Assurance maladie: 5 things to know about France's public healthcare system
From costs to access for foreigners and essential vocab to navigate the admin, here are some of the things you need to know about France's public healthcare system.
1 It's good
Visitors from some countries assume that public healthcare is the second-tier option and that you will get better care if you pay for private cover, but that's not the case in France where almost everyone uses the public system.
It is, of course, your choice if you prefer to pay for private cover, but the public system gives you access to any doctor or specialist that you wish to see and allows you to book an appointment directly, rather than having to be referred or go onto a waiting list. You're also allowed to 'shop around' to find healthcare professionals that you like, rather than being assigned to a particular doctor or practice.
Private hospitals do exist but while you're likely to get your own room, slightly nicer surroundings and better food, the care itself isn't significantly different.
That's not to say that the French system is perfect of course, especially in 'medical deserts' where there is a shortage of doctors, but in global rankings it usually comes out well.
2 It's a reimbursement system
Unlike the UK, where healthcare on the NHS is free at the point of delivery, the French system operates on a reimbursement model.
That means that you pay the doctor/pharmacist/other health professional upfront during your visit.
If you're registered in the French system, the medic then swipes your health card and the French government reimburses the cost of your appointment, treatment or prescription directly into your bank account (usually within a few days).
The government sets the prices for drugs, treatments and appointments and also sets the level for how much of the cost will be reimbursed by the state. For example, a standard GP appointment is €25 and the reimbursement rate is 70 percent. So when you visit your GP, you pay them €25 and the government reimburses you €17.50.
There are different reimbursement rates depending on the type of illness (eg cancer treatments are reimbursed 100 percent) and by the type of patient - pensioners, pregnant women and people on low incomes get 100 percent reimbursement - you can find the full details here.
Before visiting a doctor, check whether they accept credit or debit cards as some (an increasingly small minority) will only accept cash.
3 It's accessible to foreigners and tourists
If you have lived in France for more than three months you are entitled to register in the French public health system and get the carte vitale which allows you access to state-funded care - here's how.
If you're working in France you can register directly on the principle that you're paying into the system via your taxes so you're entitled to use it.
If you receive a pension from another country then you can still register but it might be down to your home country to pay for your care (for example via the S1 system for UK pensioners) and if you fall into the 'grey area' of not working but not receiving a pension, you can register via the PUMa scheme - here's how.
If you're just visiting France then you can access healthcare, but you will have to pay for it. Depending on whether you have European health cover or private health/travel insurance, you may be able to claim costs back later.
In most countries you can access emergency healthcare as a visitor, but if you need to see a doctor for non-urgent reasons while you're in France you can simply book an appointment with a GP or request a home visit without needing to go through the emergency process.
Full details HERE on accessing non-emergency healthcare.
Naturally if you have an emergency, you can go straight to the Emergency department (Urgences) at the nearest hospital, or call an ambulance.
READ ALSO Emergency in France: Who to call and what to say
4 It's called health insurance
Slightly confusingly, especially if you are dealing with information translated into English, the French system is simply known as Assurance maladie (health insurance), which for many English-speakers suggests private health insurance.
If you see any references in French to Assurance maladie, this means health cover - so for example if you see requirements for visas or residency cards for Assurance maladie this simply means proof that you have health cover, either through being registered in the French system or through private cover - they're not demanding that you have extra private medical insurance.
Being registered in the French state system is sufficient cover for all residency-related tasks - in order to prove that you are covered you can request an Attestation des droits.
The other name that the French system is sometimes referred to by is Ameli - this is in fact the online platform where people registered in the system can do health-related admin such as check that their reimbursements have gone through and request the Attestation des droits.
Ameli: What you need to know about the French online health accounts
If you prefer to do the admin in person, you can visit your local CPAM (Caisse Primaire d'Assurance Maladie) office.
5 There's also 'top up' insurance
As mentioned, the public health system reimburses some of your healthcare costs, but usually not all.
Most people in France also have 'top-up' private insurance known as a mutuelle which takes care of the remaining percentage that the state doesn't reimburse (depending on the policy - not all mutuelles have full dental cover, for example).
This insurance is cheaper than private insurance in many other countries - the standard cost for a mutuelle for a single person is about €40 per month, or €110 for a family of four, and most policies will leave you with virtually zero out-of-pocket expenses.
If you are an employee, your employer is legally obliged to pay at least half of the cost of your mutuelle.
Mutuelle: What you need to know about France's 'top up' insurance
French vocab
Assurance maladie - medical cover
Caisse Primaire d'Assurance Maladie (CPAM) - the local office of the public healthcare system. You can visit without an appointment if you need help with the system
Ameli - the online health system
Médecin généraliste - GP or family doctor
Médecin traitant - registered GP, this is the doctor you register with when you sign up to the public healthcare system, but you are free to see other doctors if you wish
Ordonnance - prescription
Rendez-vous - appointment
Comments
See Also
1 It's good
Visitors from some countries assume that public healthcare is the second-tier option and that you will get better care if you pay for private cover, but that's not the case in France where almost everyone uses the public system.
It is, of course, your choice if you prefer to pay for private cover, but the public system gives you access to any doctor or specialist that you wish to see and allows you to book an appointment directly, rather than having to be referred or go onto a waiting list. You're also allowed to 'shop around' to find healthcare professionals that you like, rather than being assigned to a particular doctor or practice.
Private hospitals do exist but while you're likely to get your own room, slightly nicer surroundings and better food, the care itself isn't significantly different.
That's not to say that the French system is perfect of course, especially in 'medical deserts' where there is a shortage of doctors, but in global rankings it usually comes out well.
2 It's a reimbursement system
Unlike the UK, where healthcare on the NHS is free at the point of delivery, the French system operates on a reimbursement model.
That means that you pay the doctor/pharmacist/other health professional upfront during your visit.
If you're registered in the French system, the medic then swipes your health card and the French government reimburses the cost of your appointment, treatment or prescription directly into your bank account (usually within a few days).
The government sets the prices for drugs, treatments and appointments and also sets the level for how much of the cost will be reimbursed by the state. For example, a standard GP appointment is €25 and the reimbursement rate is 70 percent. So when you visit your GP, you pay them €25 and the government reimburses you €17.50.
There are different reimbursement rates depending on the type of illness (eg cancer treatments are reimbursed 100 percent) and by the type of patient - pensioners, pregnant women and people on low incomes get 100 percent reimbursement - you can find the full details here.
Before visiting a doctor, check whether they accept credit or debit cards as some (an increasingly small minority) will only accept cash.
3 It's accessible to foreigners and tourists
If you have lived in France for more than three months you are entitled to register in the French public health system and get the carte vitale which allows you access to state-funded care - here's how.
If you're working in France you can register directly on the principle that you're paying into the system via your taxes so you're entitled to use it.
If you receive a pension from another country then you can still register but it might be down to your home country to pay for your care (for example via the S1 system for UK pensioners) and if you fall into the 'grey area' of not working but not receiving a pension, you can register via the PUMa scheme - here's how.
If you're just visiting France then you can access healthcare, but you will have to pay for it. Depending on whether you have European health cover or private health/travel insurance, you may be able to claim costs back later.
In most countries you can access emergency healthcare as a visitor, but if you need to see a doctor for non-urgent reasons while you're in France you can simply book an appointment with a GP or request a home visit without needing to go through the emergency process.
Full details HERE on accessing non-emergency healthcare.
Naturally if you have an emergency, you can go straight to the Emergency department (Urgences) at the nearest hospital, or call an ambulance.
READ ALSO Emergency in France: Who to call and what to say
4 It's called health insurance
Slightly confusingly, especially if you are dealing with information translated into English, the French system is simply known as Assurance maladie (health insurance), which for many English-speakers suggests private health insurance.
If you see any references in French to Assurance maladie, this means health cover - so for example if you see requirements for visas or residency cards for Assurance maladie this simply means proof that you have health cover, either through being registered in the French system or through private cover - they're not demanding that you have extra private medical insurance.
Being registered in the French state system is sufficient cover for all residency-related tasks - in order to prove that you are covered you can request an Attestation des droits.
The other name that the French system is sometimes referred to by is Ameli - this is in fact the online platform where people registered in the system can do health-related admin such as check that their reimbursements have gone through and request the Attestation des droits.
Ameli: What you need to know about the French online health accounts
If you prefer to do the admin in person, you can visit your local CPAM (Caisse Primaire d'Assurance Maladie) office.
5 There's also 'top up' insurance
As mentioned, the public health system reimburses some of your healthcare costs, but usually not all.
Most people in France also have 'top-up' private insurance known as a mutuelle which takes care of the remaining percentage that the state doesn't reimburse (depending on the policy - not all mutuelles have full dental cover, for example).
This insurance is cheaper than private insurance in many other countries - the standard cost for a mutuelle for a single person is about €40 per month, or €110 for a family of four, and most policies will leave you with virtually zero out-of-pocket expenses.
If you are an employee, your employer is legally obliged to pay at least half of the cost of your mutuelle.
Mutuelle: What you need to know about France's 'top up' insurance
French vocab
Assurance maladie - medical cover
Caisse Primaire d'Assurance Maladie (CPAM) - the local office of the public healthcare system. You can visit without an appointment if you need help with the system
Ameli - the online health system
Médecin généraliste - GP or family doctor
Médecin traitant - registered GP, this is the doctor you register with when you sign up to the public healthcare system, but you are free to see other doctors if you wish
Ordonnance - prescription
Rendez-vous - appointment
Join the conversation in our comments section below. Share your own views and experience and if you have a question or suggestion for our journalists then email us at [email protected].
Please keep comments civil, constructive and on topic – and make sure to read our terms of use before getting involved.
Please log in here to leave a comment.