Getting my Carte Vitale and going to the doctor…finally

It felt futile. I knew the French didn’t operate this way, but I was feeling worn out and was reverting to American habits.  I was writing, in French, on a post-it note, the following message:

I am very happy to send another yet another check to cover my health insurance charges, but I still have not received my Carte Vitale.”

I knew as I sealed the envelope that some French functionary processing my cheque would see this note, laugh scornfully, then peel it off and place it delicately into the circular file.

So you can imagine my surprise when, one week later, I received a letter in the mail letting me know the only thing missing to process my Carte Vitale was a photo and my signature, after I had verified some information they had on me.  It is one of those times I was quite happy to be wrong.

This was the only part of my paperwork processing that had gone sideways as I left visitor status and transitioned into my profession liberale life.  But, since I’m not a frequenter of doctors anyway, it simply remained a slight irritation.  When four months had passed without any sign of my Carte Vitale, I made a copy of my translated birth certificate, as well as a copy of the original, and sent it to RSI with a pleasant cover letter.  No reply.  Another four months passed.  That’s when the wry (but polite) post-it note was written, which just goes to show you that every now and then an unexpected tactic might just work.

* * *

The visit to the doctor felt like an interstitial in an Inspector Clousseau skit.  I had crowdsourced a good doctor from my Paris network, one who had a decent command of English, though I made the appointment in French.  I made the mistake of not asking how to find the place (surely an address is good enough?) and when I walked into the vestibule of the apartment building that was the address for my doctor, I searched in vain for signage that would indicate my desired destination.

Not quite willing to admit defeat yet, I decided to climb the stairs (surely the doors will be marked?).  But by the time I reached the 3rd floor (American 4th) I realized that this was a fool’s way to figure things out.

Humbled, I turned around and went all the way back down the stairs.  Thankfully, on the ground floor, a resident was having her door locksmithed and I asked if she knew where the “medecin” was (on a side note, “doctor” is one of those words in French that doesn’t change ending whether you put a “le” or “la” in front of it).  She responded insouciantly (as if she gets this all the time) that “all the doctors are on the 5th floor.”

Bingo.

I took the elevator up to the 5th floor, found her office and checked in, roughly ten minutes after my original appointment time.  Ten minutes after that, I heard a gentle, “Monsieur Heiner, S.V.P” from the hallway and went in.

Her room was cheery and welcoming and full of books.  I felt like I was in a comfy study, not a doctor’s office.  She took out a clean sheet of paper, wrote my name down at the top, drew a straight and clean black line under it, then looked up at me, smiled, and asked how she could help me.

Puis-je parle avec vous en anglais?” I queried.  She smiled down her glasses at me.  “Yes, of course.”  “I just don’t have the vocabulary to speak well about my health in French.”  She nodded.

Ten minutes later she was asking for my Carte Vitale and 40€.  The carte goes into a card reader just like a chip-and-pin card, but with no pin.  “Cash or cheque?” she asked.  “Oh, you don’t take bank card?”  “Non,” she gave the slightest of pouts and shook her head.  “Is this the case for all medical appointments?” I asked.  “Non, it is a choice,” she said.  I had just enough cash on me: “You cleaned me out,” I laughed.

On the way out she handed me a form which designated her as my “medecin traitant” which in American parlance is “primary care physician.”  Getting this form to La Ram/RSI would make sure I got properly reimbursed.

I was off to the lab after that for some testing and I thought I had understood her directions about how to get there (it was in the same structure, just down a different hallway) and 7 minutes and a few dead ends later I was in front of the receptionist at the lab.  Twenty minutes and roughly 10 glasses of water later, I was prepared for my lab work.  When it came time to draw my blood, the nurse gazed at all the vials which had been set aside for me (around 11) and asked if there was a reason I needed all the tests.  I responded in French that I hadn’t been to a general doctor for 2-3 years and I figured why not check on everything?  We both laughed.

I went back to the waiting room and five minutes later the receptionist called me.  A swipe of my Carte Vitale and 80€ on my bank card later, and I was done.  I went home, dropped the form for my new “medecin traitant” in the mail, and went back to my day.

Two weeks later, to the day, an envelope arrived in my mailbox.  I had completely forgotten that I had some money coming back.  There was a check for 15€ against the 40€ I had paid for the visit, as if even 40€ was “too much” (as an aside here I’ve mentioned in the past that you can acquire a “mutuelle” policy that tops up even this copay so you are 100% reimbursed all the time, but I don’t go to the doctor enough to add that extra cost to my budget).

My first encounter with the French medical system: easy, painless, friendly, efficient, and inexpensive.  Against the roughly 700€ a year I pay to cover my national health insurance, not too bad.

11 thoughts on “Getting my Carte Vitale and going to the doctor…finally

  1. Did you receive an “attestation ” (just a paper that you can use at the Drs / pharmacies) while waiting for the actual carte vitale ?

  2. Has anyone been able to get a carte vitale with a long-term visitor visa? My understanding is that the law says we’re eligible but we’ve been hitting administrative roadblocks.

    • What kind of longterm visitor visa?
      I’ve received my CV (4 months after the application was sent off, and just 5 months after my arrival in France, I think it’s considered fast here already…)
      Did you check the ameli website for the documents required for application for CV for people with your situation (the kind of longterm visa you’re on)?

        • I thought for this kind of visa you have to get your own health insurance and provide proof of this when you apply for the visa?
          Check out PUMA, it’s something kind of new here but supposed to mean healthcare coverage for everyone, you just need to have stayed here legally for more than 3 months to apply, but then I’m not sure if it applies to the kind of longterm visitor visa you’re on though.

    • I believe that I need to rectify a couple of things as I answer your question.

      YOU
      Has anyone been able to get a carte vitale with a long-term visitor visa? My understanding is that the law says we’re eligible but we’ve been hitting administrative roadblocks.
      ME
      If I answered your question literally I would have to answer NO, it is impossible. I believe that you are referring to an immigration status called “VISITEUR” and not the visa. Therefore once you hold the OFII stamp which the initial immigration status, then YES, you are eligible to sign onto the public health coverage scheme, ASSURANCE MALADIE, and you get it through your local CPAM.
      There are 2 conditions the CPAM is very strict with:
      1 – prove that you live here and you are indeed an immigrant and not an extended tourist.
      2 – the birth certificate issue.

      So if you could be more specific regarding what kind of issues are you faced with, I could help.
      Also for about a year (most of 2016) CPAM had a very strict interpretation of what is an immigrant, residing in France, and holding a carte de séjour ‘visiteur’ was not a sufficient immigration status. Now this ruling has been reversed.

      • Do you have a reference to the ruling that was reversed? It sounds relevant to our situation.

        My wife has been here since 2014. We’ve been renting a house here for 2 years. She has been in France this entire time except for two week-long trips to London. She has a carte de séjour visiteur. We’ve been told by OFII and the CPAM English language helpline (in the latter case at least a dozen times) that we are eligible with the CDS visiteur, and that the only requirement is that we have been residing legally in France for 91 days. We were told that the type visa was irrelevant (I’m a software engineer and can work remotely, so I work for a US company, get paid in US dollars from which US federal and state taxes are deducted, and what is left gets deposited in a US bank. Thus the CDS visiteur). When I went to OFII for my titre de séjour, they actually handed me the CPAM application forms. We made an application to the préfecture (in our case in Vannes), had all the documents translated (quittance, utility bills, Orange bills, birth certificates, proof of income, etc), submitted them, and waited. When we checked on the status after two months, we were told that they couldn’t issue it to a CDSV. We went to the office of our local deputé, and his assistant called CPAM in Vannes, and from what I was able to understand, he was told that they literally couldn’t enter the application into the computer because CDSV wasn’t an option in the software. Also that French law is very complicated, and that this was a decree rather than a law, and that we should probably take this to a jurist. We’ve never actually been denied a carte vitale, either, it’s just been in limbo.

        • Charles,
          If you want me to help you with this situation, you must much more precise describing the situation. I believe that there are a lot of errors made, and I tried to identify some of them but I am not sure I got all of them.
          PUMa & Carte de séjour -VISITEUR-
          This is quoting the PUMa regulation. There is a lot more to this especially when you add the carte de séjour mention visiteur in it. Keep in mind one thing, the foreigner MUST prove that payment of premiums towards the health coverage.

          CPAM & carte de séjour -visiteur-
          CPAM reversed indeed a ruling that was in forced during the year 2016. “VISITEUR” was excluded of the then CMU/PUMa coverage. Today it goes through without problem on that end.

          Préfecture & PUMa & CPAM software does not discriminate between the cartes de séjour
          This makes absolute no sense at all. I am guessing of a different reason. As stated above the applicant to the carte de séjour must prove paying for the health coverage and this is not mentioned in the description. I assume that there is also an error here, it must be CPAM and not prefecture here where the file was submitted.
          This is not true anymore and also the software is not set up this way, it does not discriminate between the cartes de séjour that I know off.

          The 3 most common problems
          I believe that I can help as I have done quite often. These people are not using the right wording to explain the situation.
          These are the issues that currently exist and for some of them there is just a need to push with a higher hierarchy.
          1 – old regulation the “visiteur” is refused, then appeal the decision or resubmit
          2 – insufficient proof of a lawful stay in France – the carte de séjour and the French income tax is not enough, sometime 3 proof per month for 6 months is barely enough to prove the physical stay in France while holding the CDS visiteur.
          3 – mysterious calculation by Orléans URSSAF regarding the PUMa premium such that Americans with retirement payments from the USA do not count and therefore do not pay premiums which excludes them from holding a CDS visiteur.

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