In this issue:
♦ Isabelle Want ‘s article of the Month
♦ Product of the Month & Agenda for May
♦ This Month recipe
♦ Agenda & Living in France
♦ Agency news & Covid 19 information
♦ What happened in France in April
♦ Professional of the Month
♦ Useful information and contact details
♦ Some French vocabulary
♦ Useful information and contact details
ARTICLES OF THE MONTH
UNDERSTANDING 100% SANTE FOR TEETH
The new reform 100 % Santé gives you access to a large range of dental treatment including a large choice of crowns, bridges, and dentures, fully reimbursed:
- Crowns in ceramic-metal and fully ceramic for teeth that are visible.
- Metallic crown for all the other teeth.
- Replacement of bridges céramo-métalliques for replacement of incisors teeth & canines.
- Metallic bridges for all other teeth.
- Resin dentures (removable prosthesis) for all or part of the teeth.
- The repairs and change of elements in the dentures.
The teeth in light pink and green (teeth called 1st & 2nd premolar, 1st & 2nd molar & wisdom teeth) are what is called non-visible teeth so crowns in metal.
Visible teeth are in red and blue (front teeth called central incisors, canines & lateral incisors)
The 100 % Santé is available with all dentists.
Your dentist will propose a quote showing the treatment and cost with precise description.
Every act is mentioned in the quote and refers to a type of treatments defined in the new law 100 % Santé.
It exists 3 types of treatments for prostheses:
- le panier 100 % Santé: Crowns, bridges and dentures are fully reimbursed as long as you have a top up that includes the 100% santé cover. With us-Allianz, only Hospital only cover, or ECO cover do not include it. The top up contract which includes the 100% santé are called« contrat responsable».
- le panier aux tarifs maîtrisés: This is medium price so for a crown for instance, it would be 371 euro left to be paid by you and top up instead of 694 for the one below. So, crown is not fully ceramic but has metal in it.
- le panier aux tarifs libres: High price and of course according to dentist better quality or better looking so mostly fully ceramic.
Obligatory quote:
Since 1st of January 2020, all the dentists must include systematically in their quote the 100% santé treatment when it is possible. In fact, you must get at least two quotes and one of them must include the 100% santé.
The quote shows the treatment plan and the material used.
If he proposes some treatment or acts which leave you an amount to pay yourself (reste à charge or montant non remboursé) after the reimbursement done by CPAM, he must also do a quote 100% santé so nothing for you to pay or if not possible with moderate costs (panier aux tariffs maitrisés showed above).
I went to the dentist and my husband needed a crown on tooth 15 which is pre-molar. They gave us a quote. Guess what! They did not give him a quote 100% santé. So, I politely inquire, and the secretary told me 100% santé do not apply for those teeth!! I insisted and then she said yes but it is a metal crown. Ah! So, you do it but do not quote it!! Which is illegal. Note that the French government is lenient now but if they carry on not playing fair, it will be a fine of 1 500 euro per patients!! Please note that the majority of dentist do play fair.
Below is the first page of the quote which explains the type of materials, type of treatments (between the 3 I explained above).
The quote shows the teeth number which in this case is 1st premolar, the type fo treament 3 which is free pricing for the dentist!! The materials, etc. You can see the total amount, the amount set by cpam, amount reimbursed by Cpam and what is left for me to pay!!
The second quote was included but the secretary did not mention it and surprise, the total amount and type of treatment (which in this case is medium-between 100% santé and free price) is not on it!!I guess it made it harder for me to realise it is cheaper!!
General things to know about dentists in France:
Do not wait to have tooth ache to register with a dentist. Do it now and even before you get your carte vitale. Most of them have a waiting list of 6 Months or more and some even refuse to get you on the waiting list!!
The dentist must inform the patient of the treatment included in the 100% santé but he is not obliged to do the treatment. In this case he must refer you to one of his colleagues.
Do insist for the 100% santé. Especially if you are on a budget!! I have a metal crown on my premolar, and I can live with it, and nobody has noticed.
Please do visit your dentist at least once a year as it has been proven that bad teeth are a cause to heart problems!! Bacteria go into your blood stream and affect your heart.
When you need to have heart surgery, it is now an obligation to visit the dentist before the operation.
Please feel free to contact me for a quote for a top up insurance. Note that the law has changed now, and we can cancel your existing top up contract at anytime as long as you have had the contract for at least one year so please do not hesitate and contact me for a quote. You probably have a contract with extra level of cover for teeth where now it is not necessary as 100% is enough so you could have a cheaper contract! Plus, with Allianz, you can choose better cover for hospital while staying on low level for teeth or glasses, etc. Most companies have level 1, 2, 3 etc. so if you want best cover for hospital, you have no choice but have best cover for all the rest as well.
Conclusion: The new law is fantastic and means you can get treatment covered fully by your top up as long as you have the proper contract (Contrat Responsable). But you need to know the law before you visit your dentist!! Now you do!!
And remember to check out our web site www.bh-assurances.fr/en for all my previous articles and register to receive our monthly Newsletter. You can also follow us on Facebook: “Allianz Jacques Boulesteix et Romain Lesterps”
And don’t hesitate to contact me for any other information or quote on subject such as Funeral cover, inheritance law, investments, car, house, professional and top up health insurance, etc…
PRODUCT OF THE MONTH
Allianz Health top up
Like any other top up, premium is simply based on age, level of cover and postal address. Yes, for some reason, it is more expensive if you live in Paris or Bordeaux compared to Angoulême!!
There is no health questionnaire. You get a Tiers payant card (piece of paper in fact) that prooves you are insured. You can check your reimbursment, send quotes and bills and reprint your card directly from your Allianz customer account.
I have on the spreadsheet below detailed 5 types of cover and premium for someone born in 1953 so 68 years old. This example includes a 10% discount as a customer (meaning this person already has another contrat with us, either car or house, etc).
HOSPITAL ONLY COVER
What does it cover: This cover is quite good in regards to hospitals as it is 400% cover and also up to 150 euro per day for an individual room. In France, you either share the room with someone else or you can choose to be on your own like an hotel room (with your own bathroom). Note that the cover does not guarantee you will be able to get the room, it simply covers the cost if you can get one. Usually, you can always get one in a private hospital (Clinique).
It also covers things outside the hospital such as ambulance, x-rays, scans and blood test.
What it does not cover: Well, mostly it does not cover things outside hospitalisation such as dentists, opticians, glasses, GPs, consultants, medicines, physios. However, do note that you are covered a certain percentage of the cost by CPAM (French health system) for those. For instance, the GP visit is covered 70% (GP visit cost 25 euro).
ECO COVER
What does it cover: This cover is the basic cover at pretty much everything at 100% of the CPAM set price. It is the cheapest basic cover as it does not include the 100% santé reform.
What it does not cover: Well, it does not cover surcharges, medicines that are only reimbursed 15 and 30% by CPAM and other perks such as individual room, alternative medicine, etc. Also, it might not be enough cover to reimburse fully your glasses and teeth treatment if these are complicated. It also does not include the new reform of 100% santé so if you want hearing aid, glasses or crowns covered by the new reform, do not choose this cover.
CONFORT COVER
What does it cover: This cover is the basic cover at pretty much everything at 100% of the CPAM set price and also include the 100% santé reform so covers hearing aid, crowns and glasses.
What it does not cover: Well, it does not cover surcharges. Also, it might not be enough cover to reimburse fully your glasses and teeth treatment if these are complicated and above the new level of cover set by the French government via the 100% santé reform. It does include the 100% santé reform.
SERENITE HOSPITAL COVER
What does it cover: This cover is the best cover for hospital and also up to 125 euro per day for an individual room and 100% for the rest plus some perks.
What it does not cover: Surcharges made by consultants and specialist (for consultations). Also, it might not be enough cover to reimburse fully your glasses and teeth treatment is those are complicated and above the new level of cover set by the French government via the 100% santé reform.
GOLD COVER
What does it cover: This cover is the best cover for hospital and everything else.
What it does not cover: Not much really!! Although you still might have to pay surcharges on tooth implants.
FAQ:
When does the cover start: Straight away.
What about pre-existing conditions: There is no health questionnaire, so they are covered.
Can I upgrade or downgrade the level: Not the first year but any time after that yes.
Does the top up cover me abroad: Only if CPAM does. It is a top up not a private health insurance.
How do I cancel it: On the anniversary date each year or if you leave France, we need proof of address abroad. Or now with new law at any time once the first year has passed.
If you already have a top up but not with us, we will do the cancellation for you, so you have nothing to do.
How does it work:
When you have your carte vitale: When you visit your GP or other medical professionals, you first give them your carte vitale and then you pay. The reimbursement is then automatically done by CPAM and Allianz is linked with CPAM by the “télétransmission” so the top up from Allianz follows within 10 days of CPAM reimbursement.
Tiers payant card: That is your top up card. This card does not show your level of cover. It simply proves that you have a top up and gives information to the medical profession in case of a “prise en charge”- this is when the top up pays instead of you.
You can download it from your Allianz customer account.
COVID 19 INFORMATION
Remember the application called “tousanticovid” to download. When you download it, it will tell you if you have been in contact with someone else who has it, but it is also full of good advice, information like where to get a test, how many affected daily, etc and you can download the attestation to go out. Vaccination is now open to everybody above 12 years old. Go to your local pharmacie or visit the web site www.doctolib.fr to book an appointment. The curfew is over!! And night clubs can re-open from the 9th of July but you can only enter with a proof of vaccination or a negative test. All those measures are subject to the situation of each department. If the number of cases per 100 000 inhabitants goes over 400, the Department goes back to its previous stage. You can find details new rules on: https://www.gouvernement.fr/info-coronavirus
Important numbers:
As of 29/06/2021 there have been 111 086 deaths in France (84 613 in hospital), +28 in the last 24H. There have been 5 772 844 confirmed cases (+2 314 in the last 24H), 875 people being hospitalised (in the last 7 days), 200 of them in intensive care. And 33 533 728 people have been vaccinated. You can find all the information on this web site: https://www.santepubliquefrance.fr/dossiers/coronavirus-covid-19
AGENCY NEWS
All our agencies will be shut on Wednesday the 14th of July as it is a bank holiday.
Isabelle Want will be on holiday from the 10th of July to the 2nd of August!! Summer holiday!!
Needless to say that the August newsletter will be late and light!!
Our 2 days seminar was great as nobody got badly injured!! It consisted more on a series of team bonding excersises which includes an assault course, archery, finding a treasure and a electric bike ride around Cap Ferret. Sunset was great and we got to say goodbye to Annick who has now retired.
AGENDA FOR JULY IN THE CHARENTE
30th of June to 27th of July: Summer soldes- second big discount fo the year.
2-3rd: Wine feast of St Sornin
14th: Bastille day and bank holiday, expect firework everywhere
17-18th: Medieval feast in La Rochefoucauld
27th: Rouillac Monthly big fair
You can find the majority the Charente’s activities and visits in this free “sortir” magazine. It is available at most bakeries, shops and tourist office and you can also download it online:
https://www.sortir-label-charente.net/
THIS MONTH RECIPE
Conchiglioni, spinach, ricota and salmon
Ingredients for 3 persons:
-21 big conchiglioni pasta!
-3 slices of smoked salmon
-250g of fresh spinach
-1 shallot
-I pot of ricotta cheese
-50 g of Gruyere cheese (not cheddar!!)
-3 soup spoon of parmesan
-Fennel ferns
-Olive oil
-3 Soup spoons of cream
-Salt and pepper
Peel and slize the shallot finely, fry it in olive oil until brown, then add the spinach. Let it cook a few minutes and put aside.
Cook the pasta (don’t over cook them so aldente)in salted water and put them under cold water and drain them.
Preheat oven at 200°C.
Chop the spinach and put it in a mixing bowl and add the ricotta, parmesan, aneth (finely slized) and mix well. Cut the salmon in small cubes and add them to the mixture.
Stuff each pasta with this mixture and place them in a baking dish. Sprinkle the gruyere cheese on top and put in the preheated oven for 10 Minutes.
THIS MONTH RECIPE
Conchiglioni, spinach, ricota and salmon
Ingredients for 3 persons:
-21 big conchiglioni pasta!
-3 slices of smoked salmon
-250g of fresh spinach
-1 shallot
-I pot of ricotta cheese
-50 g of Gruyere cheese (not cheddar!!)
-3 soup spoon of parmesan
-Fennel ferns
-Olive oil
-3 Soup spoons of cream
-Salt and pepper
Peel and slize the shallot finely, fry it in olive oil until brown, then add the spinach. Let it cook a few minutes and put aside.
Cook the pasta (don’t over cook them so aldente)in salted water and put them under cold water and drain them.
Preheat oven at 200°C.
Chop the spinach and put it in a mixing bowl and add the ricotta, parmesan, aneth (finely slized) and mix well. Cut the salmon in small cubes and add them to the mixture.
Stuff each pasta with this mixture and place them in a baking dish. Sprinkle the gruyere cheese on top and put in the preheated oven for 10 Minutes.
LIVING IN FRANCE
SPORT TOURISM IN THE CHARENTE
As it is July and the weather is great, why not make the most of our wonderful department and try some rambling, climbing, archery, horse riding, sailing, paddle, mountain biking or canoeing!!
There is a special site https://sportsdenature16.lacharente.fr/presentation introducing the variety of sports available in the Charente and where you can do them.
You can also buy a book called Tour VTT de la Charente who have all the trails for mountain biking in the Charente . Web site is www.vtopo.fr . This book is available for purchase in most tourist offices and supermarkets of the Charente.
Kayaking or Canoeing is very popular in the Charente with more than 71 000 boats on hire!! You can do it on the Charente, Touvre, Vienne, Dronne and Tardoire rivers all over the Charente from 5 euro for half an hour to 35 euro for the day.
Rambling is fun but to avoid people getting lost there is an app called Loopi which shows the itineraries with gps tracking. Should work all over France, not just in the Charente!!
Here is a list of websites that can help you enjoy your holiday in the Charentes:
https://www.infiniment-charentes.com/
https://charentestourisme.com/
https://www.sudcharentetourisme.fr/
https://www.tourisme-charentelimousine.fr/
https://www.angouleme-tourisme.com/fr#/
https://www.ruffecois-tourisme.com/
https://www.tourism-cognac.com/
https://www.saintes-tourisme.fr/
https://www.leboat.fr/croisiere-fluviale/france/charente
https://www.routes-touristiques.com/tourisme/visiter-nos-regions/poitou-charentes/charente/
https://www.charente-limousine.fr/index.php/fr/economie/tourisme
WHAT HAPPENED IN FRANCE IN JUNE 2021
In general, Paris will now have a Police Municipale whose role will be to fine people for parking illegally but also urinating in the street, throwing rubbish on the floor or don’t pick up their dog poos!! They won’t be armed but will have a bullet proof vest. Until now only the Police Nationale was in charge of doing this!!
The emergency numbers 18, 17 and 15 had stopped working on the 2nd of June from 6pm to midnight due to a breakdown of the system managed by Orange causing 4 deaths including a 28 Month baby!
The Department and regional elections have set a new record for people not turning up to vote!! 2 out of 3 of voters (15 million out of 47.7 million registered voters) did not turn up in the first round. It did not improve in the second round with 65.7% of voters not turning up. Not surprising when you know that I turn up to vote for the Department only to find out I was also voting for the Region!! French people were not really interested!! Me included!
In general, the same people have been voted in, so France is split between left and right with no victories for either the far right, far left nor the party of our President.
An illegal Rave party with more than 1 500 people has been taking place in Britany. The participants have been displaced by the Police and some people were arrested following some clashes with the police.
A building has collapse in Bordeaux injuring 3 people, one seriously. The building was being renovated.
A series of freak weather phenomenon has occurred this June including hailstorms, flooding and tornadoes. Thankfully not all in our area but please note that we are trying to cope with all the claims as best we can.
Lesbian Women can now access Medically assisted Pregnancy legally in France.
In Crime, a woman was thrown out of her 8th floor window in Colmar by her ex-husband who was not allowed to visit her. She died and is now the 48th female victim of their partner this year, husband or ex!!
Our President has been smacked in the face by a man who is from the far right and fan of the Middle Ages. He shouted Montjean St Denis when he smacked him which is the rally cry of the old monarchist Medieval France!! He got 4 Month Prison sentence. Quite lucky as it could have been a medieval punishment instead!! Afterall he is a fan of this period so he would have deserved it!!
In sport: Toulouse has won the French top 14 Rugby championship.
PROFESSIONAL OF THE MONTH
Mamie’s Bar
Situated in the central place in Montemboeuf (16310).
Previously Chez Mamie.
Beers – Cider – Wine – Spirits – Coffee and soft drinks without alcohol – crisps and similar snacks –
If the sign is marked open and the door is open you are more than welcome…
Unfortunately cash only –
INSURANCE FRENCH VOCABULARY
French | English |
Une Franchise | Excess |
Un Sinistre | Claim |
L’Assistance | Breakdown cover |
Une Assurance | Insurance |
Un Bris de glace | Windscreen cover (In France it also covers head lights and all windows) |
Un Remboursement | Reimbursement |
Une Cotisation | Premium |
Une Echéance | Renewal date |
Une Date d’effet | Contract start date |
Une Résiliation | Cancellation |
Un Avenant | Amendment |
Un Devis | Quote |
Un Incendie | Fire |
Un Dégats des eaux | Water damage |
Un Domage electrique | Electrical damages |
Un Accident de voiture | Car accident |
Pneu | Tyre |
Un Chevreuil/ Sanglier | Roe Deer/ Wild boar |
Un Fossé | Ditch |
Une Clôture | Fence |
Un Portail | Gate |
Une Tempête | Storm |
Un Arbre | Tree |
La Grêle | Hail |
La Neige | Snow |
La Pluie | Rain |
Le Verglas | Black ice |
La Toiture | Roof |
La Maison | House |
Les Murs | Walls |
Le Portail | Gate |
Grange | Barn |
Le Contenu | Content |
Un Objet de valeur | Valuable item |
Une Carte grise | Car registration paperwork |
Un Permis de conduire | Driving licence |
Un relevé d’information | No claim certificate |
Contact us !
In order to discuss and meet your need as best as possible, feel free to contact us with a mail, phone call... We can also schedule a meeting in one of our four agencies... Or directly to your home !