Every month, we publish Jean Taquet’s Q’s and A’s — his practical answers to life in France. His first column was published in the March 1994 issue of what was then called the Paris Free Voice and in 2002, International Living published the entire compilation of them as the “The Insider Guide to Practical Answers for Living in France.” (http://www.insiderparisguides.com/answers/index.html) This document continues to be updated with his latest questions and answers, and certainly continues to be both fascinating and enlightening.
All of us who have moved to France have experienced the trials and tribulations of acclimating to this complicated and ancient society. Jean Taquet, a legal advisor with a foot in both worlds, manages to untangle and align our legal foibles with his practical approach to the law and life.
The following is an excerpt from today’s column of Q’s and A’s; the entire of which including his poignant introduction can be found at /parlerparis/practicalanswers.html. I urge you to take the time to read it all and for past columns you can go to Past Newsletters (http://www.internationalliving.com/paris/eletters.cfm) then seek those at the beginning of each month to find his columns.
To receive his columns directly, he will be happy to add you to his mailing list by writing: mailto:[email protected]?subject=Taquet_Column
I am affiliated with the French Social Security System and have a “mutuelle” as complimentary insurance. I received a root canal treatment from my dentist, who told me that the French security system would not cover the procedure, since it is “hors nomenclature, HN,” but that my mutuelle should at least partially cover it.
When I received the final reimbursement from the mutuelle, I found out that the HN was not reimbursed (EUR757.44) because the French system does not do so. I cannot find a way out of this dilemma. Is there any way that I could be properly covered in France with my auxiliary contract working for an international organization – in other words, to have my dental treatment fully covered? Is there any way I can write it off on my U.S. tax return next year?
The Sécurité Sociale system works in many ways like most American HMO health plans. Some doctors and other medical professionals are registered (almost 100% of them) with the system, and some are not. Of those who are registered, some doctors are registered as charging the exact amount defined in the policy; others are registered as charging more (there is a maximum limit). Medical personnel can also perform treatments that are not covered, mostly because they are done purely for comfort or for cosmetic reasons. Because the Sécurité Sociale (known as the “Sécu”) is covering less and less, mutuelles, which are secondary private health insurance policies, are now offering plans of various scopes of coverage.
The first level pays the difference between the Sécu reimbursement and the amount defined by the Sécu policy
The second level pays the difference between the Sécu reimbursement and the amount actually paid by the patient.
The third level pays also a fraction of what is not covered by the Sécu, as long as it has some medical merit.
The best coverage covers any medical expense in full, first as a complement to the Sécu system ,and second, covering everything medical that is not covered by the Sécu.
From what you say, your mutuelle does not cover anything outside the Sécu coverage and only works as a complementary system. My conclusion is that you based your decision to have this dental work done on bad information. Legally speaking, there is not much you can do, since you authorized and paid for the procedure and you knew that it was HN. It would be virtually impossible to prove that the dentist had deliberately given you false information and that you had no way of verifying the exact terms of your policy. It is legally assumed that you knew the nature and the extent of the coverage of your mutuelle when you purchased it.
My advice is to go back to your dentist with the negative answer from the mutuelle and make a huge scene, the French way, saying it is a disgrace to be lied to that way, you will report him to the “conseil de l’ordre,” and so on. By the way, it took my American wife about five years living in France before she mastered this “technique,” which emphasizes drama and never mentions having rights to something or deserving customer satisfaction. You could get a break in the cost of the procedure. This is not a sure shot, but you should really try. This dentist misled you quite a lot; the decent thing to do would have been to warn you of the risk you faced and make sure you got a confirmation from your mutuelle regarding its terms about HN.
There is a “conseil de l’ordre” for each profession in France that requires a license. Only senior professionals in the field are members of this body, which attempts to find a compromise between preserving the profession’s good reputation and helping a fellow professional. As always in France, unless you have sufficient written documentation of what has happened, you will not get proper satisfaction from this procedure,
as it becomes your word against this professional’s.
As for the tax write-off, I cannot see how a dental expense in France can be considered as a professional expense in the USA.
A la prochaine…
Editor, Parler Paris
E-mail: [email protected]
P.S. Jean Taquet will be speaking at the upcoming Working and Living in France Conference at the end of October on immigration issues.
* Further resources:
* Get a priceless orientation to Paris you have never before had.
* Need to know just a few basics to get by while you’re here in Paris?
* You may be one of those people who dream of working and living in France but don’t know how to go about simply DOING IT.
* Learn things about Paris you never expected to know…realizing the true depth of this magnanimous city.