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If you are a member of the Social Security scheme of a Member State of the EU, Iceland, Liechtenstein, Norway or Switzerland, you can benefit from coverage of your medically necessary care during a temporary stay in France.

Come to France with your EHIC

• By presenting your EHIC (European Health Insurance Card) to healthcare providers in France, you will be covered under the same conditions as the members of the French scheme.
• If your EHIC is forgotten, lost or stolen, apply for a provisional replacement certificate (PRC). The PRC has a shorter period of validity than the EHIC but works in the same way.
• You will generally have to pay your healthcare costs in advance and apply for reimbursement from the French health insurance fund of the place where you received your care.
• If you have not applied for a reimbursement during your stay in France, send your invoices to your health insurance fund on your return.

Terms of reimbursement of your healthcare in France

• Submit to the primary health insurance fund (CPAM) of the place where you received your care:
  • your treatment forms (feuilles de soins)
  • in case of hospitalisation, the discharge form (bulletin de sortie)
  • your prescriptions
  • and a copy of your EHIC.
• Specify your permanent address and your bank details (bank name, address, SWIFT code, account no. with IBAN or BIC).
• Keep a copy of all the documents you send.

The services concerned

In France, the total or partial reimbursement of certain healthcare expenses (benefits in kind of the Health Insurance Scheme) concern medical, pharmaceutical, dental (treatment and prosthetics), hospital, laboratory (tests and analyses), and medical transport costs.

Use the Health Insurance Scheme Directory to find a healthcare professional:

• sector 1: consultation rate fixed by the French Health Insurance Scheme (fees not exceeding the statutory rate)
• sector 2 “controlled pricing practices (OPTAM)”: more expensive consultation, but same amount reimbursed by the Health Insurance Scheme as in sector 1
• sector 2 “unrestricted fees” (honoraires libres): lower amount reimbursed by the Health Insurance Scheme
• not government regulated (non conventionné): minimal coverage.

Medical care

Medical costs are reimbursed at 70% of the maximum regulated fees. A flat-rate contribution of €2 per consultation or procedure is withheld, except for children under the age of 18 and pregnant women from the 6^th month of pregnancy.

For example, for a consultation at €30 (general practitioner and specialist regulated tariff), the reimbursement will be €19 (70% of €30 less €2).

Pharmacy

To be partly covered, the medicines must be prescribed by a doctor and be included on the list of pharmaceutical proprietary drugs reimbursed to Social Security members. They are then reimbursed at 15%, 30%, 65% or 100% of their selling price, or on the basis of a reference tariff, depending on the therapeutic value.

An excess of €1 will be deducted from the reimbursement on each box of medicines.

Dental care

The French Health Insurance Scheme reimburses 60% of the regulated tariff. It does not cover the part of any fees exceeding the statutory rate.

The flat-rate contribution of €2 which applies to medical consultations does not concern consultations with a dental surgeon.

Paramedical procedures

Paramedical procedures carried out by medical auxiliaries (e.g. by a nurse) are only covered if they were prescribed by a doctor.

The fees of the medical auxiliaries are reimbursed at the rate of 60% of the maximum regulated fees. The franchise médicale of €1 per paramedical procedure will be deducted from the amount of the reimbursement, within the limit of €4 per day and per healthcare professional.

Health transport

The costs of transport prescribed by a doctor may be covered by the Health Insurance Scheme, subject to certain conditions, generally at the level of 55% (full reimbursement in some cases).

You will remain responsible for a franchise médicale of €4 per journey, with a maximum of €8 per day for a same carrier. This franchise médicale does not concern emergency transport (transportation arranged by the emergency response service Samu) and is not applicable to children under the age of 18.

Laboratory tests and analyses

The flat-rate contribution of €2 is applicable in case of x-ray or laboratory tests (medical biology).

Hospitals

• In case of emergency, dial 112.
• Patient emergency flat rate (FPU): for a visit to the emergency department without hospitalisation, you must pay €19.61. This amount may be reduced to €8.49 or even zero, depending on your situation.
• Excluding emergency hospitalisation, you can be treated in the hospital establishment of your choice. Find out in advance the tariffs practised and the amounts that will be reimbursed to you. Some establishments apply fees exceeding the statutory rate that are not covered by the Health Insurance Scheme and a few private clinics are not regulated.
• Submit your EHIC, accompanied by an identity document, to the admission services.
• Hospitalisation costs are generally covered at the level of 80% (100% in some situations, notably from the 31^st day of hospitalisation).
• The member is liable to pay a daily flat rate of €20 per day of hospitalisation (€15 in psychiatric departments).
• For some major procedures, a flat-rate contribution of €24 applies.
• Costs for personal comfort (private room, telephone, television, etc.) are not reimbursed by the Health Insurance Scheme.
• If you go to hospital for an external consultation, the rate of reimbursement and the flat-rate contribution are the same as for a consultation in a medical practice.

Chronic and pre-existing illnesses

In case of treatment with dialysis, chemotherapy or oxygen therapy, you must check the availability of your treatment before your stay and make an appointment.

Directory of dialysis centres

In case of unfitness for work

• Consult a doctor to obtain a sick note (arrêt de travail).
• In case of hospitalisation, the hospital's admission services will draw up a status report which will act as proof of sick note. When you leave the hospital, the administrative services will issue a discharge form and the sick note established by the status report will end. If your state of health so requires, the hospital doctor or the primary care physician will write a sick note.
• In France sick notes comprise 3 pages. Once complete, you will send the first 2 pages to your usual health insurance fund, which will verify whether you are entitled to daily allowances (cash benefits from the Health Insurance Scheme) from it.
• The 3^rd page of the sick note (arrêt de travail) is to be sent to your employer, or to the employment department (for job seekers).