If you travel to another European Union or European Economic Area (Iceland, Liechtenstein, and Norway) member State while pregnant

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This section applies if you are pregnant and a member or beneficiary of a member of the French social security system. If you travel to another EU or European Economic Area (Iceland, Liechtenstein, and Norway) member State, you may be eligible for coverage of any medical care related to your pregnancy, regardless of your circumstances (salaried or self-employed worker, unemployment benefits recipient, resident, pensioner, etc.)

However, your coverage will differ depending on the reasons for your travel to that country:

I) Travel for exclusively medical reasons

1. Scheduled treatment : Pregnancy- and delivery-related care

Before you leave, you must apply for prior authorization of coverage for care that will require at least a one-night hospital stay or the use of highly specialized and costly medical equipment or facilities.

The following types of care are subject to prior authorization:

The portable S2 certificate

Legislative framework :

The portable S2 certificate, "Entitlement to scheduled treatment," authorizes you to travel to another EU or European Economic Area (Iceland, Liechtenstein, and Norway) member state to receive medical care. It means that your care will be covered as provided by local law and according to local rates. Indeed, you will receive the same care as members of the local social security system.

You will need to apply for this document (S2 form) from your local health insurance fund in France. Your application must be sent along with a detailed medical certificate issued by your designated primary care physician specifying:

You will receive notice of prior authorization or refusal of coverage from your health insurance fund within 14 days of receipt of your application. If you receive no response within this timeframe, your application has been approved.

You must apply for your authorization far enough in advance so that your local health insurance fund can process it before you leave.

Your authorization will not be granted automatically. Indeed, the following conditions apply:

If your application is approved, you will be issued with an S2 certificate you will need to show in the Member State you are visiting either to one of the local health insurance fund or directly to your health care provider so that your care is covered locally pursuant to local law.

If your request for prior authorization has been denied, the decision must be reasoned and include instructions on the appeals procedure.

Requesting reimbursement when you return to France

If you paid upfront for scheduled care for which you had prior authorization, you can submit your paid invoices to your health insurance fund to request reimbursement.

The fund will examine your request for reimbursement. In particular, it will check whether prior authorization had been granted and whether the conditions for reimbursement provided by French law, such as the requirement for a prior agreement or a medical prescription, were met.

Where applicable, the fund will reimburse you for your care based on Social Security rates in the country where the care was provided or, if you so request, based on French Social Security rates up to a maximum of actual expenses. A supplement can be considered if the foreign rates are lower than the French rates for the same treatment: the French health insurance fund will issue a supplementary reimbursement, up to a maximum of your upfront expenses. For example, for a procedure billed 150 euros, if you were issued a 100-euro reimbursement in the foreign country and the French social security rate is 150 euros, you may receive a 50-euro supplement from your French fund.

2. Scheduled treatment (Pregnancy- and delivery-related care) not subject to prior authorization

Legislative framework :

Coverage of other scheduled care, particularly standard ambulatory care, is not subject to prior authorization from your local French health insurance fund, but the care must be part of the benefits to which you are entitled in France. Otherwise, no reimbursement is allowed.

However, certain types of care or treatment may be subject to prior authorization from the French system:

Before you leave, you need to inquire whether the care or treatments you plan to receive will require prior authorization from the Health Insurance Fund in order to be covered. If so, prior authorization will be also required for coverage of scheduled care in another State.

Your designated primary care provider must fill out the request for prior authorisation of coverage and give it to you. You must then complete it and send it to the medical Service of your local Health Insurance Fund in France. You must also send the prescription (original or copy) for care or procedures performed by allied health professionals (physical therapists, speech therapists, orthoptists), for travel expenses for medical purposes, for lab exams or for medical equipment along with your application.

You will receive notice of prior authorization or refusal of coverage from your health insurance fund within two weeks of receipt of your application. If you receive no response within this timeframe, your application has been approved.

If your request for prior authorization has been denied, the decision must be reasoned and include instructions on the appeals procedure.

Requesting reimbursement when you return to France

II – Travel for another reason (non medical), during which you received unscheduled or emergency care

Legislative framework :

As a member or beneficiary of a member of a French social security scheme, you are entitled to coverage of care which becomes medically necessary during a temporary stay in another European or European Economic Area country (e.g. during vacation, business trips, or foreign-language programs). This care is covered by your European Health Insurance Card (EHIC). The EHIC is proof of your entitlement to coverage under the French health care system. However, you may still need to pay for your care upfront.

The EHIC covers all care that becomes medically necessary during your stay: all unscheduled or emergency care, including hospital care, regardless of whether it is provided in a public or private facility in the country you are visiting.

If you paid for your care upfront, you will need to submit your paid invoices to your French health insurance fund. The fund will then examine your request for reimbursement as if the care had been received in France.

In particular, the fund will check whether the conditions for reimbursement provided by French law, such as the requirement for a medical prescription, were met.

Where applicable, the fund will then reimburse you for your care based on Social Security rates in the country where the care was provided or, if you agree, based on French Social Security rates.