation,  Help with planning permissions,  Certified and Sworn Translations (registration via the Tribunal in Saintes) 

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Anglo-French Communication La Basse Rivière, 22630 - EVRAN, BRITTANY	Rachel Gallard Telephone: (0033) 2 96 27 43 16 Mobile: (0033) 6 26 10 99 08 info@anglofrenchcommunication.com

No matter how many books one reads or how much advice one seeks from others who have made the move to France sadly there are always pitfalls.

My customers save a great deal of time and stress by using my service, that's what they tell me, and I can see the relief on their faces. I am Rachel Gallard, a French National and I am tri-lingual; I also speak German fluently. Having lived and worked in the Channel Islands for many years I can understand the frustrations felt by my UK clients trying to deal with another culture, in particular - the French way.

The French approach to business and service can be hard to comprehend even for the French, so I have developed an accurate and up-to-date knowledge of the system, I spend my time ensuring the answers are in place before the questions arise.

Anglo‑French Communication is registered with the French authorities and as such is legally required to meet their standards in providing a legitimate and accurate service to customers.

Through Anglo‑French Communication my clients have easy access to other professionals who I trust and work with, here in Brittany. Even if your problem is utterly unique, you have our combined experience to draw on for a fast and effective solution to any headache.

The stories are true, every branch of the French civil service adores red tape and paperwork, let us handle the administration while you enjoy your new life in France!

We provide high quality services to individuals and all types of businesses paying close attention to the needs of each client. 

Expats in French Health Cover Lottery

Tuesday 15 June 2010

Our recent exclusive on the EU investigation of French health rules provoked an interesting reaction from both readers and health insurance professionals.

One of the widely made comments concerned the difficulties faced by those with a pre-existing medical condition, both amongst those hoping to relocate to France and already resident.

Chris from Worcester wrote to us advising that he is planning to relocate to France, but due a recent stomach operation was concerned that he might not be able to find private health insurance.

‘When we do relocate we will have a modest income, so we cannot afford to pay large sums each year for health insurance,’ he stated.

Some of you had also applied for to get private health insurance, and had been turned down.

Adrian Metcalfe stated that he suffers from high blood pressure, for which he is undertaking medical treatment to keep it under control, but that was enough for the private insurer to whom he made application to turn down his request for health cover.

‘The result is that we fear we may actually have to return to the UK, as there is no way we can stay in France without having some form of health cover.’
However, it does seem all is not lost for those with a pre-existing medical condition.

Tony Mason of Soficas insurance brokers in Bordeaux states that for those with a medical condition there is a route of entry into the French system.

'If someone makes an application to us for insurance, and we refuse due to a pre-existing medical condition, we will provide the applicant with a letter that they can use to make application for entry into the CMU', he stated.

'Under the rules of entry, those who are resident in France through an E form, can make application to join the CMU when their cover expires, provided they have been refused private health insurance.

''Indeed, we have numerous applicants who have taken precisely this route and they have been successful.

''The only downside is that it is unlikely in the future you would be able to obtain a mortgage or secured credit in France, as your application for life insurance would probably be refused', he stated.

Strictly speaking, admission to the Couverture Maladie Universelle (CMU) because of the refusal of private health insurance only applies to those who developed a medical condition after they relocated to France, although it is clear the local health authorities are not necessarily applying this interpretation of the rules.

Given the unclear position, Peter Owen of Expathealthdirect.co.uk says people need to act with caution: 'If you are affiliated via E106 and during this period you have an illness and subsequent claims relating to this condition were excluded by a private insurer, then on expiry of the E106 it is possible, even probable, affiliation via the CMU would be granted, as a CPAM would judge this an accident de vie.'

'But', he continued, 'it is less certain if affiliation via CMU would be extended on expiry of E106 if you arrive in France with a pre-existing condition. A CPAM office could well argue this is no accident de vie at all, and may (harshly) judge this as somebody engaged in medical tourism, which the new rules intended to extinguish.'

In his view: 'Individual CPAM offices have always varied in their interpretation of regulations; it is a fact of life. As a result I would never advise a client that once an E106 has expired, affiliation via CMU would be automatically extended because of a pre-existing condition being excluded by a private insurer.'

Lack of Consistency in Rules

The differences in intrepretation of the rules was also commented on by a number of readers.

Thus, several months ago we heard from Jane Stewart in the Dordogne who told us that she was unable to obtain private health insurance as a result of an illness developed in France, but she received a blank refusal from her local CPAM for health cover.

At the time, we advised her to appeal against that decision, as is her right.

Following our article, she wrote to us last week to say: 'My application did not even go to the appeal panel, as the local CPAM director simply decided to sign off the application for me to be admitted to the Couverture Maladie Universelle (CMU)!'

A similar picture emerged from a conversation with Ron Wright of Exclusive Healthcare who pointed out to us that, in his experience several expats he had come across had actually been admitted to the CMU, even though they did not qualify under the rules of the French government circular of 23 November, 2007.

‘I know of three cases in three different health authority areas where the local CPAM have decided to admit them into the CMU, purely on the basis that they had been resident in France for more than 3 months in a stable and regular manner and had no other health cover', he stated.

‘There seems not rhythm or reason why this should have happened, and it all seems a bit of a post-code lottery. CPAMs seem to be making up their own rules, with some taking a hard line and others willing to admit you.'

David Yeates, Editor at www.french-property.com/news

Health Cover - Plus Ça Change...?

Thursday 01 September 2011

The recent Circular on health cover for early retirees may well be obtuse, but despite the cryptic language the rules really have changed.

Prior to the summer break we broke the news that the EU Commission had forced France to change the rules on granting early retirees access into the health system.

The new regulations are contained in a Circular issued in early July by the French health and social security authorities.

The Circulaire Nº DSS/DACI/2011/225 is a classic piece of French obscurification, leading a number of you who have read it to write to us seeking clarification on your own position.

The lack of clarity has not been helped by reports elsewhere, stating that, despite the initial euphoria, there has been ‘no change’ in the rules.

In order to try and shed more light we wrote to the EU, who provided us with the following statement:

'Habitually Resident'

As the EU statement confirms, the formal legal position is actually a very clear one.

If an early retiree from within the EU is 'habitually resident' in France then they are entitled to be treated in the same way as a French national. This implies an equal right to access the health system.

In order to be considered ‘habitually resident’ you must be resident in France for at least three months, with health insurance cover and the minimum level of income.

Health insurance cover provided via an E106/S1 would meet the first criteria. At the expiry of the E106/S1 (up to 2 years) you would have obtained the status of being ‘habitually resident’, and so would be entitled to access the health system, subject to the test of minimum income.

Indeed, you need continuing health cover in order to remain legally resident.

All of this is actually stated in the new Circular, despite the convoluted manner in which it is expressed, particularly the so-called 'case by case' examination of all applications.

Thus, the guarantee of continuing health cover for those who are 'habitually resident' in France is confirmed in the Circular, where it states: 'l’application des règles européennes de coordination permettant d’assurer à une partie des personnes ayant établi leur résidence en France de bénéficier d’une continuité de leurs droits en matière de maladie-maternité, acquis dans un autre Etat membre, par le bénéfice des prestations de l’assurance maladie française.'

It goes on to say: 'Si l’intéressé «n'a droit à aucun autre titre aux prestations en nature d'un régime d'assurance maladie et maternité», français ou européen, l’article L.380-1 et l’article L.861-1 du code de la sécurité sociale ouvrent l’accès à la couverture maladie universelle (CMU) et complémentaire (CMU-C) aux personnes qui justifient d’une «résidence stable et régulière en France».'

Local Interpretation

Now we have no doubt that despite what the Circular may say, some early retirees who meet the criteria will continue to be refused entry into the system by their local health authority, the Caisse Primaire de l'Assurance Maladie (CPAM).

The capricious nature of local public officialdom is an indelible feature of life in France.

Ever since the original Circular of November 2007, which ostensibly excluded early retirees from the health system, there has been wide variation in the way the Circular has been interpreted by local health authorities.

Despite the many reports of health authorities taking an inflexible and narrow approach, there have also been a large number of CPAMs who have simply ignored the Circular and carried on in the same old way, granting entry to early retirees at the expiry of their E106/S1.

So we fully expect that the same lack of consistency in policy implementation will continue and some of you will be denied access into the system, despite the fact that you may be eligible.

The current uneven application of policy is inevitable, particularly when the guidance from the centre is not spelt out clearly.

Appeal Procedure

If you are unreasonably refused access into the system, what should you do?

Do not accept the decision as irrevocable is what you must do.

You need to challenge it, for there is a reasonable chance you will be successful, and only by determined action against local intransigence will this issue ever be put to rest.

Your local CPAM are required by law to justify their decision to you, which they must do so in writing. You should not be put off by a verbal refusal from a local official. Insist on a letter of explanation.

If they are not prepared to give you a letter explaining their reasons, then you should make a written complaint to the Conciliateur of the CPAM. The CPAM will have their contact details, which is normally the local CPAM office. Send the letter by recorded delivery.

If you do have a letter of refusal, you have an automatic right of appeal to a local board, called the Commission de Recours Amiable (CRA).

The appeal procedure is very simple. A recorded delivery letter must be sent to the CRA within two months of the (written) decision you contest. You are not required to attend a hearing. The absence of a response from the CRA with one month implies a rejection of your appeal.

If the CRA do reject your appeal, then within two months you can take the matter to the social security and health tribunal - the Tribunal des affaires de sécurité sociale(TASS).

If you are refused health cover, you should also make a complaint to the EU Commission, which you can do at EU Citizens Complaints. We urge you to make use of this complaints procedure.

We would be most interested to continue to hear from you on this issue, as it is of fundamental importance to many who seek to relocate to France and, indeed, to many who are currently resident. E Mail: editor@french-property.com

Dordogne Makes Concession on Health Cover

Friday 01 June 2012

The health authority in the Dordogne has agreed to admit early retirees with a long term illness into the health system.

According to Tony Mason of health insurance brokers Soficas those with what is known as an 'Affection de Longue Durée (ALD)'* prior to losing their health cover rights under an S1/E106 will now be able to obtain cover under the Couverture Maladie Universelle (CMU).

‘It still remains a little unclear to me why the CPAM have changed their position’ he says,‘but in large measure I think it is genuinely because, until we made them aware, they simply had no idea of the scale of the difficulties being faced by a large number of early retirees, who simply had no medical cover.’

The enlightenment of officials to the problem began several months ago when Tony attended a meeting of around 70 British expatriates in Perigeux organised by Angela Martyn, the President of the North Eastern Dordogne Women's Association. He arranged for local CPAM officials to be present.

At the time, the health officials denied that there was a problem of access into the health system.

''So as if to prove the point' say Tony, 'I opened the matter up to a show of hands in the room, when around one-third of those present stated that they had been refused health cover by the CPAM.

The look of disbelief on the faces of the officials was only matched by my own astonishment that they should appear to be so blindingly oblivious to what was taking place in their department.

At the end of the meeting officials confided to me that they clearly needed to undertake some internal consultation, and the outcome now appears to be the change in policy administration.''

Tony advises that those in the department of Dordogne with a pre-existing long-term illness should contact him to discuss whether they might be eligible to obtain access to join the CMU.

Those who develop an Affection de Longue Durée (ALD) after they come to France already have a right of access into the health system under ‘accident de vie’ provisions, on a case by case basis.

The position of those early retirees who do not have a long-term illness remains unchanged, although we would suggest you discuss your circumstances with Tony to see what can be done. You can contact him at tony@soficas.fr.

The same applies to those living in other areas of France, where the position of many local CPAMs remains intransigent, although not in all cases.

We are finding that a number of health authorities are conceding when pressured, while others are recommending that early retirees secure a residence permit, on the basis of which the health authority would then be able to grant them access into the system. We covered this point in our last Newsletter.

We await further news from the European Commission who are pressing the French government for a relaxation in the rules and infringement proceedings remain in force. It remains to be seen how matters might develop with a new government in place in the country.

*Affections de Longue Durée (ALD)

The list of those illnesses (in French) classified an ALD provided from the French health service website is show below. It currently excludes high-blood pressure, removed from the list last year, but this may by under review by the new government.

• Accident vasculaire cérébral invalidant
• Insuffisances médullaires et autres cytopénies chroniques
• Artériopathies chroniques avec manifestations ischémiques
• Bilharziose compliquée
• Insuffisance cardiaque grave, troubles du rythme graves, cardiopathies valvulaires graves, cardiopathies congénitales graves
• Maladies chroniques actives du foie et cirrhoses
• Déficit immunitaire primitif grave nécessitant un traitement prolongé, infection par le virus de l'immuno-déficience humaine (VIH)
• Diabète de type 1 et diabète de type 2
• Formes graves des affections neurologiques et musculaires (dont myopathie), épilepsie grave
• Hémoglobinopathies, hémolyses, chroniques constitutionnelles et acquises sévères
• Hémophilies et affections constitutionnelles de l'hémostase graves
• Maladie coronaire
• Insuffisance respiratoire chronique grave
• Maladie d'Alzheimer et autres démences
  
• Maladie de Parkinson
• Maladies métaboliques héréditaires nécessitant un traitement prolongé spécialisé
• Mucoviscidose
• Néphropathie chronique grave et syndrome néphrotique primitif
• Paraplégie
• Vascularites, lupus érythémateux systémique, sclérodermie systémique
• Polyarthrite rhumatoïde évolutive
• Affections psychiatriques de longue durée
• Rectocolite hémorragique et maladie de Crohn évolutives
• Sclérose en plaques
• Scoliose idiopathique structurale évolutive (dont l'angle est égal ou supérieur à 25 degrés) jusqu'à maturation rachidienne
• Spondylarthrite grave
• Suites de transplantation d'organe
• Tuberculose active, lèpre
• Tumeur maligne, affection maligne du tissu lymphatique ou hématopoïétique