Payment by the CPAM for a breast prosthesis.

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Jane W
Posts: 3
Joined: Tue Mar 20, 2012 11:19 am

Payment by the CPAM for a breast prosthesis.

Postby Jane W » Tue Oct 09, 2012 2:50 pm

Hi

Has anyone had experience of breast prostheses in France. Even though I have ALD for cancer on my Carte Vitale, the CPAM only paid a very small amount.
My Mutuelle will only pay 150% oif the CPAM payment, so we are paying a bout 112 euros.
I think that this is disgraceful, obviously, I wouldn't need the prosthesis if I had not had to have a total mastectomy.
Is this something that CSF could take up with the CPAM?

Jane W

pennycsf
Site Admin
Posts: 609
Joined: Sun Jan 24, 2010 7:19 pm

Re: Payment by the CPAM for a breast prosthesis.

Postby pennycsf » Wed Oct 10, 2012 12:20 pm

Hi Jane
It very much depends on which prosthesis you choose. The CPAM reimbursement is €69.75 towards the cost of a prosthesis. There is a prosthesis made by Anita which costs exactly that.

However, if you choose one of the Amoena Contact types (stick-on) then you can reclaim €160 which is, in fact, the full cost. You can find a list of what you can claim for on the Ameli website - look for "Liste des Produits et Prestations Remboursables" - this tells you the name of the product and/or how much CPAM will contribute.

The top-up from the Mutuelle depends on the type of policy that you have, some pay fully for protheses, some only a part.

Hope that helps. :)

Penny


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