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All students at The American University of Paris are required to have health care insurance. The French government also requires health insurance for all non-French students residing in this country. The American University of Paris has contracted with the AXA Group to provide our students with such coverage.

 

 

What General Principles Guide the Plan?

 

The Highlight table gives the specific reimbursement schedule for each treatment or service, but it is useful to understand some of the principles on which the Plan is built:

 
 

 

  Coverage is worldwide, 24 hours a day, including travel outside of France during vacations. There is no maximum overall ceiling. There are no deductibles, no medical screening, no waiting periods (1).

 

  Students normally do not need to spend any money in order to obtain good medical care in Paris. When enrolled, you will receive an insurance card in your name which with a valid American University of Paris ID card gives you access to a group of English-speaking medical and dental practitioners who bill European Benefits directly for the treatment you receive from them.

 

  Students who go to doctors or dentists outside the Direct Billing group have to pay the practitioner first, fill out a claim form and then be reimbursed afterwards by European Benefits. Before reimbursing a claim, European Benefits evaluates the charges to determine if they have been furnished by qualified providers of medical care, if the services were medically necessary, and if the charges were reasonable and actually incurred. Services which are not medically necessary are not reimbursed (2).

 

  Certain procedures may not be covered, in particular, cosmetic surgery, elective surgery and treatment which is not recognized by the French Social Security System. When in doubt, do not hesitate to ask European Benefits.

 

  Medical repatriation is provided when AXA Assistance physicians are convinced that repatriation is possible and absolutely necessary on medical grounds. It is important to note, however, that the quality of French doctors and hospitals is very high and situations where a medical repatriation is absolutely necessary are rare. No medical repatriation is covered unless AXA Assistance agrees to it in advance and handles all the arrangements.

 

 
 
 

 

 

(1) Nevertheless, European Benefits requires that you obtain a pre-certification agreement in all cases of repatriation, surgery, and non-emergency hospitalisation. These are important, expensive decisions. This procedure helps to ensure that you receive the right treatment in the right facility. European Benefits pays the provider directly in most cases.

Simply call European Benefits ten days before entering the hospital or undergoing non-emergency surgery. If an emergency hospitalisation occurs, European Benefits must be contacted within 72 hours of admission.

Pre-certification is required also for :

treatment for psychiatric, mental, nervous, alcohol, and drug abuse disorders when costs exceed 600 €

dental treatment, surgery, and crowns when costs exceed 600 €

childbirth

repetitive and serial medical procedures (8 or more over a four month period)

 

 

Failure to obtain a pre-certification agreement from European Benefits may result in a refusal of a claim or reduction in reimbursement up to 50% of total expense.

 

 

 

 

(2) The Plan normally reimburses all essential medical expenses, as the ceilings in the Plan are set sufficiently high to cover nearly all medical practitioners in France. However, it is not a blank cheque. Students who want dental crowns or who choose to go to a small group of expensive practitioners known as "Non-Conventionné" are well advised to inquire carefully about the costs of the proposed treatment, because they may not be reimbursed for charges more than four times the limits set by the French Social Security System. Use your head, talk with the Student Affairs Office, stay with "Conventionné" or "Conventionné Honoraires Libres" physicians, and use first the medical providers on the Direct Billing List.

 

 

A complete description of the benefits and the full terms and conditions will be found in the Master Policy issued to The American University of Paris.

 

 
 
 

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