lundi 3 juin
(Note, adopting the French way of not capitalising days of the week and month names there)
Pool opening day. Not a fixed day of course, whenever the weather seems to fit it generally, and the availability of Andrew, an English pool specialist here who is very good and helpful around advice too. This year has been a very mild and wet winter and it’s only really now in June it feels like summer. I know that isn’t weird back home, but here, in a good year it feels like a Scottish summer from about March or April usually. This year we had the most rainy May in 30 years, and folks talk of the wettest winter they remember. At least the water table should be good and full for summer, maybe even no water restrictions (Usually for us this just means we do not top up the pool level at all due to loss, and use waste shower water for plants and the water butt). Being more with it on steroids, I asked again for Andrew to talk me through the process so I can eventually do it myself, partly because it’s an expense that will be good to cut down on, but also because he might not always be around.
mardi 4 juin
When we arrived here we met with a lady from AXA to set-up our mutuelle health and other home insurances. We met again after we bought this house and updated things for that, but we didn’t have much contact after as we didn’t ask. Since both me and my partner have potential surgeries coming up, we thought we should review our cover and make sure we were set-up best for those. It was a very illuminating meeting! As ever, with the steroid clarity, it showed me how I have not been on top of details at home, struggling with working and dealing with the basics of life, and more subtle things getting lost in the background.
We confirmed that we have the top coverage you can get, and have many more benefits than we realised, one of which I have failed to exploit twice to my cost. Basically, if I need specs, and I go to an AXA partnered optician, I pay nothing at all.
Now I have said here before that I have bought specs here once, and I actually just paid for another set, and was impressed both times as to how little it cost me. Now I see even that cost was avoidable, so lesson learned for next time.
To give an example, back home a single pair of specs for me, with varifocal, photochromatic, thinned lenses etc, could set me back most of £500, no doubt even more now in the UK, and here I just bought a new pair, plus fitting of reading / computer use only to an old set of frames, and it cost me £235, less than half of that one UK pair, and of course next time £0 €0 which will be even better.
Other benefits we weren’t aware of were that we can get 6 instances a year of care from an osteopath, chiropractor, acupunturist, podiatrist or psychotherapist, when it is not already re-imbursed by social security here. We were also advised to request home-help post-operatively, which is 20 days of someone helping around the home as needed for cleaning/shopping etc when you are recuperating. So that was a very useful meeting and we should’ve had it sooner. Though it made more sense now that we have used the healthcare system more here, as we didn’t get fully registered until Spring 2021 and only started to use more specialist care the year or two after that.
You’re thinking now how much does it cost and how does that compare to the UK? Difficult to easily answer because of course some of this is paid by the French state via our taxes, which are of course higher in France than in the UK. A quick search says the average tax burden in the UK for a person was 23.7% in 2023, and in France it was 27.5%, OECD average being 24.9%. So, for sure you pay more, no doubt partly to pay for all the government apparatus and bureacracy in France, which is large, but also more healthcare spending and heavily devolved and de-centralised governance compared to the UK, a choice and one I think is a better one and worth the price. There is also the simple fact that you feel you can see a difference for that 3.8%, in terms of lack of bad roads/potholes alone, as well as the state of hospitals and other facilities, which although not always very recently built, just look like they have been maintained, rather than the bare minimum being done with meagre budgets.
In terms of the mutuelle cost, I can easily give that; It costs £65/month each, or £2 a day - not sure what you can buy daily for £2 these days in the UK? Comments please.
Given what you get for that and your tax, it seems like a decent deal to me. Another example I can give that is that, after my first coloscopie here, I asked about travel help as it I had got a taxi in and it is 20 miles each way from home to the CH Angoulême hospital, which is not cheap, even with getting a lift back from our French tutor pal, Murielle, whom I have course reimbursed for her fuel and time too. I was given a form to book a taxi, which is paid for, because I have an ‘Affectation du longue durée' (ALD - a long term chronic illness) in having maladie de Crohn, as well as maladie rénale chronique, which is also an ALD. This also means that any treatment at all directly related to that is covered entirely by the French state and is not charged to the mutuelle as a claim.
Again, much as it is insurance and claims are made, you are not getting premium increases due to claims. It can go up in cost over time, but that is more a negotiated and regulated thing between state and mutuelles. It is still possible to pay out yourself in some cases, for example, a doctor might not accept the state healthcare Carte Vitale smart card: This card contains some of your health data, that practioners can access, like basic ID and any long term health conditions, as well as your insurance details. If the doctor does not accept the card/scheme, they can quote you some figure and charge you, and the mutuelle may not cover the entire cost, but you can also say, nope, too rich for my blood and go elsewhere, or negotiate it down, or make a payment plan, but so far that doesn’t seem to be an issue for us. The only thing we will be out of pocket for we can see coming is a dental implant or two, as those are not currently covered by the state system, and hence mutuelle. Dentists are quite keen on them as they get paid more of course. Crowns, if an option are covered by the mutuelle.
One last point is that it is different and confusing for sure to get used to paying at (Non ALD) appointments, but when the Carte Vitale is accepted, as is almost always the case, it is a slick process. Each time you see a receptionist, you hand the card over, and if it’s your first visit to a clinic/practioner, your printed mutuelle slip also. Once that is entered, and you pay on the way out, the re-imbursement of what you are due from the mutuelle gets taken care of without you doing anything. If you forget your card, or their machine doesn’t work say, or they don’t accept it, they will give you a printed form you send to CPAM, which is the social security health service section, and they pay whatever the state covers, and the proof of that payment from the portal, ameli you send to the mutuelle, who pay whatever you are entitled to under that cover.
In some cases, like GP visits, you don’t pay at all, just give them the Carte Vitale and it’s all taken care of as it’s standard stuff, apart from that one time Dr Lagrot’s card reader was playing up, which was a nightmare ; ) You don’t ever forget the card as it’s basically habit here to have your ID card, or Carte de Titre Sejour in our case (Brexit Withdrawal folks who have were living in France before 2021), and Carte Vitale on you along with your bank card. I just keep my mutuelle one separate as I only need that at the doctor or pharmacy.
Bonne santé, et passe un bon week-end.