Whether you are working, unemployed, resident or retired, if you are insured under the social security system of Iceland, Liechtenstein, Norway or Switzerland, you are entitled to medical treatment that may become necessary when visiting France.
Legislative framework:
Before your departure, you should apply to the competent institution in your country for the European Health Insurance Card (EHIC).
The card will ensure that you have access to healthcare in France without having to complete any formalities with the French authorities. As regards the services provided, you will be treated in the same manner as anyone covered under the French state system.
NB: If your EHIC is lost or stolen while you are abroad, or if your card hasn't been issued by the time you leave for France, the competent institution in your country can issue you with a Provisional Replacement Certificate (PRC). This document provides the same cover as the EHIC, but for a maximum period of three months.
The place to contact for information about conventionné doctors (working within the state health system) and conventionné and agréé (approved) hospitals and medical facilities is the Caisse Primaire d'Assurance Maladie (CPAM) in mainland France or the Caisse Générale de Sécurité Sociale (CGSS) in the overseas départements. You also apply to the Caisse for the reimbursement of medical costs. Each département has at least one CPAM (or CGSS). To find the local CPAM or CGSS where you are staying, you can do a search (by département) on the website of the Caisse Nationale d’Assurance Maladie des Travailleurs Salariés (CNAMTS).
Benefits in kind include medical care, medicines, dental care and prostheses, hospitalisation, laboratory analyses and transportation.
Before making an appointment with a doctor or dentist, make sure that they are conventionné. Conventionné practitioners fall into one of two categories:
You can find a healthcare professional in the area you are staying by consulting the CNAMTS website.
As a non-resident insured in another state, you are not subject to French laws governing the parcours de soins (coordinated medical consultation procedure) where patients are required to appoint a médecin traitant (“acting doctor”) from whom they must obtain a referral before seeing a specialist. To prove that the parcours de soins isn’t applicable to you and avoid paying any additional charge, you should show the doctor (whether a general practitioner or specialist) your European Health Insurance Card or Provisional Replacement Certificate.
You pay the doctor directly and the latter will fill out a feuille de soins (treatment form) and a prescription if necessary.
As the parcours de soins doesn’t apply to non-residents, you can consult a specialist directly without going through a general practitioner.
Paramedical services provided by allied health professionals (nurses, physiotherapists, etc.) are covered if prescribed by a doctor.
You can obtain your medication from any chemist (pharmacy) on presenting the feuille de soins and the doctor’s prescription. The price of the medicine is printed on a second feuille de soins that the chemist will give back to you with the prescription. You pay the chemist directly. The vignettes (stickers) on the medicine packaging must be removed and stuck on the feuille de soins in the space provided.
If you have to travel to receive medical treatment, the health insurance system will in some cases cover the cost of transport prescribed by a doctor.
Once you have dated and signed the feuille de soins and attached the vignettes, you should send the form to the local CPAM (or CGSS), together with the prescription and a copy of your European Health Insurance Card or Provisional Replacement Certificate. You should also fill in the feuille de soins with your permanent address and give your bank details (name of bank, address, SWIFT code, account number and IBAN or BIC).
The French health system does not usually cover the entire cost of treatment. Part of the cost, known as the ticket modérateur, is borne by the patient themselves.Various other charges are also at your expense:
For extensive medical or surgical procedures costing upwards of €91 (procedures assigned a coefficient of 50 or above), the reimbursement rate is 100%, with an €18 flat-rate charge (ticket modérateur) borne by the patient. This co-payment applies regardless of the cost of the procedure and whether it’s performed in a doctor’s surgery or a hospital.
Doctors’ and dentists’ fees are reimbursed at 70% of the official social security rate. 22The official social security rate is €22 for a consultation with a general practitioner and €25 for a consultation with a specialist. For a visit to a general practitioner for example, the Caisse will reimburse €14.40 and the patient covers the remaining €7.60. The amount reimbursed as shown on the statement of reimbursement is the amount payable after deduction of the ticket modérateur and €1 charge.
The cost of laboratory tests and analyses is reimbursed at 60% of the official social security rate. A €1 charge per laboratory procedure (up to a daily maximum of €4) will be deducted from the total amount reimbursed.
The fees charged by allied health professionals are reimbursed at 60% of the official social security rate. A €0.5 charge per paramedical procedure (up to a daily maximum of €2 for services provided for the same patient by the same health professional) will be deducted from the total amount reimbursed.
For transportation for medical care and treatment, 65% of the cost is reimbursed. A €2 charge per journey (up to a maximum of four journeys in any one day) will be deducted from the total amount reimbursed.
The different reimbursement rates are given on the CNAMTS website. .
Medicines are reimbursed when prescribed by a doctor and included in the positive list of reimbursable pharmaceutical products. Reimbursement rates are 15%, 35%, 65% or 100% of the sales price, or of the reference price for medicines included in reference-priced generic groups:
The €0.5 charge per item of medicine will be deducted from the amount reimbursed.
If you are admitted to hospital in an emergency you should present your European Health Insurance Card or Provisional Replacement Certificate to the hospital admissions department. You may also be asked to show your passport or other valid identity document.
If you are admitted to a private hospital or clinic, you should check that it is conventionné.
The Caisse will cover 80% of your hospital expenses and in some cases 100%. If you present your European Health Insurance Card or Provisional Replacement Certificate on admission, you will not have to pay refundable costs upfront, only the 20% co-payment (including the daily hospital charge) or the daily €16 hospital charge in the case of 100% cover.
If you undergo an extensive medical or surgical procedure while in hospital, you will be required to pay the flat-rate contribution of €18 in addition to the daily hospital charge or 20% co-payment.
If you will be needing kidney dialysis or oxygen therapy during your stay, you should make an appointment with a specialist centre in advance.
Legislative framework:
If you become incapacitated for work while on holiday in France, you should obtain a sick note from a doctor registered in France, which you should submit to the local CPAM within three days of the onset of the incapacity.
The CPAM will send the appropriate documents to the competent institution in your country.
This will then examine your entitlement to sickness benefits.
It is also the institution responsible for paying any sickness benefits to which you are entitled