EHIC - paying upfront and getting reimbursed

slopemaster

Does anyone have experience, especially in France, of paying up front for medical care and actually getting reimbursed using the EHIC?

It's actually never worked for us; they always seem to fob you off. I've put in a few smallish claims in the past - eg one for my mum for emergency dental. Sent to the correct French authorities, with all the correct paperwork, but never paid. They were fairly small claims so I always gave up in the end.

Now we are in France and OH has broken his leg.
The emergency care was excellent, and there was no problem at all about the EHIC covering all the hospital treatment.
But now he has been discharged we are supposed to pay up front and claim it back. (For prescriptions, nurses visits, blood tests, follow-up visit to surgeon, x-rays....) And they are basically refusing to pay. We have already paid out several hundred euros and there is plenty more to come, so I really need to get this refunded!

The letter from the French CPAM basically said, you haven't produced any evidence of having a right to reimbursement. I've written back to say, oh yes I have - the EHIC. I've attached another copy of it, and also quotes from a couple of official websites on how it is supposed to work.

I also phoned the UK number of the [FONT=&quot]Overseas Healthcare Team. They said there is a procedure for getting reimbursed after you return home, and they can send me the forms. BUT I expect this will need the original receipts and prescriptions etc which I had to send to the local office in France. Also she warned me it will take 4 months!

I realise its unlikely anyone here is an expert in how the French system works or doesn't. But I'd be interested to here from anyone who has - or hasn't - managed to get reimbursed.
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knightstyle

We have just got over 100€ back after making a claim at the end of July.
The doctor, nurses and pharmacy give you brown forms when you pay, you need to take these to the local CPAM, they copy your EHIC fill in another form and they will then pay into a French bank account or send a cheque.
You will get between 40 and 70% back. Although some things which are deemed to be life threatening are not charged for. Plus some things such as hospital "housekeeping" is not refunded at all.
That is how it should work, the CPAM actually get the money back from UK so no loss to them.
We are using the CPAM in Niort who we have always found to be very helpful.

As you are having troubleI would suggest you get your local mairie to ring them and if that fails write to your European MP and get them to earn their pay!

You can PM me if you like as we have a lot of experience in this.

martindow

I think that French citizens are obliged to pay for an insurance either a state system or via an insurance company. Without this can you apply for re-imbursement of fees?


However your travel insurance should cover the fees that you have had to pay.



Are you travelling by air? There may be limitations on travel with a leg in plaster or the need to buy extra seats. Again, this is another thing to be dealt with by the insurers.


I hope that he makes a quick recovery.

slopemaster

We don't have insurance that covers this, as it should be covered by the EHIC

CM66

slopemaster wrote: »

We don't have insurance that covers this, as it should be covered by the EHIC

You should always have separate travel insurance, EHIC would not cover you for repatriation if you needed to fly home etc

slopemaster

I know EHIC would not cover you for repatriation if you needed to fly home etc.

But we have decided we are willing to take that risk when travelling in countries covered by the EHIC. Insurance is expensive for us (age, pre-existing conditions, "dangerous" sports...)

And anyway, why wd we want to be repatriated from France (or Spain, or Austria) when their medical care is better than ours anyway!

comeandgo

It's very expensive to take a body back to uk, that's what your repatriation is for too.

slopemaster

That is a point I hadn't really thought about.
But even so, I think we wd take the risk ourselves.
Worst case scenario, arrange a local cremation and take the ashes back for ceremony in UK!

pattycake

Is proper insurance as expensive as the costs you have just had to bear which you are dubious about recovering? What if the accident/illness you suffered was even more serious than a broken leg?

My DH has a heart condition but we pay for proper travel insurance. Money well spent if the unthinkable happened.

slopemaster

The majority of insurance requires that you use your EHIC first, to reduce the costs they have to reimburse.
So I would probably still have this hassle.

slopemaster

I do have insurance when it's essential, but am always v sceptical about them paying up.

I'm still dealing with a claim from our previous trip - to south africa.
A theft claim from May was recently paid, but for a 300 pound claim they made me send about 30 documents - not just claim form and police report but also UK utility bills, original air tickets, copies of passports and driving licences etc etc.

And a substantial medical claim is still outstanding