CPAM Refunds

[suein56]

I've got a heart valve defect problem which is stable but inhibiting for strenuous exercise (which I'd avoid anyway) so what benefits of ALD might I expect?

For my OH he has Angina and has had operations for that and for blocked arteries .. which is classed as smthg that needs constant care and surveillance .. so perhaps that is a clue.
Not that he is afflicted but I know for Stage 1 diabetes it isn't going to away on its own so it needs constant attention so that's why that is an ALD.
There is list of the ALDs .. cancer is on there too, I think there are about 30 problems covered.
I have no idea of the benefits other than necessary treatment is covered at 100% .. but we still pay part of the cost of a private room in the Hospital - as it costs more than our Mutuelle will pay out. If you want no charge for your room then you have to share.

[Polarengineer]

sharing a bed an be fun

[Hotrodder]

Very interesting to hear the €25 was phased out. We have been paying every visit for many year twice or more a year. I used to wonder when I saw about €17 drop into my bank account but can't remember seeing in such input for a while now. Its all such a complicated mess these days.
We just had a go at asking for a RDV at the tax office. To use their secure messaging system online took the best part of half an hour. I have a feeling next year it will be exponentially worse.

[exile]

We too have always paid the MT - which incidentally has gone up to €26.5 - and await reimbursement from CPAM which always falls short due to the charges - €1 to the MT plus the pharmacy contributions.

ALDs are defined so some long term conditions are not covered (high blood pressure for example), while some more serious ones are.

[elsie]

These links should work; you will need to give your postcode to take you to your particular AMELI

This is the full list of Tarifs conventionnels des médecins généralistes en France métropolitaine https://www.ameli.fr/herault/medecin/ex ... -metropole
They are the levels of CPAM reimbursement. If the doctor charges more then it will not be covered by CPAM but may be covered by your mutuelle

This is the list of ALD https://www.ameli.fr/val-d-oise/medecin ... nition-ald

[manonthemoon2]

Finally my S1 is agreed with CPAM, only 5 months since I received it

I downloaded my new attestation and it doesn't show my 2 ALDs so I asked my Dr to apply for them.

Also there is a comment that says "hospitalisation et soins externes hors budget global". Does this mean I will get a bill to pay?