Go Back  British Expats > Living & Moving Abroad > Europe > France
Reload this Page >

A cautionary tale re ALDs

A cautionary tale re ALDs

Old Jun 15th 2019, 10:46 am
  #1  
dmu
Lost in BE Cyberspace
Thread Starter
 
Joined: Apr 2008
Location: Hérault (34)
Posts: 7,342
dmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond repute
Default A cautionary tale re ALDs

ALDs "Affections Longue Durée" have been mentioned on the forum before now. Normally it means that you're 100% covered for one or more of the ailments listed, and there's nothing to pay upfront, provided you present your Carte Vitale and your Médecin Traitant has registered you. This was the case for OH, but he was always treated in a Public Hospital.
Then I managed to contract an ALD myself this year and, by a series of circumstances beyond my control, I found myself being operated on in a semi-private Clinique. The surgeon was brilliant, but his fees were beyond the Sécu's threshold ("dépassement des honoraires") and I was billed over 700€ on being discharged (some of which was the cost of staying overnight). I have yet to see how much the Sécu will be reimbursing, and how much my Mutuelle will be topping up, but know that it won't be 100%. This applies to an operation. "Normally" there'll be nothing to pay up-front for follow-up care away from the Clinique.
Be warned, and ensure that, if you contract an ALD, need an operation, and the finances are tight, go to a Public Hospital!
dmu is offline  
Old Jun 15th 2019, 12:09 pm
  #2  
BE Forum Addict
 
Tweedpipe's Avatar
 
Joined: Oct 2007
Location: Halfway between Ricard & Absynthe
Posts: 3,472
Tweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond repute
Default Re: A cautionary tale re ALDs

Wow, that's tough. I had a very similar experience 5 years ago with an ALD contract, then an op in a semi-private clinic. I recall that my Mutuelle were excellent, but the system/surgeon stung with a ticket modérateur / dépassement des honoraires, which from memory was a hurtful 500euros.
Will be interesting to hear what you get back from your Mutuelle.
In the meantime I wish you a steady recovery, and "bon-courage".
HERE and HERE are interesting links for those not familiar with this aspect of French bureaucracy.
Tweedpipe is offline  
Old Jun 15th 2019, 4:34 pm
  #3  
BE Forum Addict
 
Annetje's Avatar
 
Joined: Mar 2010
Location: Var, South of France
Posts: 3,967
Annetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond reputeAnnetje has a reputation beyond repute
Default Re: A cautionary tale re ALDs

I hope you recovered 100 % DMU !

That's all very strange. When my late OH got ill (c) he was taken to a private hospital for the final days (single room).
I never ever saw a bill for anything related to this illness..He was never operated though. Would that be the difference ?

I did get a bill for transport but when they found out he passed away they told me to throw it away. Can't remember which department this was.
Annetje is offline  
Old Jun 15th 2019, 6:30 pm
  #4  
dmu
Lost in BE Cyberspace
Thread Starter
 
Joined: Apr 2008
Location: Hérault (34)
Posts: 7,342
dmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond repute
Default Re: A cautionary tale re ALDs

Originally Posted by Annetje View Post
I hope you recovered 100 % DMU !

That's all very strange. When my late OH got ill (c) he was taken to a private hospital for the final days (single room).
I never ever saw a bill for anything related to this illness..He was never operated though. Would that be the difference ?

I did get a bill for transport but when they found out he passed away they told me to throw it away. Can't remember which department this was.
For the moment, I'm 100% OK, thanks! But the follow-up care will take time....
I just wanted to warn BE members who won't have budgeted for such a bill, however reimbursed later, to make sure that the surgeon is "conventionné"....
I'll keep you updated when I've been reimbursed!
P.S. OH suffered from another ALD and was hospitalized several times when he was opened up for various procedures. If your OH wasn't treated by a surgeon, then that must be the difference... Sorry to have brought back unhappy memories....


dmu is offline  
Old Jul 11th 2019, 7:11 am
  #5  
dmu
Lost in BE Cyberspace
Thread Starter
 
Joined: Apr 2008
Location: Hérault (34)
Posts: 7,342
dmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond repute
Default Re: A cautionary tale re ALDs

Originally Posted by dmu View Post
For the moment, I'm 100% OK, thanks! But the follow-up care will take time....
I just wanted to warn BE members who won't have budgeted for such a bill, however reimbursed later, to make sure that the surgeon is "conventionné"....
I'll keep you updated when I've been reimbursed!
P.S. OH suffered from another ALD and was hospitalized several times when he was opened up for various procedures. If your OH wasn't treated by a surgeon, then that must be the difference... Sorry to have brought back unhappy memories....
The Mutuelle coughed up 311€ out of the 500€ which the Sécu didn't reimburse, so I'm almost 200€ out of pocket. I've no intention of paying more each month for a better coverage, so will make sure I consult a "conventionné" the next time I need a surgeon!
dmu is offline  
Old Jul 11th 2019, 8:38 am
  #6  
BE Forum Addict
 
Tweedpipe's Avatar
 
Joined: Oct 2007
Location: Halfway between Ricard & Absynthe
Posts: 3,472
Tweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond reputeTweedpipe has a reputation beyond repute
Default Re: A cautionary tale re ALDs

Depending on which report one reads, a recent one states that 5 million French are without a Mutuelle due to not having the finances necessary.
Many of us are somewhat more fortunate, but I agree that when the dépassement des honoraires are excessive, it's often very tough also for those who do have cover and need to cough up more.
Hope you are well on the road to recovery DMU. Bon courage.
Tweedpipe is offline  
Old Jul 12th 2019, 6:39 am
  #7  
dmu
Lost in BE Cyberspace
Thread Starter
 
Joined: Apr 2008
Location: Hérault (34)
Posts: 7,342
dmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond reputedmu has a reputation beyond repute
Default Re: A cautionary tale re ALDs

Originally Posted by Tweedpipe View Post
Depending on which report one reads, a recent one states that 5 million French are without a Mutuelle due to not having the finances necessary.
Many of us are somewhat more fortunate, but I agree that when the dépassement des honoraires are excessive, it's often very tough also for those who do have cover and need to cough up more.
Hope you are well on the road to recovery DMU. Bon courage.
Thank you for that! I'm fine, in fact it's the post-op aftercare which is taking it's time to get up and running. Being optimistic, this must be a good sign as it means I'm not an urgent case (the treatment is preventive), but the wait is frustrating....

Last edited by dmu; Jul 12th 2019 at 6:41 am.
dmu is offline  

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Contact Us Archive Advertising Cookie Policy Privacy Statement Terms of Service

Copyright © 2018 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.