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Healthcare in France

It may have its faults but, on the whole, the French healthcare system is one of the best in the world. In fact, it was even ranked the best healthcare system in the world by the World Health Organisation in 2000. It’s state-ran, efficient and you can access it, if you or your spouse have basic state health insurance.

There will inevitably be some paperwork but once you know how to work the system, you will discover the beauty of the France’s health service. So, how does it work and how do you qualify to access healthcare in France?

An overview of the French healthcare system

You are eligible for basic French state healthcare if social security payments are deducted from your monthly pay slip. The amount deducted from your monthly salary is approximately 7-8%, which means you’re eligible for basic health insurance. Your social security contributions cover approximately 70% of most healthcare costs.

Your employer should help you register for social security. Having basic health insurance in France is obligatory if you live in the country more than 180 days, so if you are self-employed or unemployed in France, you’ll need to register at your nearest Caisse Primaire de l’Assurance Maladie (CPAM) to get your social security number.

You’ll need to fill in a form, provide a copy of your birth certificate, with a copy of a certified translation and your RIB bank number, so you can receive reimbursements. Once you’ve received your social security number, you’ll be eligible for state-ran medical treatment.

If you have a French spouse, it’s likely you’ll qualify as a dependent on their healthcare coverage. Likewise, if you have a spouse and/or children, they could be covered on your healthcare coverage, so it’s well worth finding out.

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Top-up insurance schemes (Mutuelle)

To make up for the remaining costs, most residents pay a top-up private healthcare insurance, otherwise known as a mutuelle. Certain employers offer corporate mutuelle schemes as part of salary packets, so it’s worth negotiating. Mutuelle payments are approximately €30 per month, usually working out cheaper if under the corporate mutuelle scheme.

Certain mutuelle coverage schemes don’t offer benefits until a few months after paying. This is to avoid patients claiming expensive treatment, and then cancelling the mutuelle afterwards. Double check to ensure when full mutuelle coverage begins.

It is worth noting, however, that even if you have mutuelle coverage, you may still be liable to cover some of the costs out of your own pocket. The basic health insurance covers the estimated cost. For example, the usual charge for seeing a specialist is €23. However, if the specialist charges more, you’ll only be reimbursed for 70% of €23.

The mutuelle particularly comes in handy for hospital stays. Generally 80% of treatment costs are covered by the state. However, costs which are deemed to be “hospitality” ie. staying the night, meals etc. are not covered and can incur high charges.

Most mutuelle packages cover prescription costs. Depending on the prescribed medication, you may be liable to cover 15%, 30%, 60% and 100% of your costs. The reimbursement percentages depend on the necessity, the efficacy and other factors. Ensure to look for a top-up insurance which will cover these costs, as it could save you money over time.

As stated, the majority of French healthcare is funded by the state. However, when you receive any medical treatment, the French healthcare system works on a pay-now, reimbursement-later scheme. One way to get reimbursed soon after treatment is via your Carte Vitale.

Carte Vitale

So what is a carte vitale? It’s essentially a card which has all of your medical details and health insurance information. Every time you go to the doctor’s or pharmacy, you should present your carte vitale. You will still have to pay at the time of receiving treatment or your prescription, but you will get reimbursed soon after as the carte vitale has your RIB details.

As is the norm in France, it may take a while to receive your carte vitale. Therefore, if you don’t have your carte vitale when receiving treatment, you will need to request a feuille de soins from your doctor or pharmacist. You will then need to send it to the CPAM and you will receive reimbursement in due course.

GP Treatment

To get GP consultations at the full 70% reimbursement, you need to choose your GP (médecin traitant déclaré), by filling out the form (provided in this link) and get the chosen doctor to sign it. The form then needs to be handed into the CPAM. If you do not have a declared GP, you could be reimbursed as little as 30% of the €23 consultation fee.

Whilst it is possible to see consultants without a referral, you get more reimbursement if you are referred by your GP beforehand.

Certain exceptions do apply to the penalty reimbursement: If your declared GP is on holiday, you can be consulted by another GP and receive the full 70% reimbursement. Additionally, if it’s an emergency, you can see another GP without having your reimbursement reduced.

Dental and Optical Treatment

This is another area where mutuelle coverage comes in useful, particularly for optical prescriptions. Coverage will cover up to a certain amount of optical prescriptions per year, however lenses and glasses are not well covered under the mutuelle scheme.

Dental consultations work under the same guise as medical consultations, without needing a declared dentist. Major dental procedures, however, are not well covered under the mutuelle scheme, which could incur hefty charges for the patient.

As with most public institutions in France, there is a lot of red tape to get access to the healthcare system. Regardless of the hassle, frustration and waiting, the paperwork is worth it. Especially when you consider you’re getting access to one of the best healthcare systems in the world, at a relatively low cost.