Moving to France Tutorial - Part Five

I know it's been a couple of months since my last Moving to France post, but this one was a bit of a challenge to put together.  

(Update: Check out this article)

Once you arrive in France and get your Carte de Séjour sorted out, you will want to join the fabulous French health system.  Actually you must join the French health system.  All permanent residents in France are obliged by law to have national health insurance, which comes in the form of a little green card, the Carte Vitale.
The information on this topic is rather extensive, so in the end, instead of painstakingly re-wording the material from the French government websites, I have simply copied the relevant sections of the Sécurité Sociale guide.  

So, without further ado...how to join the French health system.


As it states in the Livret de Santé:
"In France, everyone is entitled to health insurance to cover the cost of medical care. It is preferable to apply for it before becoming ill. The first step is to apply for “basic” public health insurance, which can be extended by paying for private supplementary insurance ("mutuelle"). For people with a low income, supplementary insurance is available free of charge and is known as supplementary universal medical cover (CMU-Complémentaire).

Who is entitled to “basic” public health insurance?
“Basic” public health insurance (including “basic” CMU) is an entitlement for anyone legally residing in France for at least three months before the request for healthcare (except asylum-seekers who are exempt from this condition).

Where should I apply for public health insurance?
Go to the public health insurance centre in your neighbourhood (ask for the address from the Town Hall’s CCAS, or social assistance centre). If you are using a government-assigned address, go to the public health insurance centre whose address is listed on your certificate of domiciliation.

Documents required:
- Identity: the preferred document is birth certificate, otherwise a passport, identity card or certificate of registration with the OFPRA (French Office for the Protection of Refugees and Stateless Persons) for asylum-seekers or any other document giving proof of your identity;
- Address: certificate of accommodation (with receipt for rent or EDF bill) or government-assigned address registered with an approved organisation. Important: make sure that letters actually reach this address;
- Legal residency in France: any valid residency document issued by the Prefecture: residency card, temporary stay card, proof of receipt of application, temporary approval for stay, appointment/summons, asylum notice, etc.;
- Income: written proof of all income received from January to December of the previous year (wages, welfare benefits, etc.).
 
Using the Public Health cover System
As a general rule, the public health insurance system reimburses two-thirds* of your healthcare expenses (except on glasses and dentures), but the patient must pay the entire sum first. In healthcare centres, hospitals and certain doctors’ offices and pharmacies, patients may pay only one-third of the expenses (known as the “ticket modérateur”), by showing their health insurance card (paper certificate or Vitale Card). Supplementary CMU insurance or mutual and private insurance companies cover the additional amount.
Important: the “100%” is not free in all cases: those with certain chronic illnesses can be exempt from paying the ticket modérateur, and are considered “100% covered by the public health insurance system”. However, the “100%” applies only to the care received for chronic illnesses."

The French Government Website (in French)

I have to add that the following documents may or may not be asked for (some have already been listed above) but you should have them ready just in case.

• Passports
• Details of place of birth (as well as your partner's and children's information)
• Marriage and birth certificates of all family members
• Proof of address in France with proof of ownership (deeds) or rental agreement
• Date of permanent arrival in the departément
• Proof of residency in France for at least three months (in the form of three months EDF or France Télecom bills, rent statements or mortgage payments or a notarized statement of your home purchase)
• Proof of income for at least the previous 12 months, whether in France or elsewhere or an avis d'imposition or latest French tax bill.
• A RIB (Relevé d'Identité Bancaire) provided by your bank

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Our Carte Vitale story just goes to show that doing your homework when dealing with French bureaucracy will (sometimes) get you everywhere!

We went to the local CPAM office in Béziers to apply as soon as we got our Cartes de Séjour, as we had been informed to do.  Luckily we had armed ourselves with knowledge of the current law, because even though it had passed a few years before, the powers that be obviously forgot to send the memo down south to the CPAM office in Béziers.
The man behind the desk told us quite confidently that non, we couldn't join the French health system because France had no reciprocity with America, which is true - France and America do not have reciprocity when it comes to medical care.  In turn, we confidently and patiently told him that it didn't matter, because (at the time) the law stated that anyone legally residing in France for at least three months of the year must join the system.
He sat there for a moment, staring at us with a kind of deer-in-the-headlights look, then suddenly grabbed the telephone and made a couple of calls.  When he hung up he looked at us with a smile and said oui, you are correct."
Phew!
Thirty minutes and a mountain of paperwork later, we were official Carte Vitale carrying residents of France.

*To cover the 30% of costs that are generally not covered by the system, we purchase a Top Up, or mutuelle from a private company.  The price for the two of us is about €130 a month and although many people we know choose not to have the added expense, we like that it gives us the freedom to go to private doctors as well as state doctors.


The next installment of the series will be about obtaining the elusive 10 Year Carte de Résident.  Some of the stories I've heard on this subject have been real doozies and would love to hear from more of you if you want to share your experiences.

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Ten Reasons I Love Living in France

La Belle France. I was seduced by her charms at an early age and have been a passionate francophile ever since. There are dozens of reasons why I love living here, and here are my top ten.

1) The cheese!
Obviously


2) The people we've met and the friends we've made

3) The food
You just can't think of France without thinking of food. It is the raison d'être.


4) Quaint harbor towns
Honfleur, Saint-Palais-sur-Mer, Collioure, Cassis, Antibes, Mèze


5) The health care
Just read the story of my broken arm and you'll understand why.

6) Paris
I am totally smitten with this city.


7) The cafés
Simple, honest food, wine by the carafe and the best people watching.


8) The markets
So cliché, I know. But they are an intrinsic part of life in France and I love shopping at them.


9) The vineyards


10) I am now one of them
"Bienvenue au club," they say with a smile. Pin It

The Saga of the Broken Arm - Part II - Days of Wine and Needles

So there we were, driving around Lézignan-Corbières on a dark and stormy August night, trying to find the hospital. After a few wrong turns, and the help of some locals, we finally found it. Pain relief was on its way!

One thing to remember: It was August. The month for holidays in France.
If you don't know, August is the month when cities become ghost towns because the bulk of the population leaves to go on vacation and the beaches are wall-to-wall sweaty bodies soaking up the sun. And the hospitals are understaffed.
It was August and it was a Friday night in a small town hospital in rural France. Oh dear.

Not surprisingly, it was very quiet when we arrived, so thankfully we were helped immediately. But the first thing they did was take X-rays, not administer pain relief! Then they had to draw blood and the nurse couldn't find a single vein in my arm from which to do it. She kept jabbing and stabbing until husband found the doctor on duty, grabbed him, and asked for help. One quick jab and success! What a relief.
Only then did they give me some pain killers.

The X-Ray did indeed show that my arm was broken. In two places. I would have to go to the hospital in Narbonne for surgery and the next available ambulance to take me there wouldn't be available for at least 2 hours. Thanks, but no thanks. We grabbed my X-rays and drove there ourselves.

I finally got checked into a room about three in the morning and was told that I would be having surgery the next day. I slept a blissful, drug induced sleep until the evil, needle-bearing nurses arrived the next morning to inject me with more medication and to get me ready for surgery. "Getting ready" required a full body, and I mean every nook and cranny, scouring.
As they were vigorously scrubbing me up and down in the bathroom, with both the door to my room and door to the hallway wide open I might add, they told me that the anesthesiologist would be arriving soon to discuss her role in the procedure. La voilà, there she is! Ready to have our little chat while I'm standing there in all my naked glory, being buffed and cleansed.

It is rather humiliating to try to discuss medical terminology in a foreign language while high on painkillers and totally naked while having all of your bits washed. I don't recommend it.
I know the doctors and nurses are used to seeing people naked. To them it's no big deal. C'est normal. I, however, am not used to it.

So I was trying to ignore my humiliation and focus on what the anesthesiologist had to say. Something about putting the IV in my neck, straight into my jugular vein? I assumed that I had somehow misunderstood her. I mean, that sounds barbaric!

I didn't misunderstand her.

When they finally took me downstairs to knock me out before surgery, we had a bit of a problem. They couldn't get the needle into the right spot. Here they were, two trained anesthesiologists, standing over me with this long needle, jabbing me over and over in my neck, unable to find the exact angle or something. What I remember most is that I felt like a lab rat being experimented on. Complete and utter hell.
I finally begged them to stop. And that I didn't want them to administer the painkillers through my jugular. They would have to go through a vein in my arm.
They were quite unhappy with me and told me in rather disgusted voices that the drugs would take much longer to work that way, did it anyway, then said they were going to lunch.
And left me lying in a cold room with only a thin sheet to cover me. I was freezing.

Thankfully that is all I remember until after the surgery.


When I woke up husband was sitting in my room with an ice cold can of Coke, thinking that it would taste good and refreshing after not having anything to eat or drink in more than 24 hours. The nurses told him, "absolutely not!" I was only allowed a bit of water dabbed onto my lips. No Coca Cola!
Ok, fine.

Friends started arriving and family started calling from America. The hotel operator knew me as l'Américaine, and as soon as she heard an English voice, she transferred the call to my room. It was great to see and hear from so many people.
I was in a complete morphine induced fog, so didn't remember until much later that when our neighbors came by with their 13 year old daughter to say hello, there was nothing covering my upper body, leaving my left breast totally exposed. My right arm was all wrapped up against my torso so I couldn't put a shirt on, and nobody had bothered to cover me up with a sheet or a blanket when they arrived.

So now our neighbors know what my boobs look like. Great.
Hell, half the hospital had seen me naked by this point so I guess it really shouldn't matter.
When I later asked husband why he didn't bother covering me up he responded, "It's ok, they didn't mind."
Um, Hello? I did!
To this day, I'm still stunned that he didn't think it was a big deal. Especially after he made such a fuss about me leaving the house the night before with no clothing on.
?

The next day they brought the lunch menu and asked if I wanted beer or wine with lunch. I pointed at my IV and said, "but I'm on morphine." No problem! It was medicinal! Besides, I would only be served a small bottle.
Who was I to argue with doctor's orders?


In the end it took several days in the hospital, lots of drugs, six months of physical therapy, many follow-up visits to the surgeon, a lot of frustration and tears, and endless patience on husband's part. But now my arm is completely healed.
And even with the overuse generous use of needles (did I happen to mention that I have a phobia of needles) and inability to find my shy veins, in my experience the medical system in France is excellent. The doctors and nurses are friendly and helpful, they take their time with you and they are thorough.

But I never, ever want to have to go to the hospital again. The wine may have been good, but it wasn't that good. Pin It

The Saga of the Broken Arm - Or, My First Encounter With the French Health System

One August evening, four summers ago, I opened the skylight on our top floor to help keep the house cool. That one, innocent act means that I will forever have a titanium rod and two little screws in my right arm.

~

The clouds started building late that afternoon and by 9pm the thunder was rumbling and the lightening started flashing. I was in our bedroom changing into my p.j.'s when the skies opened up and the rain came crashing down. I quickly ran upstairs to close the skylight and as soon as my foot hit the water that had pooled on the floor, I slipped and came down hard on my right elbow.
Lying there stunned, I felt some pain in my upper arm and immediately thought that I had dislocated my shoulder. You know how you see in movies or on shows like ER that a dislocated joint can be popped right back into the socket?
Well, in my infinite medical wisdom I thought, "Ok Jennifer, no big deal, just be brave and pop it back in," then grabbed a hold of my upper arm with my left hand and pushed.
YEOW!
My shoulder wasn't dislocated. My arm was broken.

So there I am, totally naked, skylight still open, rain pouring through a hole in our roof into our house, and husband is down on the main floor, totally oblivious to what is going on up on the third floor. Yes, I was the I've fallen...and I can't get up lady from those TV commercials.

I started calling for him, somewhat loudly at first, then screaming, "honey! HONEY!" He came running upstairs, grabbed some towels, got the skylight closed and the floor mopped up. I was eerily calm when I told him that I thought I had broken my arm and needed to immediately go to the hospital.
He gave a brilliant response, "But...you're naked." (I still tease him ruthlessly about this)
Like I cared! The fact that I wasn't wearing a stitch of clothing was the least of my worries. I would have happily walked out to the car and gone into the hospital just as I was. Getting some pain relief was priority number one!

In the end I didn't go in my birthday suit. He helped me pull on a pair of sweats and wrapped a summer robe around my shoulders. Putting a shirt on would have been impossible anyway, as I couldn't move my arm.

It was about 10pm by now and as I said, we were having a dramatic thunderstorm. Out into the pouring rain we went, driving over the rugged roads while I held my arm and tried not to scream every time we hit a bump, to the nearest hospital in Lézignan-Corbières. Of course, we didn't know exactly where the hospital was. Just knew that there was one...

Part II of the Saga- How I Survived the Needles and Enjoyed the Wine in the Hospital.

My lovely black and blue marks in my good arm from the endless IV's and needles - Photo taken by Jon Knowles

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