Access to Healthcare in France
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Access to Healthcare while visiting France

2015
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English speakers ? If you need information about your French health insurance rights, call the special Advice Line provided by Ameli :

  • 0 811 36 36 46
    from France (local call price from fixed-phone line)
  • 0033 811 36 36 46
    from foreign countries (call rates vary between operators).

I. If you are a citizen/resident of an EU Member State, Iceland, Liechtenstein, Norway or Switzerland

If you are insured (or a beneficiary of the insured) under the social security system of an EU member state, Iceland, Liechtenstein, Norway, or Switzerland, you may be covered for any medically necessary healthcare you receive while visiting France, regardless of whether you are working, unemployed, a resident or a retiree.

Entitlement to medical treatment in France with the European Health Insurance Card

Legislative framework :

  • art. 19 of Regulation (EC) No 883/2004
  • art. 25 of Regulation (EC) No 987/2009
  • art. 27(1) of Regulation (EC) No 883/2004

Before your departure, you should apply for the European Health Insurance Card (EHIC) with your local health insurance fund.

The card will ensure that you have access to healthcare in France without having to complete any formalities with the local 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, your local health insurance fund can issue you a Provisional Replacement Certificate (PRC). This document provides the same cover as the EHIC, but for a limited period of time.

Using the EHIC in France

Benefits in kind include medical care, medicines, dental care and prosthetics, hospitalisation, laboratory analyses and examinations and transportation.

Medical and Dental Care

Before making an appointment with a doctor or dentist, make sure that they are conventionné. Conventionné practitioners fall into one of two categories :

  • Conventionné (Secteur 1) : The practitioner fully adheres to the national agreement between practitioners and the French social security system and charges the official social security rate
  • Conventionné (Secteur 2) : The practitioner adheres to the national agreement between practitioners and the French social security system except with regard to fees and is free to set his/her own rates.

In both cases, the local CPAM (or CGSS) will reimburse a fixed portion of the official social security rate.

As a non-resident insured in another state, you are not subject to French "healthcare pathway" laws that require patients to appoint a médecin traitant (primary care physician) from whom they must obtain a referral before seeing a specialist. To prove that the healthcare pathway isn't applicable to you and avoid paying any additional charges, 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 getting a prescription from a general practitioner.

Paramedical services provided by allied health professionals (nurses, physiotherapists, etc.) are covered if prescribed by a doctor.

Medicines

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 will be printed on the feuille de soins that the chemist will give back to you with the prescription. You pay the chemist directly.

Transportation

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.

Reimbursement

Once you have dated and signed the feuille de soins, 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).

There is at least one CPAM in every French department (or CGSS for the overseas departments). You can determine which CPAM or CGSS to apply to for your reimbursement by doing a department-by-department search on the CNAMTS (National Health Insurance Fund for Salaried Workers) website.

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 :

  • A €1 charge for a visit to, or procedure performed by a general practitioner or specialist, as well as for X-ray examinations and laboratory tests. These charges may not total more than €4 per practitioner or laboratory in any one day. As this out-of-pocket charge is limited to €50 per person in any one year, you should keep the statements of reimbursement you receive over the course of the calendar year to request an exemption from payment of any amount exceeding the €50 annual limit.
  • A charge for paramedical services provided by allied health professionals (nurses, physiotherapists, etc.) as well as medicines and transportation for the purpose of receiving medical treatment :
    • €0.5 per item of medicine
    • €0.50 per paramedical procedure up to a maximum charge of €2 for any one day
    • €2 for transportation for medical treatment up to a daily maximum of €4
    • Such charges may not total more than €50 in any given calendar year. You should keep the statements of reimbursement of medical costs to request an exemption from payment of any amount exceeding the €50 annual limit over the course of the calendar year.

For extensive medical or surgical procedures costing upwards of €120, 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. For information purposes, the official social security rate is €23 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 Fund will reimburse €15.10 and you will cover the remaining €7.90. 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.

Medicines are reimbursed when prescribed by a doctor and included in the positive list of reimbursable pharmaceutical products. Reimbursement rates are 15 %, 30 %, 65 % or 100 % of the sales price, or of the reference price for medicines included in reference-priced generic groups:

  • 100 % for medicines considered to be not substitutable for serious and incapacitating conditions,
  • 65 % for medicines of high or significant therapeutic value (SMR) and pharmaceutical preparations,
  • 30 % for medicines of moderate therapeutic value (SMR),
  • 15 % for medicines of low therapeutic value (SMR).

The €0.50 charge per item of medicine will be deducted from the amount reimbursed.

Hospitalisation

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.

Outside of emergency hospitalizations, you may seek treatment at the public or private facility of your choice.

If you see a doctor prior to being hospitalized, your practitioner can recommend a facility that will meet your needs, with consideration for quality of care.

You are advised to check the rates of the hospital you are considering as well as the amounts you will be reimbursed as some facilities charge extra fees that are not covered by the French social security system. Please also be aware that there are a few clinics that are not "conventionné"; i.e. that do not adhere to the national agreement between practitioners and the national health care system. You can check the website ameli direct to locate a facility and find information on its rates.

As a general rule, the Caisse will directly cover 80 % of your hospital expenses and in some cases 100 %. If you show 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 €18 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.

Kidney Dialysis and Oxygen Therapy

If you will be needing kidney dialysis or oxygen therapy during your stay, you should make an appointment with a local specialist centre before you come to France.

If you are prescribed medical leave during your stay in France

Legislative framework :

  • article 21 of Regulation (EC) No 883/2004
  • article 27 of Regulation (EC) No 987/2009

If you become incapacitated for work while on holiday in France, you should obtain a three sheet sick note from a doctor registered in France. After filling out the sick note, you should send the first two sheets to the competent institution in your country and the third one to your employer or to the employment services to advise them of your incapacity.

If you are admitted to hospital, the hospital admissions department will hand you a "bulletin de situation" (status report) that will double as a medical leave certificate. When you are discharged from hospital, their administrative department will give you a bon de sortie (discharge authorization) and the medical leave (bulletin de situation) will no longer be valid. If necessary, the hospital doctor or the general practitioner will deliver a new sick leave certificate.

You may download the medical leave form -the first or an extension (prolongation)- along with the instructions, on the CNAMTS's website (ameli).

Any sickness benefits to which you are entitled will be determined and paid directly by the fund to which you belong in your country of residence.

II. If your home country has signed a bilateral social security agreement with France

AlgeriaAndorraBeninBosnia HerzegovinaCape VerdeGabonJerseyMacedoniaMaliMoroccoMonacoMontenegroNigerNew CaledoniaFrench PolynesiaQuebecSerbiaTogoTunisiaTurkey

III. If you come from a country not listed above

Ask your home country's social security system whether and to what extent it covers health care costs incurred abroad. Visitors are advised to take out a private insurance policy to cover any health care costs you may incur while in France. A private health insurance policy is required for tourist visa applicants.