News Gerep

Best practices in managing your insurance

Posted on 11 July 2014

 We have designed this guide to help you manage your health insurance and so we can better meet the requirements of our customers. 

It is intended as a guide in your dealings with Gerep on a day-by-day basis.   Every time you need to contact us or if any change occurs in your circumstances. 

Keeping to best practices helps improve our services and speed up our response to your requests. 

Best practices in managing your insurance

HEALTHCARE:

 

1. Your policyholder number is your "identity card" for our staff. It is the key to identifying who you are. 

Please, therefore, quote your policyholder number in all correspondence with our departments so they can easily identify you and provide you with the best answers to your questions. This is the number that appears on your "attestation de tiers payant" membership card: in the box in the top left corner. (see photo)

2. When you receive your Social Security statement make sure that the phrase "télétransmission" [electronic transmission] appears on it. This indicates that you benefit from automatic transmission of details of your medical expenses to the organisation handling your supplementary health insurance plan. There is no need therefore to send the statement to that organisation. (see photo)

3. If you need to see a practitioner for optical or dental treatment, do not hesitate to ask for a cost estimate. 

We can then make a (non-contractual) simulation based on that estimate in order to determine the percentage reimbursement due to you and how much you will be left to pay.

4. If you are requesting cover for hospital treatment then it is important that you send us full details either via your customer area online (by clicking on this link) or else by telephone on 01 45 22 52 53.

5. For certain items of treatment you will need to send us the original bills by post. This is the case for:

  • treatment not reimbursed by Social Security but covered under our policy,
  • hospital fees in excess of the standard scale of charges,

Copy bills are acceptable for all other items of treatment. You may send these either by email or by post.

However, when paying for glasses or lenses you must send us the bill and the original prescription for optical items. 

N.B. In order to claim reimbursement, the bill you send us must show the full name of the beneficiary and the treatment date.

6. When Gerep is your second line supplementary healthcare insurer then you must send us the original statement from your first line insurer or else precise confirmation from them that they do not cover the expenses that you are claiming from GEREP.

 

MEMBERSHIP:

 

In order to claim benefits from Gerep you must send us details of any change in your circumstances such as:

  • change of address
  • change in Social Security office [Caisse d'Assurance Maladie] due to change of address. You will need to send us confirmation from the Social Security of these changes.
  • addition or deletion of a beneficiary (giving his/her full name)
  • when you retire
  • when you leave the company that employs you.
  • If you qualify for portability (continued membership of the plan after cessation of your work contract) then you must provide us with proof you have signed on to a Job Centre [Pôle emploi]
  • change of bank. Please provide bank details (RIB) in the SEPA format.
  • You should provide us with details of any other supplementary health insurance (or Mutuelle) in order to avoid any breakdown in electronic transmission and therefore break in reimbursements.
  • You should inform us if your children are attached to both parents' social security number, by giving us both those numbers.
  • You should inform us if your child (a student) changes social security number and provide us with a Certificate of School Attendance [certificat de scolarité].

 

FAQ page coming soon. GIVING YOU INFORMATION ON OTHER ISSUES