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utilisateurs:postdocs:health_insurance

Health insurance

The CEA International Office has a full guide on health insurance:

http://internationaloffice.ceasaclay.com/spip.php?article57

Caisse Primaire d'Assurance Maladie (State-provided health insurance)

  • CEA will submit the request to CPAM for your Carte Vitale (Social Security card) at your medical examination soon after you sign your contract. You will first receive a letter asking for a photograph - then a month or so later, the card arrives. Keep the Green Form that the card comes with, it is a very important document!
  • CPAM/Carte Vitale english speaking helpline: 36 46 from France, +33 811 70 36 46 from elsewhere, open Monday to Friday 09:00-18:00: http://www.ameli.fr/assures/votre-caisse-paris/nous-contacter/english-speakers-your-special-advice-line_paris.php
  • CPAM health insurance information in English: https://www.ameli.fr/assure/english-pages
  • Save medical receipt forms for consultations/treatment/pharmacy visits incurred before the Carte Vitale arrives (including stickers that come with medication)
  • Register at www.ameli.fr (can only be done when you have your Carte Vitale). They will first mail a password to your home address after registering.
  • Send in the medical receipt forms to your CPAM office with social security number from your Carte Vitale written in the space at the top right (and track progress via ameli.fr). Sign and fill out your birth date/address information.
  • Check carefully the receipt letter received from CPAM as it will state (in the small print) whether or not they have passed the claim to your Mutual Insurance Company (e.g. SMAPRI or AXA) to pay their share of the reimbursement. Send the receipt from CPAM to your Mutual Insurance Company if CPAM have not done this already.
  • If you travel around Europe or you are European and you go to your home country, it may be useful to order in advance the ‘carte europénne d’assurance maladie (CEAM)’. It is a free card that gives you access to medically necessary, state-provided healthcare during a temporary stay in any of the 27 EU countries, Iceland, Lichtenstein, Norway and Switzerland. When you have registered at www.ameli.fr, you will find a link to order it online.
  • To be reimbursed fully for medical expenses, you need to declare a specific generalist doctor as your primary doctor, using the form on this website: http://www.ameli.fr/assures/soins-et-remboursements/comment-etre-rembourse/le-parcours-de-soins-coordonnes/vous-etes-hors-du-parcours-de-soins-coordonnes.php. Otherwise you will only be reimbursed partially (it will say ‘HORS PARCOURS COORDONNE’ on your statement). This rule doesn’t apply to emergency consultations, and various other things listed in the link above.
  • A generalist doctor’s appointment usually costs 23 euros (this is the standard rate for ‘Category 1’), and the state will refund 70% of this, and your medical insurance the rest. If you are having more specialist treatment, the amount of refund that you receive depends on a complicated formula of state policies and what kind of medical insurance you have (you can choose to pay a monthly subscription on top of the basic cover that CEA/CNRS/whoever will pay for). You are arrange an appointment yourself with a specialist (‘Category 2’) doctor directly, but this route will cost more than if you are first referred there by a generalist (‘Category 1’).

Mutuelle (top-up health insurance, provided by your employer)

  • ‘Top-up’ health insurance should be organised for you at your medical examination soon after you sign your contract.

Finding a doctor

Others

  • If you want to take part in any kind of competitive sport event, such as a 10k race, you need a doctor’s note for this under French law, which lasts for a year at a time, and which any generaliste can provide
utilisateurs/postdocs/health_insurance.txt · Last modified: 2018/09/12 10:32 by cmorice