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GUIDE CAMPUS FRANCE health insurance assistance CAMPUS FRANCE health insurance assistance This guide is intended for persons covered by an Campus France social protection plan: "Mainland France 80%" or "Mainland France 100%"– "Guests". You will find that it contains information and practical advice in addition to the general and special terms and conditions of which you were notified when taking out Campus France insurance cover. You are covered by one of the Campus France social protection plans. This is a private health plan and consequently you do not come under the general French social security and healthcare system. You are not concerned by the coordinated healthcare plan no by the requirement to consult a specific medical practitioner. This information is important and should be communicated when you consult healthcare providers. Campus France will not issue you with a Carte Vitale and will not give you a French social security number. IF YOU FALL ILL You may consult the medical practitioner of your choice. Various types of medical practitioners existin France: Accredited practitioners (charging Standard Fees): Sector 1 Practitioners in Sector 1 have undertaken to charge standard fees fixed by agreements entered into with the French National Healthcare Authorities. They may only charge supplementary fees in exceptional circumstances, e.g. when complying with a specific request made by a patient, such as a home visit when the patient is quite able to go to the practitioner's surgery, or when the patient wishes to see the practitioner outside the latter's normal consulting hours. Supplementary fees are not reimbursed by Campus France. They are borne by the patient or by a Mutual Health Fund if the patient has taken out extra insurance cover with such a body. For information purposes, the official standard fee as of 1st January 2011 charged by a general practitioner stands from EUR 23 to EUR 28 for a consultation with a specialist. Accredited practitioners (charging own fees): Sector 2 It is best to verify the fees charged before consulting a practitioner in Sector 2, since practitioners in this sector are free to fix their own fees, which are higher than officially fixed standard fees. B: Campus France will not reimburse the difference between the fee actually paid and the N official standard fee. This is borne by the patient of by a Mutual Health fund if the patient has taken out extra insurance cover with such a body. Practitioners operating in this sector are required to post their fees in their waiting room. You may also ask what their fees are when you phone to make an appointment. Non accredited practitioners (no-fee agreements with the authorities) A practitioner who does not belong to either of the above categories is completely free to fix his own fees. B: Campus France will not reimburse fees paid to consult a practitioner in this category who N has not entered into any fee agreement with the French National Healthcare Authorities. PATIENT 'S CONTRIBUTION TO PAYMENT OF EXPENDITURE Under the French tiers payant system, patients do not need to advance payment to doctors or chemist’s themselves, since payment is made automatically by the insurer (social security office, insurance company or top-up scheme). Campus France has set up a tiers payant system with certain practitioners, healthcare centres and pharmacists, whose names and addresses are to be found in the list appended to this notice. You should show your health insurance card when having recourse to these practitioners, healthcare centres and pharmacists. GUIDE Health Insurance 11/2011 - 2 CAMPUS FRANCE health insurance assistance Persons covered by the "Mainland France" social protection plan will only be required to pay the 20% patient's contribution, known as the "ticket modérateur". NB: the 'patient’s contribution' corresponds to that part of medical expenses to be borne by the patient. For persons covered by other social protection plans, no payment is required, unless certain healthcare expenses are excluded from cover under special conditions. If you see a doctor or use the services of a pharmacist or healthcare centre not included on Campus France tiers payant scheme, you will have to pay first then apply to us for reimbursement. For major healthcare expenses (such as hospital care and re-education), you should submit a request for prior approval (entente préalable), after agreement of the medical adviser upon which we will pay the bills directly. TERMS OF REIMBURSEMENT Reimbursement rate Persons covered by the "Mainland France 80%" social protection plan will be reimbursed at 80% of the French Social Security standard rate. Persons covered by the "Mainland France 100% and Guests" social protection plan will be reimbursed at 100% of the French Social Security standard rate. What do I have to do to be reimbursed? Send us the following: • The healthcare form showing proof of payment, duly filled in by the practitioner or healthcare centre and showing the name and forename of the patient. This healthcare form is handed to the patient by the practitioner or the healthcare centre after consultation, • The medical prescription issued by the practitioner or healthcare centre justifying expenditure on X rays, laboratory analyses and other treatment, • Pharmacist invoices completed by the accompanying labe (these labels are to be found on the boxes containing medication and must be stuck on the healthcare form in the place specified). NB: Campus France will not be able to reimburse you unless you comply with these requirements. How do I fill in the healthcare form? The following details must be entered on the healthcare form: • number of the file • name and forename • personal address in France • signature. Where should I send my mail? • Applications for reimbursement, applications for prior approval, and mail addressed to the Campus France consultant physician, should be addressed to: Campus France 28, rue de la Grange aux Belles – 75010 Paris NB: No application for reimbursement will be accepted 2 years after the date of the healthcare involved. GUIDE Health Insurance 11/2011 - 3 CAMPUS FRANCE health insurance assistance EXEMPTION FROM PAYMENT OF THE PATIENT'S CONTRIBUTION Persons suffering from long-term illnesses may be exempted from payment of the patient's contribution. This means that your medical expenses will be covered 100%, on the basis and within the limits of standard social security fees. An application for such exemption should be sent to the Campus France consultant physician, whose opinion will determine whether Campus France accepts or refuses the application. If the application is granted, exemption from payment of the patient's contribution: • Will be granted for the period determined by Campus France after consultation with the Consultant Physician of Campus France • Will be limited to care and treatment directly connected with the long term condition justifying the exemption Medical care and treatment not connected with the long term condition justifying the exemption will be reimbursed in normal conditions. IF YOU NEED TO STAY IN HOSPITAL Campus France will only cover expenditure incurred by a stay in accredited hospitals and clinics charging standard fees. Any stay in hospital must first obtain prior approval, no later than 10 days prior to admission, accompanied by the medical diagnosis sent in a sealed envelope to the Campus France consultant physician. In cases of emergency, the application for cover must be sent within 48 hours of admission to hospital, accompanied by the medical diagnosis sent in a sealed envelope to the Campus France consultant physician. Campus France may refuse cover due to exclusions listed in paragraph VI – Article 17 of the General Terms and Conditions or if requisite procedures have not been complied with. It is therefore in your interest to apply for prior approval before any stay in hospital. If Campus France agrees to such cover, it will, upon presentation of the relevant invoice, settle all hospital fees directly, together with the daily occupancy fee at 100% of the social security standard rate. Any additional costs, telephone, private room, fees over the standard rate shall be borne by the insured person. For any medical advice, insurance cover and prior approval, please contact the Consultant Physician of Campus France: Docteur Paul Walecki 01 40 40 57 17 [email protected] DRIVING A MOTOR VEHICLE Any consequences arising from the driving of a motor vehicle and any and all trailers or containers towed by or coupled thereto or piloting airplanes without prior authorisation by Campus France are excluded from insurance cover, in accordance with Article 17 of the General terms and Conditions. If you intend to drive a motor vehicle, we therefore strongly suggest that you check: • That your motor vehicle has the requisite insurance cover • That your driving licence is valid on French territory and we request that you send Campus France an application for permission to drive a motor vehicle together with a copy of your driving licence, your insurance certificate and the vehicle registration book. GUIDE Health Insurance 11/2011 - 4 CAMPUS FRANCE health insurance assistance Campus France accredited Practitioners and Healthcare Centres in Paris Alain BALDO Philippe GUIGARD 65, boulevard Kellermann 75013 Paris 01 45 88 36 07 Métro : Cité Universitaire Stéphane MEDIONI 36, boulevard Saint-Michel 75006 Paris 01 44 07 26 27 Métro : Saint-Michel / Odéon Bernard JOMIER 31, rue d'Hautpoul 75019 Paris 01 42 40 00 72 Métro : Ourcq / Botzaris edited Medical Centres Centre de Santé de la Mutualité 24, rue Saint-Victor 75005 Paris 01 40 46 11 16 Métro : Maubert Mutualité/Cardinal Lemoine MGEN 178, rue de Vaugirard 75015 Paris 01 44 49 28 28 Métro : Pasteur / Saint-Jacques / Glacière Centre de Santé René Laborie 29, rue de Turbigo 75002 Paris 01 40 39 75 86 Métro : Les Halles Institut Alfred Fournier 25, boulevard Saint-Jacques 75014 Paris 01 40 78 26 00 RER : Denfert Rochereau Accredited Dental care centres Centre Dentaire Saint-Lazare 46, rue de Londres 75008 Paris 01 45 22 09 71 Métro : Europe / Saint-Lazare Campus France accredited Practitioners and Healthcare Centres outside Paris AIX-EN-PROVENCE Armand ARROUAS 4, rue Peyresc 13100 Aix-en-Provence 04 42 21 35 44 AMIENS Isabelle LUCIANI 73, mail Albert 1er 80000 Amiens 03 22 92 51 72 BESANCON Myriam FORNOT Véronique DUPUIS 1, rue de l’Épitaphe 25000 Besançon 03 81 88 77 97 BORDEAUX Maison des Jeunes et de la Santé 45, rue Vital Carles 33000 Bordeaux 05 56 48 95 88 Centre de Santé Etudiant - SIMPPS 13, avenue Pey Berland 33600 Pessac 05 56 04 06 06 Pavillon de la Mutualité 45, cours du Maréchal Gallieni 33082 Bordeaux cedex 05 57 81 24 24 BREST Arnaud GUIGANTON Jacqueline LAGUIN 179, rue Jean Jaurès 29200 Brest 02 98 44 31 06 CAEN Jean Louis NOTINI 6, avenue du 6 Juin 14000 Caen 02 31 50 14 14 CLERMONT FERRAND Isabelle FLAGEOLET Alain BOYE 32, rue Alexandre Ribot 63000 Clermont Ferrand 04 73 27 01 11 Alexandre TROUSSEAU 6, place de l’Europe 25000 Besançon 03 81 51 00 97 GUIDE Health Insurance 11/2011 - 5 CAMPUS FRANCE health insurance assistance DIJON Bruno LOUIS 32 bis, boulevard de l'Université 21000 Dijon 03 80 74 93 50 MARSEILLE Yves CHEMLA 19, boulevard Sakakini 13004 Marseille 04 91 49 88 85 GRENOBLE Isabelle & Thierry ROUGIER 13 bis, avenue Général Champon 38000 Grenoble 04 76 87 05 43 METZ Olivier SAUZE 123, avenue André Malraux 57000 Metz 03 87 65 44 96 LA ROCHELLE Dominique PERRIER Frédéric BOSSE Résidence Must - Les Minimes 5, rue Lucile 17000 La Rochelle 05 46 44 08 20 MONTPELLIER Patrick FORNOS Immeuble Le Mail-J. Cartier 75, place de Québec 34000 Montpellier 04 67 65 16 93 LE HAVRE Matthieu BLONDET 3, rue Jean Mascoet 76600 Le Havre 02 35 43 13 13 NANCY MGEN 6, rue Désilles 54000 Nancy 03 83 17 76 00 LE MANS Laurent SIZARET 16, place de l’Epéron 72000 Le Mans 02 43 39 97 97 ORLEANS Patrice RUET 9, avenue Bolière 45100 Orléans 02 38 63 03 61 LIMOGES Fabrice DURAND 35, avenue Berthelot 87000 Limoges 05 55 77 61 73 PAU Bruno BORDACARRE 3, place Albert 1er 64000 Pau 05 59 27 94 34 LYON MGEN 44, rue Feuillat 69003 Lyon 04 72 11 30 09 Métro : Montplaisir / Lumière POITIERS SIUMPPS – Campus universitaire 2 allée Jean Monnet 86000 Poitiers 05 49 45 33 54 MARSEILLE Didier FAREAU 23, boulevard de la Concorde Mazargue 13009 Marseille 04 91 40 64 23 RENNES Jean Yves GUILLO 1, place du 5e Régiment d'Artillerie 35000 Rennes 02 99 31 42 54 ROUEN Alain ROTBARD 72, rue Jeanne d’Arc 76000 Rouen 02 35 89 60 61 STRASBOURG MGEN 4, place du Pont-aux-Chats 67000 Strasbourg 03 88 21 14 60 TOULOUSE ACZEL / UZAND / SAINT-DIZIER / GARIPUY Hôpital Joseph Ducuing 15, rue de Varsovie 31000 Toulouse 05 61 77 34 00 TOURS Corinne ROLAND 197, avenue Grammont 37000 Tours 02 47 05 21 76 VICHY Claire PAVAN 36, rue Callou 03200 Vichy 04 70 98 91 98 REIMS Cabinet médical des Jardins de la Vesle Claude FENAUX Emmanuel MASSART 18, chaussée Bocquaine 51100 Reims 03 26 09 95 39 GUIDE Health Insurance 11/2011 - 6 CAMPUS FRANCE health insurance assistance Campus France accredited Pharmacists in Paris and the Paris Region PARIS Pharmacie Colonel Fabien 65, rue de la Grange aux Belles 75010 Paris 01 42 08 13 29 Pharmacie du Sénat 42, rue Monsieur le Prince 75006 Paris 01 43 26 03 50 Pharmacie Kellermann 71, boulevard Kellermann 75013 Paris 01 45 88 23 24 Pharmacie Mutualiste 5, rue Palestro 75002 Paris 01 40 39 75 38 Pharmacie de la Sorbonne 49, rue des Écoles 75005 Paris 01 43 54 26 10 CANNES ECLUSE Pharmacie FORTIER 6, rue Saint Georges 77130 Cannes Écluse 01 64 32 29 92 MONTEREAU Pharmacie Victor Hugo 90 rue Jean Jaurès 4 rue Victor Hugo 77130 MONTEREAU 01 64 32 00 59 CRETEIL Pharmacie de l’Université 25, rue des Mèches 94000 Créteil 01 42 07 41 55 Pharmacie Jourdan 109, boulevard Jourdan 75014 Paris 01 45 40 78 53 Campus France accredited Pharmacists outside Paris and the Paris region AIX-EN-PROVENCE Pharmacie Rotonde-Mirabeau 3, cours Mirabeau 13100 Aix-en-Provence 04 42 26 12 15 CLERMONT FERRAND Pharmacie DUREL BOUISSOU 39, boulevard Claude Bernard 63000 Clermont Ferrand 04 73 26 60 42 GRENOBLE Pharmacie PASTEUR 3, place Pasteur 38000 Grenoble 04 76 46 37 68 AMIENS Pharmacie FORGET 16, rue Saint Leu 80000 Amiens 03 22 91 33 17 CAEN Grande Pharmacie du Progrès 2, place St Pierre 14300 Caen 02 31 27 70 10 Pharmacie PICCO RANC 1, rue Barnave 38000 Grenoble 04 76 44 14 64 BESANCON Pharmacie du Stade 13, avenue de l’Observatoire 25000 Besançon 03 81 50 54 79 DIJON Pharmacie de l’Université F. Compain 95, boulevard Mansard 21000 Dijon 03 80 66 42 78 BREST Pharmacie DENNER 172, rue Jean Jaurès 29200 Brest 02 98 44 11 69 LIMOGES Pharmacie BONNAFY place des Bancs 87000 Limoges 05 55 34 63 80 Pharmacie BOUSQUET GIROL 1, place des Bancs 87000 Limoges 05 55 34 19 92 GUIDE Health Insurance 11/2011 - 7 CAMPUS FRANCE health insurance assistance LYON Pharmacie de l’Avenue 73, avenue Jean Jaurès 69007 Lyon 04 78 72 44 33 Métro : Jean Macé MARSEILLE Grande Pharmacie Castellane 11, place Castellane 13006 Marseille 04 91 48 70 20 REIMS Pharmacie GELARD 33, rue du Colonel Fabien 51100 Reims 03 26 08 05 87 RENNES Pharmacie DUVAL GUIHARD 24, place du Vieux Colombier 35000 Rennes 02 99 31 48 37 Pharmacie BELSUNCE 10, cours Belsunce 13001 Marseille 04 91 90 14 58 ROUEN Pharmacie CLEMENT-DUBOIS 63, rue Jeanne d’Arc 76000 Rouen 02 35 71 32 69 METZ Pharmacie JACQUES 32, rue Serpenoise 57000 Metz 03 87 75 04 75 ST MARTIN D’HERES Pharmacie du Campus 37, avenue Gabriel Péri 38400 St Martin d’Hères 04 76 54 49 25 MONTPELLIER Pharmacie de la Gare 2, rue Serane 34000 Montpellier 04 67 58 37 68 Pharmacie Gabriel Péri 94/98, avenue Gabriel Péri 38400 St Martin d’Hères 04 38 37 02 66 NANTES Pharmacie JOSSO 90, rue de la Bourgeonnière 44100 Nantes 02 40 76 40 52 TOURCOING Pharmacie Mutualiste UDEV Pôle Santé 80, rue Nationale 59200 Tourcoing 03 20 26 50 40 NICE Pharmacie DE LA BUFFA 27, boulevard Gambetta 06000 Nice 04 93 96 29 40 TOURS Pharmacie CHAUVIN Didier 140, avenue Grammont 37000 Tours 02 47 66 71 66 PERPIGNAN Pharmacie Notre-Dame 5, quai Battlo 66000 Perpignan 04 68 35 21 04 VICHY Pharmacie DEPREZ 1, rue Maréchal Foch 03200 Vichy 04 70 32 18 31 GUIDE Health Insurance 11/2011 - 8
