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Medical costs

How to pay and claim reimbursements

Regardless on whether you are insured in France or in your home country, you are generally required to pay medical expenses as they occur, e.g. when visiting a doctor, buying prescribed medicines and for medical tests. Then you can ask to be reimbursed by your health insurer.

A general doctor may charge from €20-25 for a consultation, a specialist €25-30. Fees will be higher at night or the weekend - a home visit will also cost more.

Types of payment vary: doctors usually prefer payment by check and some organisations might not accept cash. Only in some cases - such as some hospitalisations or if you are covered by specific heath coverage - you may be exempt from advance payment.

Reimbursements

If you have international heath insurance, you should keep carefully all documents of your medical treatment and invoices of your expenses in France. Make copies and send the originals to your insurer, following any other requirements your insurance policy contract might request.

If you are subscribed to the French social security, you need to send a completed form (feuille de soins) to your CPAM (Caisse Primaire d'Assurance Maladie). These are issued by a doctor or a healthcare organization. Keep a photocopy of this form just in case it gets lost. When making your first claim, you should enclose your bank account details, called RIB (Relevé d'Identité Bancaire) - so payment can be made. Reimbursement takes usually 2-3 weeks and you can check on-line on www.ameli.fr (you should receive access information in the documentation provided by CPAM).

If you have a Carte Vital and the doctor (or a healthcare organization) is linked to the social security system, it is possible you may only pay the non-reimbursable part instead of having to claim it back afterwards.

For some medical costs (e.g. dental or orthopaedic prostheses), you must get prior approval from your CPAM to ensure subsequent reimbursement.

Level of reimbursement

A large percentage of medical costs are reimbursed when you are subscribed to the French social security system. Examples for 2004 were:

Fees of doctor, dentists and hospital consultations:		70%
Paramedic and auxiliary personnel fees		60%
Charges for laboratory analysis		60-70%
AIDS and Hepatitis C screening		100%
Life-saving or/and very expensive medicines		100%
Medicines with white colour detachable label (vignette) i.e. for mayor illnesses		65%
Medicines with blue colour detachable label (vignette), i.e. for minor illnesses		35%
Optical (not glasses)		65%
Small devises and accessories:		65%
Prostheses and large devices for handicapped people		100%
Human-origin products (blood, milk)		100%
Transport and accommodation costs		65%
Thermal therapy with hospitalization		80%
First month of hospitalisation		80%
Hospitalisation beyond the first month		100%
Transfer from one hospital to another		100%

Complementary private insurance

The remainder of the medical costs not reimbursed by the French social secuirty - called Ticket modérateur - remind on your charge. This is why most people - nearly 85% of the population in France - choose to take a complementary private insurance (mutuelle, assurance complémentaire). This additional coverage covers partly or completely the percentage of medical costs not paid for by the general social security system. Some employers pay for some or all of an employee's supplementary coverage. In our directory, you find a list of some mutual heath insurance organizations.

For the latest news on healthcare and insurance in France, visit our website on expatriate healthcare: http://www.expathealth.org .