L'Assurance Maladie Denial

There is no need to post the same question again. Please be patient and wait for someone to answer you.

Hi, what exactly have you supplied? Birth certificate, marriage certificate etc??

I was asked several times for documents already submitted and most recently, demand for a US embassy-issued marriage certificate with my parents name on it.  No such document exists, confirmed and forwarded by an official email.

Submission:

Cover letters

Cerfa request form

Medical certificate

Passport

Visa

Birth certificate

Marriage certificate (EN/FR officially translated)

Proof of living in France

Bank statement with IBAN

Notarized sworn statement of truth and accuracy off all submitted documents

Usually it is the birth certificate or extract that must show the parents  information (filiation).

I don't understand the question. The information you supplied is not used to obtain a Carte Vitale. It is used to get on the national health system (PUMa, etc.). Once you are accepted (ie, receive the attestation des droits), getting the Carte Vitale is straightforward.

I see nothing on the CERFA form (N° 15763*02) for the ouverture des droits that mentions either marriage or a bank statement or a sworn statement!!

Just what have you applied for?

Ok, so I had a similar problem as my birth certificate was a "short one" as in it didn't show my parents names. I supplied them with the "long version" clearly stating both parents names. This was accepted immediately.

    Ok, so I had a similar problem as my birth certificate was a "short one" as in it didn't show my parents names. I supplied them with the "long version" clearly stating both parents names. This was accepted immediately.
   

    -@sharoncook2004

Yes, officials don't like the A5 ones, they have always have to be A4 full-size ones.

@AARO health

My sentiments exactly! 

She submitted all the necessary documents in the first filing then came three more requests (and responses) seemingly out of the blue.

Her notarized statement of truth was my idea as the tone of correspondence suggested she is a fraud.

Her documents are  complete and in good order. I need a fresh set of eyes to fairly evaluate my case.   

The deadline for the latest (impossible) request is approaching.

Any advice would be greatly appreciated!

@mrice30

Who is the she and her in your response? Whom so you suspect of fraud? The S1106 is submitted to your local CPAM and may be processed by the departmental CPAM.

If there are problems with processing, you can go to the local CPAM for help. All the documents you provided should have been scanned into your record, so they can be viewed by any agent at the local CPAM.  That way you can have a direct conversation.

Re. the embassy document, maybe what is being requested is an apostille. To my knowledge, some country embassies/consulates can issue apostilles, but the US does not, probably because of the organization of vital statistics by state. In this case, the apostille for a marriage might have to be obtained from the state of marriage, though I don't know if these contain filiation info.

See:

https://www.hcch.net/en/states/authorit … 3/?aid=353

But, again, you might be better off making an appt at the local CPAM to go over the record and documents of the application.

OK, thanks I’ll make an appointment.  To be clear, I don’t suspect fraud, quite the opposite.  The coordinator seems suspicious of my wife by denying her birth and marriage certificates as truthful.  I thought a sworn statement would help, apparently not.

You didn't mention it, but is your wife American? If so, it seems strange your US birth certificate extract was accepted and not your wife's. You say that both your wife's birth and marriage certificates are treated with suspicion, but isn't there only one marriage certificate?

Since the reform in 2016 (PUMA), each individual is supposed to have his/her own health coverage registration. This was intended to remove coverage delays following life changes such as transition from minor to major or divorces, etc. Is it correct that BOTH your registrations are being held up?

Social security code L160-5

Article L160-5

Version en vigueur depuis le 25 décembre 2016

Toute personne qui déclare auprès d'une caisse primaire d'assurance maladie, dans des conditions fixées par décret, ne pas bénéficier de la prise en charge des frais de santé mentionnée à l'article L. 160-1 bénéficie de cette prise en charge auprès de cette caisse dès qu'elle justifie de son identité et de sa résidence stable et régulière.

@mrice30

One last question.  I just received a notice that my wife’s file was sent to Caisse Nationale d'Assurance Vieillesse for approval.  I am not looking for a pension, just a Carte Vitale for a long stay visa expat.  Is this the correct location for approval?

Thank you

@mrice30

Normally ur supposed to send it to the assurance maladie but u still sent it to a social office so it should work. Im not 100% sure tho

@mrice30

Is there some missing part of the story? You first wrote that YOU were denied. Then it turned out your wife was denied. Now your wife's case has been referred to the CNAV.

There is a scenario in which the CNAV's involvement would make sense, which is if your wife were entitled to a French pension. It doesn't take much. One trimestre of work could create eligibility, even though the amount of the pension would  be minuscule.

That pension would make her exempt from any premium (cotisation)  for the PUMA coverage.

So is it possible that the CPAM is verifying your wife's pension status with the CNAV?

Social security code

Article L380-2

Les personnes mentionnées à l'article L. 160-1 sont redevables d'une cotisation annuelle lorsqu'elles remplissent les conditions suivantes :

. . .

2° Elles n'ont perçu ni pension de retraite, ni rente, ni aucun montant d'allocation de chômage au cours de l'année considérée. Il en est de même, lorsqu'elles sont mariées ou liées à un partenaire par un pacte civil de solidarité, pour l'autre membre du couple.

This says the other half of a couple is also exempt from the cotisation in this case.

Sorry for the confusion, now I understand. My wife started the post and I continued.  Oops, poor grammer on my part.