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How Long Does Coverage Last?
New students are covered
from September 1 (Fall Semester) or January 1 (Spring Semester)
respectively, provided premiums are paid. Coverage runs through
December 31 (Fall Semester) or June 30 (Spring Semester).
Returning students who pay
the insurance fee prior to July 1 are enrolled for a six month
period which runs from July 1 through December 31. Spring
semester coverage for these students runs from January 1 through
June 30.
If a student stops his or
her studies and/or withdraws from the academic program at The
American University of Paris, coverage stops on the day the
withdrawal is recognized by the University.
Upon leaving the
University, students who maintain their residence in France
provided they have been insured for at least one year are
guaranteed access to a private health insurance policy. Contact
European Benefits for more information.
During the first six months
after leaving AUP, insured students are covered at no extra
premium cost (after a 762 € deductible) for major medical costs
which result from an accident or illness whose first symptoms
manifested themselves during the coverage period at AUP.
How Do I Enroll In The AUP Plan?
All AUP students are
automatically enrolled in the insurance plan at the beginning of
each semester, unless they have received an exemption from the
University Bursar. The cost of the health care insurance will be
charged directly to your account and payment is due for new
students when they register. For returning students, premium is
due on July 1.
Am I Entitled To An Exemption?
All students are required
to enroll in the insurance program except for those who fall
into the following categories and
request an exemption:
(1) French residents who are
covered under the French Social Security national medical
program.
(2) Residents of other EEC
countries who have national health insurance programs and who
have a E111 form providing emergency care reciprocity with
French Social Security. The E111 form, which has to be presented
at registration, must indicate on the
form that the E111 coverage extends to the end of the current
semester.
E111 regulations
normally limit cover to emergency care and medical or dental
care which can not wait until return to the home country.
Reimbursements from French Social Security, which normally take
two to three months, only pay a portion of medical expenses in
the Paris area.
As soon as students with
an E111 form arrive in France, they should register with the
following Social Security center and obtain information on the
local rules and regulations: Caisse Primaire d'Assurance Maladie,
Centre des Relations Internationales, 175, rue de Bercy, 75586
Paris Cedex 12.
(3) Other Students who have written
proof of a comprehensive private medical insurance plan which
covers outpatient medical care and inpatient hospital care. The
policy must include medical repatriation.
Proof of such insurance
should include the name of the student, the dates of the
coverage which must extend to the end of the current semester,
and a complete policy or detailed statement of what is covered
and what is excluded by the policy.
Students qualifying for exemption must officially request one
and show proof of their coverage to the Bursar prior to
registration. The final deadline for exemptions is September 11,
2004 for the Fall semester and January 22, 2005 for the Spring
Semester. No exceptions will be made. Paperwork turned in after
these dates will not be accepted, and students will be charged
the full price for health insurance, regardless of the validity
of their claim.
What Is Health Care Like In France?
Health care tends to vary
greatly from country to country in terms of both quality and in
terms of the types of treatment offered. Many students are often
surprised by the types of treatment prescribed for them in a
foreign country and tend to view any deviation from the type of
care they would receive at home as barbaric or inadequate. This
is almost never the case. Different types of examinations and
treatments are rarely either worse or better. They are just
different.
Health care in France is
excellent. The training of doctors and nurses is as good, if not
better, than in any other country. You may be surprised that
doctors' offices and hospitals are not as lavishly furnished as
you are used to, but there are a number of reasons for this, the
most important being that health care is made available to all
French citizens, regardless of their ability to pay for such
care. You should feel assured that the quality of medical care
you will receive in France is excellent.
As was mentioned, the type
of treatment you receive while in France may be different from
that which you are used to. For example, French physicians are
excellent diagnosticians and tend not to use expensive lab tests
and procedures before prescribing a treatment.
If you have any questions
or concerns about your health care, please speak with the
Student Affairs Office. They will be happy to assist you, and
also have information and brochures about all types of
health-related issues. These include such subjects as diet,
birth control, stress, alcohol use and abuse and abortion.
What Do I Do In Case Of Hospitalisation Or Surgery?
In all cases of
non-emergency hospitalisation and surgery, you need to
contact
European Benefits at least ten days in advance so
that a pre-certification agreement ("prise-en-charge") can be
issued directly to the hospital. In an emergency, simply ask the
hospital to immediately call European Benefits. The payment
arrangements will be made directly. The Hertford British
Hospital charges reasonable and customary rates.
Remember: Elective surgery is not covered,
and for any other type of hospitalisation or surgery,
a
pre-certification agreement is required from European Benefits
or the claim may be rejected or only paid at 50%.
What If I Go To A Doctor Who Is Not On The
Direct-Billing List?
IMPORTANT NOTE
In most cases the Plan
covers 100% of medical expenses up to a limit which usually is
defined as 400% of Social Security Tariff, i.e. 4 times the
official rates per treatment procedure. French medical
practitioners are classified into three categories: a) "Conventionné"
who abide by the official rates; b) "Conventionné Honoraires
Libres" who generally charge between 1,5 and 3 times the
official rates; 3) "Non Conventionné" who charge more than 5
times the official rates.
When you inquire about good
practitioners in France, you will discover that they are well
represented in all three categories. If you choose to see very
expensive doctors (who charge more than 4 times the official
rates), you will pay a large part of the medical bills out of
your own pocket. If you pick physicians who charge reasonable
rates, normally you will be completely reimbursed for all
necessary medical care.
When outside of France,
however, medical expenses can often be much higher than for the
same service performed in France. These expenses will be
reimbursed as per the limits detailed in the Plan. To avoid the
risk of being overcharged for services and eventually paying a
large part of the expense out of your own pocket, do not
hesitate to contact European Benefits for advice prior to
incurring the expense. In the case of a
hospitalisation or surgery, this is a must !
How Do I Get Reimbursed If I Go To A
Medical Provider Who Is Not On The Direct-Billing List?
Claim forms are distributed
at registration and may be obtained afterwards at the
Office of
Student Affairs, the
Bursar's Office, and
European Benefits.
Each time you send in a claim to European Benefits, you will
receive in return a statement detailing how the claim was
settled and a new claim form.
INSTRUCTIONS
1. You pay the medical provider you
have chosen.
2. In France ask for the official
bill which is called a "feuille de soins" which your doctor,
dentist, pharmacy or other provider must fill out.
3. Fill in Page 1 of the "feuille de
soins" as follows:
i. Numéro d'Immatriculation: The AUP Student ID Number
ii. Nom-Prénom: Family name, then first name
iii. Adresse: The American University of Paris
iv. Skip over the rest of Page 1, but sign on the bottom
right-hand corner. Your signature confirms that the document has
been completed honestly.
4. When a pharmacy gives you
prescription drugs, remove the proof of purchase sticker
("vignette") located on the container and paste it on the area
of the "feuille de soins" labeled "1ère ordonnance". You will
only be reimbursed if you attach the "vignettes" to your "feuille
de soins".
5. A doctor's prescription must
accompany all bills for eyeglasses, contact lenses, prescription
drugs, laboratory tests, or physical therapy.
6. Please group small claims in order
to avoid payments lower than 50 €.
7. Fill in the claim form carefully
and mail it within 12 months of treatment with the original "feuille
de soins" with "vignettes" and prescriptions (for eyeglasses
also send the optician's bill which indicates
separately the cost of lenses and
frames) to:
EUROPEAN BENEFITS
(THE AMERICAN UNIVERSITY OF
PARIS PLAN)
28, rue de Mogador
75009 Paris, France
8. Normally you will be reimbursed by
cheque sent to your address as you indicate it on the claim form
(please write clearly) or to your mailbox at The American
University of Paris. If you do not have a bank account in France
and would like to cash your reimbursement cheque, go to the
cashier's desk at the Société Générale, 106 rue Saint Dominique,
75007 Paris, and present your Passport and AUP ID card for
identification purposes. If you would prefer, however, to be
reimbursed by bank-to-bank tranfer into your account, send to
European Benefits a bank account identification slip (Relevé
d'Identité Bancaire). Bank-to-bank transfers eliminate the
possibility of lost or stolen cheques.
9) For all treatment or medical
supplies outside of France,
you must send complete medical bills which clearly describe:
-
the full name and date of birth of
patient
-
date of treatment
-
a detailed description of medical
services/procedures/supplies
-
a clear diagnosis or cause for medical
service
-
the currency and amount of charges
corresponding to each category of treatment or services
-
the name, address, telephone number of
doctor, pharmacy or hospital.
10) In the event of an accident
(automobile, etc.) you may be covered by another insurance plan.
Additionally, accidents occuring while working as an intern are
covered by a separate policy which the University carries.
Contact European Benefits who will help you coordinate benefit
payments.
11) If you are also covered by
another group insurance policy or government plan (ex. Social
Security), you must obtain the reimbursement to which you are
entitled before filing The American University of Paris claim.
In this case enclose with your claim to European Benefits a copy
of all medical and dental bills relating to the claim as well as
the original statement of the Social Security or other plan
prior reimbursement.
12) If you have any problems,
call European Benefits.
Who Should I Contact If I Have More Questions?
In general, if you have any questions or
problems, or simply need general advice and support,
get in
touch with the Student Affairs Office at the University or with European Benefits.
If you telephone or visit the European
Benefits offices, you will be able to
discuss your problem with native speakers of English, French,
and nearly all the European Languages, as well as Arabic, Farsi,
Cantonese and Mandarin.
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