scrubbedexpat056

Hi All,
We have finally got our provisional healthcare numbers in lieu of out cartes vitale. Having never done this before and having failed to achieve anything searching this forum, could someone outline simply the procedure for reclaiming medical expenses? We have not needed access to the system so far (touch wood), but my wife has a lifelong condition and has been buying her own drugs here, mercifully without a prescription. I understand this should be reimbursed 100% (we will be taking out mutuelle insurance for anything else), but how does she go about this and indeed what is the procedure in general to get reimbursed for medical matters.
Thanks.

dmu

Hi, in general, while waiting for your Carte Vitale, you pay the Doctor and Pharmacie (and Physiotherapist, Nurse, etc...) and they give you a Feuille de Soins which you fill in and send to your CPAM. They'll reimburse the 70% directly into your bank account, and when you've taken out a Mutuelle, they in turn will reimburse directly, depending on what coverage you're paying for.
Has your wife's Médecin Traitant applied for her ALD status? The CPAM will send an acknowledgement that they've accepted it shortly afterwards, but the "Protocole de Soins" document will take longer to arrive. I don't know what happens if she hasn't got a Carte Vitale yet. When you've got an ALD, you have to update the CV in the machine at the Pharmacie so that they don't charge upfront....
As you realise, the 100% is only applicable for that particular disorder, your wife would have "norma"l coverage for anything else not connected with it.
HTH

EuroTrash

As DMU says - you need to get your MT to diagnose your wife and sign off the ALD asap (hopefully you have already registered an MT?). I suspect you won't get a refund for anything you have bought over the counter - chemists don't normally issue feuilles de soins unless you have a prescription, plus in any case I believe you have to attach a copy of the prescription to the feuille de soins when you apply for your refund. I don't know if ALDs can be backdated but even if they can't you should have been able to claim the normal 70% refund if you'd gone to a doctor and got a prescription, hindsight is a wonderful thing isn't it. Although obviously you would have had to pay for the consultation so it all depends how much the items cost, swings and roundabouts..

scrubbedexpat056

We haven't signed up with an MT yet, it's on the list of a million things to do when emigrating. Obviously an important thing and should (and will) be at the top of the list now. In fact the drugs haven't been a problem financially, she was just relieved to be able to buy them without a prescription. Some might remember from a previous thread of mine that we were kicked out of the NHS when we thought we were only gathering information for CPAM so simply having access to the drugs is a massive relief.
One more question, does anyone know how to go about getting our medical records from the NHS or is this done automatically between the health care systems (just writing that sounds naive to me). How does my wife prove her condition to the MT?

EuroTrash

He's a doctor! He will examine your wife and diagnose the condition for himself and decide what treatment to recommend. Even if you do go along with NHS records, he's not going to simply take another doctor's word without doing his own diagnosis.
I don't know how you get your NHS records. I never bothered cos I very rarely saw a doctor in the UK. But once you're in the system here you will be called up for routine scans and France will take over your healthcare.

cyrian

You have the right to access your medical records.
Ask your former UK GP for a printout - they may or may not make a small charge for this.
You could ask a relative or friend to collect them and post them to you.
HTH

scrubbedexpat056

Ok, thanks.

dmu

It didn't occur to me to mention this, as I misread the post and thought the MT had told them about ALDs. From experience, ALDs can be backdated, but OH obviously had a CV during the process.
Things may be different now, but you used to have to remove the little labels on the medicine packages and stick them on the prescription before sending the papers for reimbursement. When using the CV, the pharmacist passes the prescription through a scanner and enters the delivery of the medicines on the computer.
As said, a Doctor won't issue a prescription without examining the patient, and even prescribing a blood test, before diagnosis and treatment.

Notdunroamin

Astonished that a pharmacy in France would sell you medication over the counter without a prescription !!!!!

EuroTrash

?????
Do chemists in your country not sell any non-prescription medication?
In most Western countries (including the UK) there is a wide range of medications and treatments you can buy over the counter, which the pharmacist will advise you on if you're not sure, alongside the list of medications you can only get on prescription.

scrubbedexpat056

Certainly my wife's drugs are pretty powerful stuff and only available with a prescription in UK so a I said before, we are agreeably surprised ourselves.

petitefrancaise

like the UK, some items are available without a dr's prescription but anything "pretty powerful" will almost definitely need a dr's prescription.