Hospital only mutuelle -what's covered?

8 Replies
Philealing

1456158568

Message

I expect all policies are different but as a general rule......... I have a 'hospital only' policy with Harmonie and needed to go into hospital in December for a fairly major operation. All went well but I have just received a bill from the hospital. It's not for the operation itself but is for the pre-op meeting and tests with the anaesthetist that I had to go for at the end of November In advance of the operation. The bill shows that the mutuelle have refused to pay. The meeting was clearly directly related to the operation and involved meeting the anaesthetist to discuss the operation as well as having blood tests and ECG. Does anyone know if this is normal or should I challenge it? As my French is not great I thought I would seek some general guidance on here before trying to wade through the small print of my policy. I like to think that because the date of the meeting was earlier than my admission  date that there might be a misunderstanding. I also realise that insurance companies will avoid paying out if they can. Thank you.

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Replies

dozygirl 1456159116

Surely "hospital only" says it all.  It's "hospital only" and not anything leading up to it or indeed, after it.  I may be wrong but I'm sure other people will advise.

kervéor 1456159126

I have my mutuelle with Harmonie and have never had this problem 'You are obliged to have a pre op RDV apart from emergency surgery ,maybe a closer look at. your policy or go in and see why they are refusing to pay .

Kerroux 1456160453

Hi ,I am paying a fortune for 100% hospital cover and its just what it says on the tin.If i am in hospital for an overnight stay or longer its covered.Xrays,tests,pre op consultations or anything that only needs a visit is not covered.

vichy-445734 1456161950

Hi you should maybe tel your insurance company, all policies differ, 


Try emailing your insurance company 


Our insurance guy speaks perfect English, you may find someone in their (your brokers office ) speaks English. 


Good luck 


V


X

Busterboy 1456164721

But the consutations should be covered by your carte vital up to 60/80%

dozygirl 1456165256

Think the poster thought the balance should be covered by a Hospital Only cover top-up.

Philealing 1456165861

Thanks all. Yes the bill is for the bit not covered by the CV. It sounds like I will most likely be covered for the pre-op so will call them and take the plunge.

genie-382498 1456171939

be careful, we paid a hospital only policy for 8 years and when hospitalized we then found out that we had to have spend more than 4 nights in hospital to claim back !! Read your policy carefully.


 

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