Procedure for claiming under your “Exclusive Healthcare EHIC Holiday Top Up policy”.
a. Every time you require treatment or drugs you must present your EHIC at the outset of the
Consultation etc and ask for a receipted bill, a “feuille de soins”, for what you have paid.
b. The receipted bills must be completed and signed by you and given to the CPAM office
local to where you are staying. The address will be in a local telephone book. CPAM will reimburse you and send you a statement showing dates, costs and the amount paid to you.
c. Post the CPAM statements to Exclusive’s EHIC claims office for reimbursement of the unpaid balance according to the terms of your EHIC policy of insurance.
The address is:
SB International Services
Exclusive Healthcare Claims Service
B.P. 9
82210 Castelmayran
France
Tel: +33 (0) 5 63 95 36 86
Fax: +33 (0) 5 67 69 96 02
Click Here to download the Claim Form
d. Please note that the settlement process can take up to three months by post to the UK.
e. But, if you have a holiday home in France ask CPAM to register your EHIC along with your address and your French bank’s RIB for much faster settlement directly to you bank and CPAM statements by post to your French address.
f. In most instances the above procedures are standard but there are exceptions and
variations as shown below:
•
Doctors – Standard. Ask if they are Conventionné. The charge should be €22.
•
Registered State Nurses. These are normally prescribed by a doctor or hospital. Attach a copy of the prescription to the bill before sending it to CPAM.
•
Dentists – standard. We would suggest that you always ask for the cost beforehand.
•
Laboratories xray and scan centres. Doctor’s prescription required, otherwise
standard but attach a copy of the prescription to the bill before sending it to CPAM. Specialists Doctor’s prescription required, otherwise standard but attach a copy of the prescription to the bill before sending it to CPAM.
•
Pharmacies (chemists)
Doctor’s prescription required for approved drugs. Present your EHIC together with the doctor’s bill and the prescription to the pharmacy which will dispense the items. Some will be reimbursable by CPAM at 35%, some at 65% and there may be items NR. Neither CPAM nor Exclusive Healthcare can reimburse the charge for NR items and the pharmacist should point this out to you.
Do not forget to remove the little peel off labels on the medicine boxes and stick them on the appropriate places against the items entered on the back of the doctor’s bill before completing it and sending it to CPAM together the duplicate copy of the prescription. Unless you do this CPAM will not reimburse you and Exclusive's claims office will be unable to either.
•
Hospital treatmentYou can be admitted on the recommendation of a doctor who may have sent you to a specialist first. If you are to under go an operation you may be given an appointment with the anaesthetist that will attend at the operation who will want to find out if you have allergies or some condition that requires consideration in selecting the right anaesthetic for you. You will normally have to pay and follow the standard procedure.
During the preadmission period please contact our EHIC Claims office, at the address above, and give them: Your Policy number, your name, your age, the date of admission, the name, address and fax number of the of the Hospital. The hospital should have made arrangements with CPAM for direct payment of the State’s share of your bill and we will issue a guarantee to pay your share according to your Policy Terms and Conditions. We would always suggest that you acquire the hospital’s fax number, so we can issue a payment guarantee.
If you are in France always send any correspondence by receipt of delivery post – letter recommandée avec accuse de reception – which can be obtain at any La Poste.
Long Stay Holiday
