France in Focus

I had my 3 monthly medical check up yesterday & as usual used the contactless payment without looking at what I was being charged.
This morning I found the payment slip in my pocket & was surprised it was for €7,50 when I thought the norm was €25 or maybe €26.
Has anything changed?

I thought that’s how it is supposed to work, CPAM reimburses the doctor directly and you’re left to pay the difference, which you will get back automatically if you have a mutuel.

DaveW wrote: ↑Thu Jan 26, 2023 12:05 pm I thought that’s how it is supposed to work, CPAM reimburses the doctor directly and you’re left to pay the difference, which you will get back automatically if you have a mutuel.

I've just had a quick look at our bank statements & for the last 6 months all doctor payments for me & the missus have been €25 with the exception of the one mentioned above plus one other @ €7,50.

Why are you paying? lived here since 2006 the only things we have paid for was Mammograms for DW not me, and some tablets and medicine but only a few euros, but we both have S1s, and have had three monthly check ups all this time, may get a small bill from the Lab that does the blood tests but not always. But the dentist is a different kettle of expensive fish.

We always pay €25 cash to the Doc and eventually get about €17 back from cpam. The difference must drop into a black hole.

Spectrum wrote: ↑Thu Jan 26, 2023 1:13 pm Why are you paying? lived here since 2006

We're paying because we thought it was the norm & the doc always pushes her card reader to us to pay. I always assumed it was reimbursed but haven't got around to checking what's been reimbursed 'cos my missus deals with all that sort of stuff & she's rather busy with other things. Is it income related?
We've been here since 2003.

Hotrodder wrote: ↑Thu Jan 26, 2023 1:18 pm We always pay €25 cash to the Doc and eventually get about €17 back from cpam. The difference must drop into a black hole.

The difference is the tiers payant. So if you have no mutuelle (TP), you foot the bill for the difference.

Just checked & it appears we usually pay €25, get €16,50 back from cpam, €7,50 from the mutual & the remaining €1 disappears.
Still doesn't explain why I only paid €7,50 yesterday.
I'm still curious to know if these things are income related.

Only insofar as those on a low income were able to claim CMU-C (became CSS then C2S). That not only provided a free or cheap 'mutuelle' but ensured that the beneficiaries didn't have to pay up front for any medical procedure. Low-income immigrants in receipt of an S1 no longer have the right to claim.
There's been a big push by the Gov to get MTs to subscribe to an automatic reimbursement system whereby they don't charge the patient, but claim directly from CPAM. Many MTs resisted because it took a lot longer to get their money and involved paperwork! Then there are the ones like our erstwhile MT who charged for everything even when he shouldn't have been
@LAF...Looks as though the €7.50 is the part that the MT expects you to reclaim from your mutuelle provider.

Quiksilver wrote: ↑Thu Jan 26, 2023 2:17 pm
@LAF...Looks as though the €7.50 is the part that the MT expects you to reclaim from your mutuelle provider.

Which quite possibly means that the doc has signed up for automatic payment from CPAM


and in true bureaucratic fashion means the victim - sorry patient - has now to claim from the mutuelle themselves rather than automatic reimbursement.