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You have to pay the hospital anyway and then claim afterwards. Ask the hospital for the address of the local  CPAM (Caisse Primaire d'Assurance Maladie).You need to send a completed form (feuille de soins) which is usually the reciept from the hospital. You may be able to claim for the £20 as well as the £45, however for a grand total of £65 I do wonder if it is worth it!

David

My lad lost a finger nail whilst camping in Italy a few years ago.  Took him to Casualty with his E111, didn't pay a thing.  The finger needed to be re-dressed three days later, we were in Germany, took him to the site's local GP, showed his E111 still paid nothing.

A few weeks ago in Spain my wife came out in a rash, because of her warfarin we first of all had to go and get it checked at a clinic.Back to hospital and for 3 days running had to go back for injections in her BUM. Showed our E111 card and passport and paid only for the pills at the chemist.