Houghos

Hello,
​​​​​​My wife needs her wisdom teeth removed, she has a devis for 550€, and I was wondering how it works with the mutual and all? Do I need to pay that upfront? Or is there a way around it so what is reimbursed by the secu or mutual I don't need to pay upfront?
thanks for any help.

dmu

I had my wisdom teeth taken out when I was still living in the UK, so I'm not well up on how the finances of such an operation work in France. Will it be done in a private or semi-private clinique, or an établissement conventionné?
If you've been given a Devis, presumably the part which the Sécu reimburses you has already been deducted from the total and is mentioned as such? Your Dentist should explain, and, like opticians, should contact your Mutuelle to find out how much you'll be reimbursed, so that you can budget for it.
There's no way of getting out of paying the sum upfront - you send the receipted Devis to your Mutuelle and wait for a certain amount to be reimbursed, depending on how much coverage you are paying for... Your reimbursement of the Dentist's tarif conventionnel will be paid by the Sécu directly into your bank account (via your wife's Carte Vitale) - you don't have to bother about the Sécu side of things.
HTH

petitefrancaise

It is your responsibility to call your mutuel and find out how much they will pay - when I worked in France we would do it for the patient if asked - usually just needed to email the devis as a pdf.
You will have to pay the dentist and then wait for reimbursement - just as an fyi the reason it's done this way is because the secu will refund you usually within a couple of weeks but will make the dentists wait 6 months or so.
Sounds a bit steep for wisdom teeth - is your wife being sedated because that would add considerably to the cost and may not be needed.

dmu

Out of interest, I did a search in French forums and found that this is more or less the norm for 4 teeth, if the operation is being performed under general anaesthetic by a stomatologist in an establishment with "dépassement des honoraires" (= private or semi-private clinic). From experience (in another field), the reimbursement of the "dépassement des honoraires" by the Mutuelle is peanuts, but it depends on how much coverage you pay for..... The OP should find this out before signing the Devis.
The search results said that, if the teeth are being extracted by a "conventionné" dentist in his/her surgery, with local anesthetic, he/she must not exceed the tariffs set by the Convention, i.e. there's no Devis.
All this suggests that the OP's dentist is sending his wife to a surgeon who exceeds the tariffs - they should enquire about other possibilities in a conventionné clinic/hospital if the high cost is an issue....
HTH

Houghos

Okay thank you for your answer. How much should it cost then?

dmu

Google is your friend. I found the following official link in answer to a question on a French forum. Scroll down for the various tariffs.
This confirms that your Devis must have been given by a "médecin stomatologiste exerçant en Secteur 2" (i.e. non-limited fees) and confirms the Sécu's "dépassement des honoraires" policy of not reimbursing proportionally.
You'd do best to find a "médecin stomatologiste exerçant en Secteur 1", i.e. one who is conventionné....

https://www.ameli.fr/herault/assure/...eses-dentaires

Houghos

Thanks a lot. That link is very useful, just when I do a research on doctolib it says conventionné but it does not mention anything about secteur 1 ou 2 si how would I go about finding that out?

dmu

Sorry, but you said once in another thread that you had lived here before and are fluent in the language:
"Secteur 1" means "conventionné"!

petitefrancaise

Hi guys, I'm in the USA so just woken up.
you might find it difficult to find a stomatologist who will do it under conventionne prices because they are paid so little.... but it's worth a try and the first person to ask is your dentist because they've probably been asked this before. It's tricky asking for a recommendation but just asking if they know someone conventionne is ok.

The next question is do the teeth need to be extracted under general anaesthetic? It's often an automatic referral if they aren't through the gums but that doesn't always mean they need it.