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06/03/2008, 11:35 David Joined on 23/08/2004 North Deux-Sevres Posts 357 Re: E121 - Long Term Incapacity Benefit At Retirement  cooperlola wrote: Certainly, it is a UK matter.  If one can keep one's head down - as in Benjamin's o/h's case - then fine, but if CPAMs are clamping down then this issue will raise its head again and again. We (FHI) asked elsewhere for suggestions for where our group might go next, and I think this subject is worthy of scrutiny, at least.  I'm pretty certain this is why Mr Fulton mentioned it to me! That would be excellent Coops.  If your group could take this up, I am sure many deserving people would benefit at a time when they might need it most. All best, David    Report

06/03/2008, 16:12 Benjamin Joined on 21/08/2005 Vendée South Posts 1,815 Re: E121 - Long Term Incapacity Benefit At Retirement You pop out for the morning to do a bit of shopping and you come back to this , now, complicated thread.  My posting of this morning regarding no change to the E121 is exactly what happened as far as Mrs Benjamin is concerned but in the light of the strong views expressed about a changed E121 I have just had long conversations with Incapacity Benefits Section and International Pensions Centre in Newcastle. The outcome is that a new E121 should definitely be issued when the benefit changes, in Mrs Benjamin's case, from Incapacity to State Retirement Pension. A new one will now be issued to her, still with me listed as a dependent, within 28 days. They can offer no explanation why a replacement E121 was not issued when she reached 60 years apart from a "well these things do happen". This, and other comments made by David and Cooperlola, throw into doubt certain other things which I believed were true. The major one was that being granted ALD status only covered you for 100% reimbursements for whatever your ALD was issued for, but other ailments were covered on the 70/30 basis. I had a conversation with the English speaking CPAM helpline last Autumn when a Nurses' feuilles des soins for flu jabs were reimbursed 70% for me but 100% for Mrs Benjamin. The explanation I was given was that the 100% was given because the individual CPAM would have taken the view that catching the flu could have been detrimental to Mrs Benjamin's ALD. I was really asking the question from the point of view of ascertaining if it was really necessary to continue with Mrs Benjamin'e top-up insurance but I was advised that we should keep it going as it was only the ALD that was covered 100%. I am now begining to wonder if prior to her reaching 60 years it was necessary to have her top-up.  That's history now and I stand corrected but I hope the confirmation from Newcastle clarifies this topic for others. Benjamin St Malo 1-New evidence suggests mis-trial    Report

06/03/2008, 16:19 cooperlola Joined on 05/05/2006 72 - Sarthe - home of les 24 heures du Mans Posts 6,418 Re: E121 - Long Term Incapacity Benefit At Retirement No, Benjamin, when she was on an   ICB E121, it was not necessary for her to have top up as all her medical needs are covered by the UK in that case as I understand it. However, I'll check with a couple of people I know who have them, just to be sure.  But that was certainly what Larry F told me and he should know as he's in the business of making money out of these things when he can! On a retirement E121 this is no longer the case.  Whether the UK pays more per capita for the former, and this is the reason, I do not know.   The DWP is correct of course, it should have been changed in theory, but it's much better if they forget! Healthcare Issues Site    Report

06/03/2008, 16:23 Benjamin Joined on 21/08/2005 Vendée South Posts 1,815 Re: E121 - Long Term Incapacity Benefit At Retirement  cooperlola wrote: Certainly, it is a UK matter.  If one can keep one's head down - as in Benjamin's o/h's case - then fine, but if CPAMs are clamping down then this issue will raise its head again and again. I don't for one minute think you intended this to be what it sounds like. It was never our intention to "keep our heads down", more a case of incompetence by two UK Government departments and ignorance born out of simply not knowing on our behalf. As you can see, as soon as it was hinted at we took appropriate action to regularise the situation and will be trotting off to CPAM with the replacement E121 as soon as it arrives.  Edit: Our postings crossed. Benjamin St Malo 1-New evidence suggests mis-trial    Report

06/03/2008, 16:27 cooperlola Joined on 05/05/2006 72 - Sarthe - home of les 24 heures du Mans Posts 6,418 Re: E121 - Long Term Incapacity Benefit At Retirement No, sorry, I certainly did not mean it in that way.  However, I have heard of a couple of cases where people were told by CPAM officials "not to bother" as they would be worse off!!!  Certainly, nobody seems to get penalised - if the DWP and the French authorities miss the fact that one should have changed then, imo, that's their problem, not yours! Healthcare Issues Site    Report

06/03/2008, 16:32 Benjamin Joined on 21/08/2005 Vendée South Posts 1,815 Re: E121 - Long Term Incapacity Benefit At Retirement Hi Coops After your conversation with David F this ought to go as a sticky. I'm normally quite clued up about this sort of thing but it certainly caught me out. Best regards Benjamin. Benjamin St Malo 1-New evidence suggests mis-trial    Report

06/03/2008, 17:35 David Joined on 23/08/2004 North Deux-Sevres Posts 357 Re: E121 - Long Term Incapacity Benefit At Retirement Benjamin, Thanks. What gracious and reasonable postings you have made today, being prepared to listen and check.  I wish some other posters could take note of a reasoned discussion without getting up on high horses, declaring incorrect "facts", and then leaving the thread without comment when they are shown to be wrong. David    Report

06/03/2008, 18:04 5-element Joined on 28/10/2006 Languedoc Posts 962 Re: E121 - Long Term Incapacity Benefit At Retirement  cooperlola wrote: No, Benjamin, when she was on an   ICB E121, it was not necessary for her to have top up as all her medical needs are covered by the UK in that case as I understand it. ! That is correct. If you are on an ICB E121, you "get the 100%" for everything (except the hospital daily fee). As far as CPAM is concerned, ICB E121 is  the equivalent of their Allocation d'Adulte Handicape - which in France is means-tested. So in France, if you are receiving AAH, you automatically get 100% of all your medical expenses (bar the hospital daily fee, about 14 or 15 euros?). Sorry if this post is written too late in the discussion to be relevant now.    Report

07/03/2008, 12:22 David Joined on 23/08/2004 North Deux-Sevres Posts 357 Re: E121 - Long Term Incapacity Benefit At Retirement I have had a pm from someone asking about 100% cover for a particular item of hospital surgery.  It seems they have an E121 issued for long term incapacity benefit, but they have been making enquiries about cover ahead of time and been told that a particular item is not covered, even though it actually relates to a condition on the ALD list. The edited question was:- Quote xxxxxx receives long term Incapacity benifit from the Uk For most stuff he does get 100 but when there is a queerie as to a condition for example he has to have an operation in a few weeks time on an internal problem which we know is a result of his "xxxx - item on ALD list", seems there is a ? as to whether Securite sociale will cover it 100%, however if it should be that due to his E121 he gets it all covered perhaps I've not used a 'magic' word to get them to understand this. As it stands at the moment, we are going to see our GP next week and ask him for an attestation to say he shoudl reeive 100%. Unquote It seems to me that this is a problem of medical suppliers such as doctors, pharmacies, hospitals etc, rather than CPAM,  not understanding about 100% reimbursement, and giving wrong advice.  I also wonder if this is where the misconception that the 100% cover only applies to the ALD list comes from, and perhaps this is leading to widespread confusion, so I decided to edit the pm for anonimity and post it here. I therefore answered as follows:- Quote I am afraid that I am not an expert on these matters, and you should really ask Cooperlola about this. I can only speak for myself, and what I have found. Do you have a written attestation from your CPAM office, as well as your plastic carte vitale (cv)?  You should receive one of these each year.  This attestation should clearly state that you receive 100%. We live in an area with few Brits, and few of them on 100%, and few unfit French people (they all seem to be super fit farmers who never take a day off sick) thus the local doctors, pharmacies, hospitals, etc are not familiar with this 100% allowance on all items.  They go into automatic ALD list mode. However, when we produce the written attestation they seem then to understand, and give the allowance, albeit with some amount of disbelief.  I have also seen them, particularly at the blood test laboratory and small pharmacies, look disbelieving at their screens when the cv tells them there is no charge.  They have even refused to give me the products without charge and told me that my cv was faulty!  This is usually, but not always, solved by showing them the attestation.  Here I have learnt to go with the flow, let them charge me, and wait for the reimbursement from CPAM. However, for a potentially large item such as yours, you must be certain, therefore you really should check with Cooperlola, and I suggest you also go to your local CPAM office, and ask their advice. Unquote. Perhaps I should have said at the end, check with CPAM and not your GP, as your GP will not understand the 100%, and will only refer to the ALD list. I wonder if Coops would like to comment on this - I would be grateful if Coops would correct me if I have given poor advice. David    Report

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France Forum » Living » Health » E121 - Long Term Incapacity Benefit At Retirement

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