FAQ : Cross-border health or health and social care cooperation agreements

Framework and cross-border agreements are designed to provide a legal framework that can be used to set up local cross-border health or health and social care cooperation agreements.

What purposes do these framework and cross-border cooperation agreements serve ?

These framework and cross-border agreements are designed to provide a legal framework that can be used to set up local cross-border health or health and social care cooperation agreements. The goal is to help build health or health and social care-related cooperation between France and border States and to improve access to high-quality care for those living on either side of the border :

by guaranteeing continuity of care and the fastest possible response by emergency services ;
by optimizing organization for the delivery of care and promoting the sharing of capacities (material and human resources)
by promoting the pooling of expertise, practices and human and material resources.

They are an addition to the measures already provided for under EC Regulations 883/2004 and 987/2009 and under EU Directive 2011/24 on cross-border care.

Why are framework and cross-border agreements necessary?

Insofar as medical care remains a domestic competence belonging to each individual member State, bilateral agreements in this area will continue to be crucial to eliminating obstacles to the free circulation of patients and health care professionals.

With which States have these framework and cross-border agreements been concluded?

Framework agreements have been signed with the following states: Belgium, Germany, Luxemburg, Spain and Switzerland.
Health or health and social cooperation agreements are currently applicable with Belgium, Germany, Luxemburg, Spain, and Switzerland.

How do patients benefit from these cross-border agreements?

Cross-border agreements are designed to benefit patients in a concrete and direct manner by allowing them to access the source of high-quality care that is closest to where they live, as the nearest hospital may be located on the other side of the border, and by guaranteeing them continuity of access to care.

They simplify coverage for this care by eliminating the need for prior approvals, setting up systems of upfront insurance coverage, and guaranteeing coverage of transportation expenses.

Am I covered under these agreements?

Please be aware that these agreements generally apply to border-area residents and health care professionals.

You will need to check each cross-border agreement’s geographical, personal, and material scope to determine whether you are covered:

geographical scope: each agreement specifies the regions, districts, or towns to which it applies;
personal scope: each agreement lists the health insurance schemes to which it applies;
material scope: the agreement specifies the types of conditions/pathologies it covers.

Feel free to contact your health insurance fund to check whether you are covered under the agreement.