Dordogne Makes Concession on Health Cover
Friday 01 June 2012
The health authority in the Dordogne has agreed to admit early retirees with a long term illness into the health system.
According to Tony Mason of health insurance brokers Soficas those with what is known as an 'Affection de Longue Durée (ALD)'* prior to losing their health cover rights under an S1/E106 will now be able to obtain cover under the Couverture Maladie Universelle (CMU).
‘It still remains a little unclear to me why the CPAM have changed their position’ he says, ‘but in large measure I think it is genuinely because, until we made them aware, they simply had no idea of the scale of the difficulties being faced by a large number of early retirees, who simply had no medical cover.’
The enlightenment of officials to the problem began several months ago when Tony attended a meeting of around 70 British expatriates in Perigeux organised by Angela Martyn, the President of the North Eastern Dordogne Women's Association. He arranged for local CPAM officials to be present.
At the time, the health officials denied that there was a problem of access into the health system.
''So as if to prove the point' say Tony, 'I opened the matter up to a show of hands in the room, when around one-third of those present stated that they had been refused health cover by the CPAM.
The look of disbelief on the faces of the officials was only matched by my own astonishment that they should appear to be so blindingly oblivious to what was taking place in their department.
At the end of the meeting officials confided to me that they clearly needed to undertake some internal consultation, and the outcome now appears to be the change in policy administration.''
Tony advises that those in the department of Dordogne with a pre-existing long-term illness should contact him to discuss whether they might be eligible to obtain access to join the CMU.
Those who develop an Affection de Longue Durée (ALD) after they come to France already have a right of access into the health system under ‘accident de vie’ provisions, on a case by case basis.
The position of those early retirees who do not have a long-term illness remains unchanged, although we would suggest you discuss your circumstances with Tony to see what can be done. You can contact him at firstname.lastname@example.org.
The same applies to those living in other areas of France, where the position of many local CPAMs remains intransigent, although not in all cases.
We are finding that a number of health authorities are conceding when pressured, while others are recommending that early retirees secure a residence permit, on the basis of which the health authority would then be able to grant them access into the system. We covered this point in our last Newsletter.
We await further news from the European Commission who are pressing the French government for a relaxation in the rules and infringement proceedings remain in force. It remains to be seen how matters might develop with a new government in place in the country.
*Affections de Longue Durée (ALD)
The list of those illnesses (in French) classified an ALD provided from the French health service website is show below. It currently excludes high-blood pressure, removed from the list last year, but this may by under review by the new government.
- Accident vasculaire cérébral invalidant
- Insuffisances médullaires et autres cytopénies chroniques
- Artériopathies chroniques avec manifestations ischémiques
- Bilharziose compliquée
- Insuffisance cardiaque grave, troubles du rythme graves, cardiopathies valvulaires graves, cardiopathies congénitales graves
- Maladies chroniques actives du foie et cirrhoses
- Déficit immunitaire primitif grave nécessitant un traitement prolongé, infection par le virus de l'immuno-déficience humaine (VIH)
- Diabète de type 1 et diabète de type 2
- Formes graves des affections neurologiques et musculaires (dont myopathie), épilepsie grave
- Hémoglobinopathies, hémolyses, chroniques constitutionnelles et acquises sévères
- Hémophilies et affections constitutionnelles de l'hémostase graves
- Maladie coronaire
- Insuffisance respiratoire chronique grave
- Maladie d'Alzheimer et autres démences
- Maladie de Parkinson
- Maladies métaboliques héréditaires nécessitant un traitement prolongé spécialisé
- Néphropathie chronique grave et syndrome néphrotique primitif
- Vascularites, lupus érythémateux systémique, sclérodermie systémique
- Polyarthrite rhumatoïde évolutive
- Affections psychiatriques de longue durée
- Rectocolite hémorragique et maladie de Crohn évolutives
- Sclérose en plaques
- Scoliose idiopathique structurale évolutive (dont l'angle est égal ou supérieur à 25 degrés) jusqu'à maturation rachidienne
- Spondylarthrite grave
- Suites de transplantation d'organe
- Tuberculose active, lèpre
- Tumeur maligne, affection maligne du tissu lymphatique ou hématopoïétique
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