Wednesday, June 8, 2011

French health care - great if you can get it

France has a great health system. Everyone says so. Not everyone is entitled to use it freely though. You have to be entitled and in the system - and that means having a social security number. Although I've lived in France for years and have been entitled to a Carte Vitale - the medical insurance/entitlement card - for a year and a half, I've only just succeeded in getting hold of the social security number, or numero secu needed to get one. The reason? France has fiendish administration. Everyone says so.

When I first moved to France I was working for a vast American corporation, spending a lot of my time on planes and in airports. Because I was away from France about as much as I was here I didn't bother too much about the Carte Vitale. I retained UK health insurance and hoped for the best. It was only when I finally registered as an autoentrepreneuse (self-employed) in June 2009, that I decided to apply for a Carte Vitale.

My accountant airily told me it would arrive automatically "in a few weeks" since I was registered as a business and paying taxes.

When it didn't arrive - quelle surprise - he advised me to contact the local tax office in town. The young woman there looked blank and told me to contact URSAFF, the French social security outfit, in Avignon. URSAFF in Avignon sent me to a strange little office in what seemed to be a block of flats where a lone staff member told me to contact RSI in Paris. "You definitely need to deal with RSI," she told me. RSI is the French 'social regime' for independent workers. They ignored me for a year and a half. Or rather, after sending me a registration number, they ignored me for a year and a half.

I emailed RSI in Paris just over 40 times - sad I know, but I started counting after the first half dozen times. I called them countless more times and got personnel who said they couldn't deal with me unless I gave them my numero secu. "That's the problem," I said. "I don't know it." They shrugged, telephonically. I sent them letters. "What do I need to do to obtain my social security number and Carte Vitale?" I asked. I wondered when they would ever reply. The answer, as with the emails, was never.

I lost count of the different numbers and organisations I rang in my efforts to find out that number. "Call this number in Provence," someone in Paris would say. "Call this number in Paris," the person in Provence would say. It was entirely circular. I gave up for weeks at a time.

One number in Provence played an eternal message that the service wasn't available. One had severely restricted opening hours - about 12 a week - and I never got through to anyone there. Another number parrotted the "Contact Paris" mantra. Yet another simply rang out. Always.

After 18 months I finally discovered my secu number. It was by chance really. I spent three solid hours calling everyone in French health administration and eventually someone, somewhere, casually mentioned an organism called RAM-GAMEX. I'd never heard of them. I got their number and called. After half an hour of muzak and the occasional cheery message telling me how much I was being charged for waiting, a woman answered. I asked her, simply, what I had to do to get a social security number. She asked for my RSI number, tapped it into a database and said "Well there's absolutely no problem with it, madame - I can give it to you now. Do you have pen?" A pen? I nearly had a fainting fit. I was euphoric and amazed.

"But I've been trying to get this number for a year and a half," I said. "I haven't been able to get my Carte Vitale..."

She sounded rather insulted. "All you had to do was ask!" she said snippily.

I wrote my number down carefully. Then I wrote it down in six other places. Then I called a friend to say I'd finally succeeded. I'd won! I'd beaten the French administration. They'd tried to beat me down but I'd perservered. I felt like a marathon runner, breasting that flimsy tape and brushing it aside.

But I know I'm still only halfway there. I have since received a Carte Vitale attestation and my numero secu but I don't yet have the actual Carte Vitale. When the woman at RAM-GAMEX told me how to apply for it, she added scarily: "It'll arrive automatically in a few weeks." Yes - I've heard that before.


  1. Ther are many times when I thank heaven for the NHS and this is one of them. I think I would have exploded by now if I were you! Chapeau for persevering.

  2. I know exactly how you felt trying to get your social security number. I lost my carte vitale more than a year ago and i am still waiting for the replacement card. Endless calls, letters and emails... no success... At least I can use the services with the atestation!