Our Blog - First Doctor Visit with the

Since we received the Carte Vitale, we have gotten several letters for screenings, basically the preventive screenings that you would have in the US. In general, it looks like every 2 years, we will get notified that we can go and get these screenings, pretty-much free of charge. I wanted to give everyone a peek at my first doctor visit using the Carte Vitale and how some of the screenings work. I will add that we do not yet have a top-up insurance/mutuelle, so there were some charges that would have been paid for by this top-up insurance that I had to pay for out of pocket.

I got notified of 3 different screenings: a mammogram, a colon cancer test, and a cervical cancer test.

I went ahead and made an appointment for the mammogram, since that did not need to be done through my GP. There was a list of radiology centers with the letter and I searched around for an English-speaking female radiologist. Yes, I could do it in French and yes, I could go to a male radiologist, but this was my preference. If I couldn't find anything, I would have gone first to French-speaking female and then to a male radiologist. The appointments weren't as easy to get as the GP but I got one for early February. No biggie I am thinking ... it is only 5 weeks away.

For the other 2 tests, I needed to consult with my general practitioner (here it is called your "médecin traitant" or "treating doctor"). You have to register one general practitioner as your médecin traitant to get the most reimbursement from your Carte Vitale (70% vs 30% for a normal doctor visit if you do not have a médecin traitant designated). After getting several recommendations, I made an appointment online with a female doctor a short bus-ride away who speaks English. While I do speak some amount of French, I am a little weak on medical vocabulary and health is an important thing, so I wanted to be sure I could clearly articulate problems and clearly understand the issues. Some people say that it is hard to find a good doctor with vacancies, but I thought this doctor was fine and I was able to get an appointment fairly quickly with her.

The trip there is about 15 minutes, and it seems like a fairly new office with multiple doctors. The waiting areas were very open and bright. I made my way upstairs and sat in the waiting area in front of her door. She was right on time (I had probably the first appointment of the morning at 9am) and showed me into her office. We sat at a normal desk and we started going through things (all in English).

First, I explained that I recently received my Carte Vitale and I needed to designate a médecin traitant. She said okay, took my card, and a couple minutes later it was all taken care of on the computer. Next I showed the 3 letters for the screenings. I mentioned that I had already made an appointment for the mammogram, and that I thought I would need to make another appointment for the cervical cancer test as the appointment was only 15 minutes. She agreed and so I made another appointment for that one. Then came the colon cancer test. This is a at-home stool sample test that she provided me a test kit for, which seems to be called a fecal occult blood test kit (Mayo Clinic information). You take a small stool sample at home and mail it to the testing center. It is fairly quick and easy ... Cost? Free.

Next, I asked her about a flu shot. When I was working, every year I would get a flu shot at work. A set of nurses would come in and setup in a conference room and you could walk by between meetings and get the jab in the arm. I believe you can also pop in to your local CVS pharmacy and get it taken care of. Here ... not quite so simple (well, maybe if you are working but I don't know). If you are in a high-risk category (over 65, have a long-term health condition, obese, or pregnant), you receive a letter from the French Health system to go and get your flu vaccination, which is free of charge. In some cases, you can go directly to a pharmacy and they will administer it (this was NEW in 2019 ...before that, the pharmacy could not administer the shot). If your pharmacy doesn't administer shots (my local ones do not), then you pick up the vaccine and visit your GP or a nurses office and they will administer it. You store it in your refrigerator until you can get it administered. Since I am not in the high-risk category, she wrote a prescription for me. I took it to the pharmacy and, as expected, had to pay for the vaccine .... 10.08 euros or a little over $12 all of which I believe would have been paid by my mutuelle. I will take it back with me this week when I visit the doctor again to have it administered.

She asked about if I had a record of my vaccinations, which, well, I kinda have. I have my shot record from my military days, and another booklet that lists shots that I got going to China. She asked if I remember having a tetanus booster in the last 10 years and I really couldn't remember getting one. Okay, so she added that to the prescription for me to get from my pharmacist. Like the flu vaccine, I got it from the pharmacy and it is sitting in my refrigerator waiting for my next appointment. Cost? Free.

I also asked her about a general health checkup, since I hadn't had one since arriving in France. In the US, every couple of years they would do a general health screening including blood tests. She gave me a couple options. She could give me a "prescription" for blood tests at a medical laboratory, or could send me for a 1/2 day "physical" at a medical center nearby. That would include things like an EKG, which she cannot do in her office. She asked a few questions about my health and family history (any history of heart problems?) and so I opted to start with the blood tests only. Perhaps next year I will go for the more extensive testing. A couple days later, I walked to my local lab (10 minutes) a little after 7am when they opened. I figured that early was better as sometimes, I see lines forming outside of that lab later in the day. As I expected, there was no waiting! I walked in and they took my information and prescription, my Carte Vitale, and asked if I had a mutuelle (I said, "not yet") ... all in French mind you. Then they asked if I wanted to come back for my results or have them sent to me. I said "umm.... sent to my doctor?" .... Yes, of course, it is always sent to your doctor but I also get it sent to me personally. Okay, then mail is fine, and she took my email address and gave me a special code to retrieve it from the website once I got the email saying it was ready. I sat down and waited maybe a minute or 2 before I was called back by a nurse. I first apologized for my horrible French, sat down and showed her my veins. She asked which I preferred and I said I had no preference, and about 2 minutes later, I was all done and she had collected 3 vials of blood. I actually got an email later that day that my results were done and ready to be collected using the special code. The readout contains all of the tests, the results, and the "good range". Cost? 17.12 euros or $21 all of which I believe would have been paid by my mutuelle.

She then checked my weight, blood pressure, and pulse. That was it and I was ready to leave. Cost? 7.50 euros or a bit over $9 (that is the 30% that is not covered by the Carte Vitale, all of which I believe would have been paid by my mutuelle). By the way, if I did *NOT* have a Carte Vitale but private insurance (which was what I had last year), I would have paid her 25 euros (her total charge) and she would have given me a paper that listed her information, my information, and the 25 euros that I could send to my private insurance for a reimbursement.

And that was that! No problems getting an appointment, no problems with the doctor. Colon cancer screening test received, done, and mailed. Blood tests done and results received. Two vaccinations ready and waiting for my appointment this week, and all for under 35 euros or $43 dollars. If you add in the 7.5 euros that I will have to pay for my next appointment, that will add the cervical cancer screening, the discussion of the results of my blood tests, and the administering of 2 vaccines for a total cost of 42 euros and change, or $52 dollars. I would say that is very affordable health care!

And I know that some people in the US will say that there is no way that the healthcare is "as good" in France as in the US. Well, I can't talk about every doctor or every procedure, but I can definitely talk about what I have seen personally. The general practitioners here are just as good as the ones I have gone to in the US. Their offices are VERY different, however. For example, the office I went to this time has 5 doctors and a "secretary" who answers phones and directs people who come in. She does not "sign you in" or ask for your insurance card. I mentioned I had an appointment and the name of my doctor and she directed me upstairs. There are no nurses who call you back and take your height, weight, blood pressure, pulse, and temperature. If those need to be taken, the doctor does it during the visit. There are not multiple people at the same time that the doctor makes their way through in multiple offices ... there is one office and you have the doctors undivided attention during your visit. You don't then walk down a hallway to find the billing window to figure out if you need to pay anything based on your specific insurance .... nope. If you have a Carte Vitale or Carte Vitale plus mutuelle, that information is in the system. In my case, I paid the 7.50 directly to the doctor as without a mutuelle, she knew that was the 30% that remained. I looked up a couple of my bills from visiting a general practitioner in Austin, TX ... $192, $134, and $131. These were just the doctor visit! Mind you, I think I ended up paying all of those amounts because I hadn't yet fulfilled my $1500 deductible for the year. I've been to an emergency room at a clinic and had stitches in a finger (due to a kitchen-knife incident) .... a couple hours, 150 euros, and I was back home with my finger stitched up and bandaged, plus the necessary medical items to re-clean and re-bandage it daily. Tom went to a hospital for an eye problem, spent most of the day there, saw multiple doctors and had a little laser surgery done to correct it ... total bill came to about 50 euros. So far, we have nothing but good things to say about the healthcare in France! Yes, I'm sure there are people with horror stories ... in both countries. But up to now ... we are quite happy with healthcare here.