No payments from CPAM

About a year ago my husband got his S1 and I’m piggy backing on it. We don’t have Mutuelle. I visited the Dr a while ago now, presented my Carte Vitale, paid etc. 3 weeks later still no reimbursement in my account. Is there something I’ve forgotten to do. S1 is registered.

Even with an S1 you still pay the same as a French person, so did you pay the whole €26.50 or just the part of the mutuelle. And you did do a mise à jour of your card?

But the easiest way to check that all’s well is to download your attestation de droits and look at the code gestion. Which should be 70.

I’m just going through exactly the same, except my card now doesn’t work at all, the mise a jour showing that the card is invalid. I could not print an attestation from my account, and all payments have stopped appearing there. Because you piggy back on your OH account, everything appears on his Amelie account. If you print an attestation from his account, then both of you will appear on the attestation. At least that’s how it’s working for me. Also I will have to re register with my MT.

I paid €26.50 and my card was updated just a few weeks before. Whats the relevance of the 70 code? I haven’t checked it yet.

As usual AMELI site is not available.

some people used to think it related to Age, :rofl: but it simply means that your Health Cover is from another country… (for us it’s the UK due to our UK SI’s)

That’s odd. My Carte Vitale was obtained after submitting my UK-issued S1, but my attestation des droits shows my code gestion as 10 - which, I think, means régime général. Should I query this?

You might as well ask 'em.
are you still working??? there’ll be some detail which has set you apart … or else it’s a mistake…

Thanks, Stella. No, I’m not working. I’ll drop them a line and report back in 2025 when they reply :wink:

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My card didn’t work and I had to fill in all the paperwork to get reimbursement until I got a new card.

Yes. Also check no mistakenly applied social charges on your tax return,

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Thanks, Jane. I’ve already checked and there are no unexpected deductions and the S1 declaration is correct on the tax forms.

When my wife first obtained her own separate Ameli account it was some time before she started to receive reimbursement payments. This was because the Assurance Maladie was deducting all those little charges of €1 here and €0.50 there which are due on visiting the doctor and having medicinal prescriptions dispensed, and it was not until those previously accrued deductions were cleared away that she started to actually receive reimbursements into her own bank account.

I have an S1 and am also in the ALD category so I don’t have to pay anything at the doctors office or at the pharmacy. However, all those little amounts still mount up and so once a year the Assurance Maladie sends me a bill for usually just under €50 to settle the account and balance the books.
I have no problem with that at all and am very happy to pay up straight away.

Given time, I expect the situation for @Shunt will sort itself out.

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I believe that there is an annual cap of 50€ - so once you’ve paid your 50 that’s it for the rest of the year.

Edit to add
Here’s the relevant info on the Ameli website

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Ah, OK, same with me then. I’ve applied for a new card so we’ll see what happens.

My administration code is 70 too

So, I contacted AMELI as to why I hadn’t received reimbursements for the visit to the dr and this was their response, I understand the French but don’t actually know what it means re my reimbursements. Any ideas?
Je vous informe que la consultation a été remboursée par votre caisse d’Assurance Maladie le 27/08/2024, avec toutefois un versement de zéro euro.
En effet, des cotisations forfaitaires et des franchises médicales d’un montant de 16,55 euros qui étaient encore en attente
de recouvrement ont été retenues sur le remboursement initial de 16,55 euros.

Ah yes… they’ve clawed back the small sums you’ve owed (accumulated) for various medical visits and whatever… these are small sums for which we are all responsible… and clawing back has left you with a zero figure to come from CPAM.
it adds up… every Dr’s appointment, prescription etc etc

Le montant de la franchise est de :

  • 1 € par boîte de médicaments (ou toute autre unité de conditionnement : flacon par exemple) ;
  • 1 par acte paramédical ;
  • 4 € par transport sanitaire.
    etc etc
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If you lookat your account on Ameli all the little €0.50 and €1.00 will be detailed there

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It’s true they were all itemised, but I used to get money back for a dr’s visit and now I don’t. The same day I went to the Dr’s I also had a blood test, which was where all the itemised things came from: € 8 for the nurse who took blood etc, etc. Had I not gone for the blood test would I have had the €16.50 for the dr’s visit reimbursed? Sorry to appear so thick, but getting my head around this system is a bit tricky.