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21/02/2008, 11:44 cooperlola Joined on 05/05/2006 72 - Sarthe - home of les 24 heures du Mans Posts 6,285 Re: Take St Gaudens off the list! Grr... Well, go to CLEISS in the first instance as you should now be a shoe-in, as an E106 holder.  Personally, I would agree to pay pro rata from the date of the letter, as you had no cover for the interim period.  But talk to CLEISS first.  I will pass this on to the Embassy, Ninethace. EDIT : You should now have a copy of my e-mail to the Embassy, Ninethace. Healthcare Issues Site    Report

21/02/2008, 12:05 Boiling a frog Joined on 06/09/2004 Charente 16 Posts 536 Re: Take St Gaudens off the list!  Ninthace wrote: I started this thread because the St Gaudens CPAM had accepted our paperwork to apply for CMU-B after the expiry of our E 106.  Our new application quoted their initial refusal to let us join, gave dossier numbers and included a copy of the latest rules for E106 holders issued by the Securite Sociale.  Today we have received a letter dated 15 Feb  which adds insult to injury. They say thank you for our application to renew our membership of the CMU but we have been refused because of the change in EU law in 2004 and decree 2007-371 of 21 March 2007.  We must have sufficient resources and have private heatlth insurance etc.  However, as a goodwill gesture, our membership of the CMU has been extended to 31 Mar 08 and we should present our Carte Vitales for update as soon as possible.  Moreover, they say we owe them €478 for the quarter Jan to March 2008! 1.    We did not ask to renew - we asked to join following E106 expiry on 5 Jan 08.  We have never been members of the CMU-B. 2.   We do not have a Carte Vitale to update - when we asked for one in July 2005 we were told we could only have one when after E106 expired. 3.   Since we were not covered  by the CMU after our E106 expired - why on earth should we pay €478 for this privilege? Suggestions please?   Go back to your CPAM office and explain to them your circumstances. They have obviously made an admin error which is not surprising what with all the various changes made in previous months.         Boiling a frog    Report

21/02/2008, 12:58 Ninthace Joined on 23/08/2004 Haute Garonne Posts 48 Re: Take St Gaudens off the list! There are errors and there is incompetence.  The dossier we submitted contained a copy of their previous rejection letter at the end of December; a letter asking them to reconsider their decision in light of the new rules, including a quote of the relevant paragraphs; a copy of the new rules and a new application to join the CMU-B, together with copies of all the supporting certificates, evidence of residence etc.  The individual who replied made no reference to any of these and treated it as a request to renew.  He could not have made this error if he had bothered to read the dossier and, had he checked his records, he would have known we were not members of the CMU-B I am going back to the CPAM this pm to give them a chance to recover the error but I am not going in hope. Edit: Postscript.  We spent a long time at the CPAM this afternoon trying to sort this out.  Fortunately we were dealing with the same individual who had accepted our reapplication.  She read the letter as said she could understand why we were "excited".  After discussion with her supervisor, she issued us with an attestation for the CMU de Base so we are in the system at last. The bad news is that they still want us to pay cotisations back to January as the cost of membership is charged quarterly and we are in the system before the start of the next quarter.  We pointed out that we had taken out private insurance as required by their last rejection letter in December so in effect we would be paying for a service we had not only not used but had been refused.  She was sympathetic but no dice, let's hope my private insurer is as sympathetic when we cancel.  We did also ask if we could join at the start of the next quarter as we had already paid premiums up to that date but that came under the heading of too difficult.      Report

21/02/2008, 17:31 seb47 Joined on 02/01/2005 Lot et Garonne Posts 141 Re: Take St Gaudens off the list! Ninthace - commiserations. We can understand how exasperated you must feel. We too have taken private insurance as directed, but have not yet re-applied to CPAM as we're waiting for some documents to arrive from England. We're inclined to wait a good while before applying in the hope that this sorry mess will be sorted out. Do you have a date for the start of the next quarter? Good luck, Sue, Sue    Report

21/02/2008, 17:42 Ninthace Joined on 23/08/2004 Haute Garonne Posts 48 Re: Take St Gaudens off the list! Sue, Next quarter is 1 Apr 08.  CMU year is 1 Oct to 30 Sep.    Report

21/02/2008, 19:23 Boiling a frog Joined on 06/09/2004 Charente 16 Posts 536 Re: Take St Gaudens off the list! So it was an error and you are in the system. I have never used French health care but pay every quarter Do you think I should demand my money back         Boiling a frog    Report

21/02/2008, 19:27 cooperlola Joined on 05/05/2006 72 - Sarthe - home of les 24 heures du Mans Posts 6,285 Re: Take St Gaudens off the list! To be fair, BaF, you were not told that the state system would not cover you and that you needed PHI - then took it out only to discover that you could be in the state stytem, but would have to pay for both, during the period in which the government dithered and subsequently did its spectacular u-turn!  It really is one of the fallout problems from the delay, nothing else, and thus, imho, the ministry's problem.  Ninethace should not have to pay for the period when he was covered by PHI, but because of the system can do little else. Healthcare Issues Site    Report

21/02/2008, 21:17 Ninthace Joined on 23/08/2004 Haute Garonne Posts 48 Re: Take St Gaudens off the list! BaF, of course there was an error otherwise I would have been admitted as a result of my reapplication which post dated the rule change.  The error was the failure to investigate the application properly, read the paperwork submitted and to investigate and apply the published rules. Fortunately I did not have to find out but presumably had I tried to see a doctor any time between Jan 05 and the present day I would have been refused support from the CMU as non entitled.  BaF, there is a difference between paying for a service you are entitled to, but do not use, and being made to pay for a service you were told you were not allowed to use. I expect my insurance company may well take the same view when it comes to refunding the premiums I paid.    Report

21/02/2008, 21:35 Boiling a frog Joined on 06/09/2004 Charente 16 Posts 536 Re: Take St Gaudens off the list! If you feel so strongly about it why not follow the correct process and put in an appeal against the charges to the concilliator . You can find all details on the CPAM website for your region.Our first year CPAM tried to charge us for  October to December but when we wrote to the conciliator pointing out that we had an E106 for that period they quickly revised their demand.           Boiling a frog    Report

21/02/2008, 21:53 Ninthace Joined on 23/08/2004 Haute Garonne Posts 48 Re: Take St Gaudens off the list! A useful suggestion BaF.  I am happy to pay for CMU or private insurance for the intervening period but I think I may be breaking some rule to have 100% private cover when apparently I was "covered" by the CMU and therefore be paying for both at the same time.  I have contacted my private insurer and am waiting for a response.  Article 18 of Loi 99-641 may be relevant.    Report

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France Forum » Living » Health » Changes to Heal... » A Glimmer of Hope?

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