The French Health Care System: Carte Vitale

I’ve been writing recently about the wonderous ease of the French Health Care System, hailing it for the way it functions. Today, the “wonderous wheel” has ground to a halt. I feel like I’ve just woken into yet another bureaucrazy nightmare. I’ve written about several of those on this blog, sad to say.

It all started when several weeks passed, and I had yet to receive a reimbursement for a doctor’s appointment I had in early January. Reimbursements tend to happen fairly quickly, so I was getting concerned. Since I knew my French was not up to the task, I hired someone to help me out. images

You see, when I arrived here, I applied for my Carte Vitale as a dependent of my spouse. That process went fairly (and surprisingly) smoothly. But once I went into business, I was responsible for my own cotisations (taxes paid to healthcare) and no longer a dependent of my spouse. I never used my Carte Vitale that first year. Didn’t need to. I used it for the first time last year in the Fall. Ironically, I was reimbursed by check for a trip to my general doctor with no problem whatsoever. So why now all of the sudden was I not being reimbursed?

When my helper emailed me back saying I needed to apply for a new Carte Vitale, the card that coordinates the coverage, along with a copy of my translated birth certificate, I thought he might be joking. Birth certificate? They already have my birth certificate. That’s how I got the Carte Vitale I have now. But no. There was no joke.

He wrote: I just spoke to someone who works at La RAM. The Carte Vitale that you have worked last year when you used it – even though you had already registered as a micro-entrepreneur – because it takes them a certain amount of time to process the administrative change. They call this period a “temps de mutation”.

Damn mutants! Figures!

Turns out, the Carte Vitale I have now is no longer valid and still tied to my husband, despite the fact that it has my French social security number on it. Supposedly, it hasn’t been valid since opening my own business in January of 2016. Nevermind the fact that it has been OVER A YEAR, and they never mentioned anything to me this whole time. Nevermind that no one asked for anything in the correspondence that said, “Welcome to RAM.” Nevermind that I have an online account with them stating I am covered and that reflects my chosen general doctor. Nevermind that check I cashed with my reimbursement back in November.

No. Forget all that. Now I have to send them a translated birth certificate and my bank details. After some time, they will decide to send me yet another form I have to fill out and send with a copy of my passport with a new photo. After some time, they might process that and send me a new Carte Vitale. Seriously?????

So now, I am required to collect a pile of “feuille de soins” or papers that verify any medical treatments I receive in order to be reimbursed retroactively. Seriously?????

Ah, another day in the life in France.

The French Health Care System II: The General Practitioner

So, in my last writing, I introduced a series of posts I plan to share on my experiences within the medical system of France.

metalmarious_medicine_and_a_stethoscopeWhile covered for health originally by my spouse, now that I am self-employed, I am covered independently. We do have top-up insurance which covers most of what the government doesn’t. However, that is only 125 euros a month for both of us, a very far cry from what we would have to pay in the United States, an amount which would total in the thousands and exclude any additional deductibles.

If you’re following along, you know that I had an appointment with a general practitioner this past week. The first comedy was in setting the appointment. I actually did alright asking for a rendezvous on the “trois Novembre” at “trois heure”…but when I hung up the phone, I realized that I might have misunderstood the receptionist because the French don’t say “trois heure”; they would say “quinz” heure which is 3PM. So, was my appointment actually at treize heure, which would be 1PM, since I might have misunderstood “treize heure” for “trois heure”?

I had to call back to clear this up the next day, but it was a bank holiday. When I did get back with the receptionist and asked the time of my appointment, she said, “quatorze” which meant 2PM. Now that that was clear as mud, we decided to show up 1PM just to make sure I didn’t inadvertently arrive late.

The doctor was running a little late, but only by a few minutes. She invited both my husband and myself into her office. We talked about my concerns, and she ordered blood tests, the first thing any doctor in France orders…so I am told.

We then went through to her examination room where she asked me to disrobe. My husband remained in the office just an open door away. I found this a bit odd. I had to fight the impulse to close the door. Everything happens behind closed doors in the US and privacy is sacrosanct.

Once on the table, I went through a blood pressure check, breast exam, a quick pelvic check…

Now, in the US, there are stirrups for these kinds of procedures and plenty of gowns and massive tissue papers with which to preserve one’s dignity…sort of. Not so here. Neither was there an ice-cold stainless-steel stirrup in site. Only now do I realize that stirrups are an absolutely unnecessary and somewhat alien addition to medical tables anyway.

The most awkward aspect of my appointment was just hanging out and talking with the doctor, me undressed and uncovered, as if it were something that happens every day. Ah, but of course, for the doctor it DOES happen everyday. Now, some might think how terribly uncomfortable that would be, but if it didn’t bother her, why should it bother me? The fact that the French are so incredibly comfortable with their bodies is something to be admired and adopted, in my opinion. The overprotected privacy measures in the states would seem to only  reinforce body shame and neurosis. Still, I will need more time to adapt in this regard.

The cold is another matter, though, which I’ll never get used to. I find no difference in that when comparing exam rooms in the US and France. If I can’t have on socks and wrap myself in a blanket, I’m going to be cold!

I filled in no paperwork (which any American knows is the whole point of going to a doctor!) other than something called a Choix de Medecin Traitant, handed over my Carte Vitale (or health card), paid my 23 euros, and was done.

I was given a long list of vitamin prescriptions (yes, paid for by the system – see my next post), my blood test request, an echogram order, and a referral to a cardiologist. This was all give without ceremony, resistance, or a hidden mental process undertaken by the doctor on how this might affect her salary, quite unlike what would have happened in the US.

It was all very easy.

Until next time…


Settling In

I haven’t blogged here in ages, and I’d like to bring things to a sort-of closure. I am writing this from my office in our new house in the Charente. It is hard to believe that just two years ago, my husband and I met and began our whirlwind, international romance. It is sometimes harder to believe we actually persevered and made it through the unbelievable challenges that were thrown at us from all sides. WE DID IT!!!

I’ve been in France officially as a resident since May of 2015. I have my Carte de Sejour now, and just yesterday, received my Carte Vitale in the mail. Today, I even managed to get myself a library card. Of course, that was significantly easier than everything else, let me tell you! I’ve even made great strides in driving the old stick shift!

I’ve been taking French since I arrived, but it is slow going. While I wish I was in school every day, out here in the country, there just aren’t opportunities for that. So I string my French lessons together as I can. I take a couple of hours in the nearest town every week. I also use the internet to study and listen to French radio and TV. I tried joining a choir but ironically, they sang a lot of English songs. I registered at the Pole Emploi, the equivalent of the Department of Labor, and will receive additional weekly lessons through them for free starting in a few months. I just wish it was starting now and happening every day!

In fact, the language barrier is now the single most important obstacle I must learn to overcome. But as long as one has some good translators to call when needed (and can afford to pay them), one can get by. Of course, I can’t wait for the day when I can actually speak and write well enough to handle things myself. It is tough to put so much trust in others who are speaking for me all the time. So much is lost in translation.

But generally, I’m finding that life here isn’t nearly as difficult as I expected it to be. Now that the worst is over, I’m finding it all pretty easy. Maybe I’m fooling myself. Time will tell…

The hardest parts about living here:

1. It is easier to meet and socialize with the English-speaking community than to integrate into French society. In my experience, there is little support to help the English-speaking community to integrate…okay, actually none! Maybe it would be different if we were in a big city like Paris, though.

2. It can be a nightmare to find the answers to important questions. Very often, the answers lead one down a rabbit hole that merely seems to produce even more questions.

3. My life has shrunk considerably in many ways in terms of friends, opportunities, and a sense of control over what happens to me.

The best parts about living here (aside from being with Stuart):

1. The view out my window is phenomenal, and there is plenty of quiet.

2. There are some real angels here and it is a joy to meet and interact with them. France is cultivating my gratitude for the finer things in life (and I don’t mean wine).

3. I’m growing by leaps and bounds and am having to overcome a ton of my fears and resistances, all very good for my personal healing. As I can’t control anything, I have no choice but to just let go and let is all unfold. That is a huge lesson and a huge gift.

Time will tell how difficult it is to make an actual living here doing what I was doing in the States. I may have to be more flexible or go in a completely unexpected direction. I may find it impossible. Who knows?  But that’s the next thing on my plate…making a living.


Bon Courage!