France set to eliminate up-front GP fees

France is set to phase out up-front fees for GP visits, the country’s Health Minister said on Monday, with poorer families set to pay nothing up front by as early as the end of next year.

France set to eliminate up-front GP fees
France will phase out up-front fees for GP visits by 2017, Health Minister Marisol Touraine said on Monday. Photo: Thiery Zoccolan/AFP

By 2017, France is set to entirely phase out up-front fees for GP consultations, French Health Minister Marisol Touraine announced on Monday.

“Between now and 2017, when you go to see your doctor, you’ll no longer have to pay the cost of the consultation up front,” she said in an interview with French daily Libération.

“And starting from the end of next year, insurers will directly pay the medical expenses of families with modest incomes,” Touraine added.

That’s in contrast to the current situation in France, where only those covered by CMU-C (universal health coverage) or AME (State medical aid) can avoid up-front fees for visiting their GP or buying medicine at the pharmacy.

SEE ALSO: Patients in France being sent for 'pointless tests'

Under the ‘tiers payant’ scheme, GPs and pharmacists are not paid up front by a sick person, but rather by the insurer – whether public or private.

Touraine’s announcement on Monday will mean that by 2017, all users will be able to avoid GP fees, even if they don’t have a Carte Vitale – France’s national health insurance card.

As part of the government’s overall health strategy, Touraine also unveiled a plan to install some 300 multi-disciplinary health centres to serve areas of France where there is a lack of medical cover.

“Medical deserts,” as they are known in France, are parts of the country where doctor-patient ratios are significantly lower than average, often due to a slow local economy or aging population.

To entice young medical professionals to live and work in such areas, Touraine announced a significant subsidy: “We’re assuring [such doctors] a guaranteed monthly income of €3,600,” she told Libération.

Touraine said 200 local doctors will be in place by the end of the year.

The health minister also said the goverment wants to change the system of patient records so that it will become easier for health professionals to exchange information, which would be of most benefit to the elderly and those suffering from chronic disease.

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UPDATE: How to access mental health services in France

On World Mental Health Day, we take a look at how to access mental health services in France - and what changes will come into place in 2022.

A man sits depressed during a mental health consultation. The Covid-19 pandemic has put us all under mental strain.
Accessing mental health services in France can be difficult. Read our guide on how to navigate this system and changes on the horizon. (Credit: Nik Shuliahin/Unsplash)

The Covid-19 pandemic has taken a mental toll on people around the world. France is no exception. 

According to a study conducted by French health authorities in September: 15 percent of French people are depressed (up 5 percent from pre-pandemic levels); 23 percent are anxious (up 10 percent); and 10 percent have had suicidal thoughts over the course of the year (up 5 percent). 

Accessing partially reimbursed or fully reimbursed mental healthcare in France can be difficult. Soaring demand coupled with a lack of staffing (close to a third of positions in public mental health hospitals are unfilled) means that waiting lists can be long. But there are ways to get help.

Accessing mental health services

The easiest way to book an appointment with a psychiatrist is through the Doctolib website. It is possible to filter your search for English-speaking clinicians. 

READ ALSO: How to get a carte vitale in France and why you need one

If you have a carte vitale it is possible to have partial or full reimbursement for psychiatric treatment in France. If booking an appointment online, be sure to check whether the doctor is conventionné secteur 1 to get the highest level of reimbursement possible.

You can read an approximate guide to current reimbursement levels HERE.

Psychologists (who are unable to prescribe drugs) are not considered doctors in France and therefore consultations with this kind of practitioner are rarely reimbursed. However, you may be able to access both psychological and psychiatric treatment if you can get an appointment in a Medical Psychology Center (centre medico psychologique – CMP). These services are free but often require a referral letter from a GP.

Counselling is another option. Generally less qualified than psychologists or psychiatrists, counsellors can provide a simple form of listening therapy. Anne Poulton, a retired professional counsellor with an NHS Community Mental Health team, set up the Counselling in France website after moving to France with her husband in 2000. It serves as a directory for English-speaking counsellors who may be able to help you. These services are not covered by social security.

READ ALSO: Health insurance in France – what you need to know about a mutuelle

Private mental healthcare will only be reimbursed if you have a private insurance (mutuelle) which specifically covers this kind of healthcare. It is however, easier to get an appointment quickly if you go down this route. 

Upcoming changes

In September, President Macron made a number of announcements that should significantly improve access to mental health services from an unspecified date in 2022. 

Psychological consultations will finally be at least partially reimbursed by the state – although you will need to have a recommendation letter from a GP to benefit from this.

For everyone with a carte vitale, the state has promised to cover ten psychological consultations at the price of €40 each. These ten consultations can be renewed once. After that, patients will continue to receive reimbursement, to the tune of €30 per session. 

READ ALSO: What your French health insurance card entitles you to

The French government intends to spend €50 million to cover these costs in 2022 and a further €100 million in 2023. 

CMPs are to employ a further 800 staff, which will help to absorb some of the demand for free mental healthcare. 

The government has also promised to invest €80 million in neuroscience research in a bid to find better treatments to the country’s mental health crisis. 


SOS Helpline offers a telephone listening service in English – 01 46 21 46 46

The UK-based Samaritans can be accessed from France – 0044 8457 909090

If you are experiencing domestic violence you can call (English-speakers may not always be available) or report online HERE.

The British Consulate is able to advise you on various treatment options available but cannot give clinical advice on individual mental problems – 01 44 51 31 00