Saturday 20 October 2012
Posted in La France at 21:12
It’s been nearly three months since my hospitalization for what turned out to be an infection of my right parotid gland; statements from the assurance maladie (national health insurance, also called sécurité sociale or sécu for short) just arrived a few days ago. As you can see, Kanoko made sure everything was set up right for photographing.
This time was my first in a private hospital, the Clinique Saint George in Nice, which is consistently ranked the top in the country, besting even Paris hospitals. I was a bit wary of whether or not their rates would be more than the sécu plus my mutuelle would reimburse, but it turns out that they were very reasonable indeed. This is likely because they have a large wing dedicated to a high-profit practice, namely plastic surgery. This is the French Riviera, after all.
The statements don’t have everything in the true chronological order, nor do all of the items concern the ER, so I’ve explained things a bit in this summary, which follows the order as printed:
– ORL, 45 euros. I paid him out of pocket (as is usual) the day after being hospitalized, and would have been reimbursed 16.10. This is probably listed first since it was one of only two expenses I actually paid (also normal), and so the sécu used it and the other to subtract several base “contributions”, as they call them – part of helping the sécu budget problems. Thus 1 euro of my 45-euro check went towards the ORL, another 5 euros towards pharmacy costs, 1 euro towards the ultrasound of my cheek at the hospital, and 1 more to a doctor consultation at the hospital. In all, I was “only” reimbursed 8.10, and my mutuelle covered the rest.
– The médecin généraliste (GP) was in fact my first stop: 23 euros is the base rate set by the sécu for GPs. Since they’re independent, they can charge whatever they want, although most stick with the base rate. I paid her out of pocket as well, and would have been reimbursed 16.10, yet again the sécu subtracted a few contributions: 50 cents to another pharmacy expense, 2 euros towards blood analyses done at the hospital, twice 50 cents to nurse care at the hospital, and another 3 and 4 euros towards more blood tests. I was reimbursed 4.60, my mutuelle covered the rest.
Keeping track of what I actually paid, in total (including what’s to follow, since the base contributions were for that): 18.50 euros. Now for the rest of the statements.
– The 06/07 (6th of July) wasn’t part of hospitalization, so we’re now at the 24/07, for when I went back to my GP to let her know how things had gone at the hospital and ORL, and to ask for a medical leave from work since the medication I’d been given was, to put it politely, kicking me in the behind. (As a reminder, medical leaves from work are paid in France, and are not limited, although things start to change for leaves that last more than 2 years, such as for cancers or severe depression.) Another pharmacy contribution was tacked on for 50 cents.
– Now we finally get to the ER! The “FORF. ACCUEIL URG.” refers to the fee charged for setting foot in the emergency room. Now, this was at the top private clinic in the country, keep that in mind: they charged 25.32 euros. Spelled out, because as an American I know how unbelievable it can seem: twenty-five euros and thirty-two cents. I didn’t pay anything out of pocket that day. The sécu reimbursed the hospital 80% of it, or 20.26, and my mutuelle covered the rest.
– The “ECHO OU DOPPLER” was the ultrasound at the hospital, which was charged at 37.80 euros. I’ll spell it out again: thirty-seven euros and eighty cents. Also reimbursed 80% to the hospital since I didn’t pay when there; as you saw above, the base contribution of 1 euro was merely subtracted from an expense that I did pay out of pocket. The hospital was thus reimbursed for 30.24 and my mutuelle took care of the rest.
– The ER doctor who looked at me charged 58 euros, an evening rate (it was 7 or 8pm by then). It was reimbursed to the hospital: 46.40 euros from the sécu and the rest from my mutuelle.
– On to the second photo. There’s a bunch of unrelated costs to skip here, all the way down to the last item on the 21/07, a week’s worth of antibiotics: 35.30 euros, which I didn’t pay for at the pharmacy, as is common practice here. The sécu reimbursed them for 28.95 of it, my mutuelle the rest.
– Now we’re on the third photo. On 23/07 I got something (forgot what…) the ORL had prescribed, again nothing directly at the pharmacy, for 4.33 euros of which the sécu reimbursed 2.81 and my mutuelle the rest.
– Then there are three “ACTE BIOLOGIE” or blood tests. A lab took several vials of blood and ran different tests on them, charging 21.60, 32.40, and 41.85 respectively, and each time with a nursing fee of 4.73. The sécu reimbursed the lab 66.03 euros of it, and (as you’ve guessed by now) my mutuelle, the rest.
– Finally, on 24/07 I went to the pharmacy yet again for pain meds, this time ones that my GP had prescribed. 4.98 euros, as usual nothing directly at the pharmacy, of which 1.49 was reimbursed to them by the sécu and the rest, by my mutuelle.
So there you have it. An evening trip to a private ER with an ER doctor checkup plus ultrasound and blood tests, then a visit to an ORL, two visits to a GP, and a few pharmacy expenses, all added up to 18.50 euros from my bank account. Eighteen euros, fifty cents.
In France you won’t hear people complain about part of our taxes going towards our universal health care system, and this is just one telling example why. Also, for those interested, three years ago I wrote about the basics of health care in France.