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How long does coverage last?
 
How do I enroll in the AUP Plan?
 
Am I entitled to an exemption?
 
What is health care like in France?
 
What do I do in case of hospitalization or surgery?
 
What if I go to a doctor who is not on the direct-billing list?
 
How do I get reimbursed if I go to a medical provider who is not on the direct-billing list?
 
Who should I contact if I have more questions?
 

 
 

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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