'Conventionné': Why you should find out what 'sector' your French doctor is
Before making an appointment with a doctor or medical specialist in France there is a key detail to find so you know exactly how much you'll be charged.
When you visit the doctor in France, the final price at the end will depend on whether your doctor is what is known as conventionné and what sector they fall into.
If they are conventionné - meaning they have signed an agreement to charge rates in line with the state's health insurance system - then they are either 'secteur 1' (sector 1) or 'secteur 2' (sector 2).
READ MORE: Healthcare in France: The essential French vocabulary you'll need if you're ill
Sector 1 doctors have agreed to rates in line with those set by France's state health insurance system L'Assurance Maladie. They have also agreed not to charge any extra fees.
Sector 2 physicians charge the official health insurance rates, but they can also add extra fees on top. Technically they are only meant to charge more for their services "with tact and moderation". This extra cost known as dépassement honoraires.
The third category of doctor is non-conventionné. These medical professionals have not signed the mutual agreement to charge state-regulated pricing, so they can decide their own prices. As such, non-conventionné (sometimes called 'sector 3') doctors tend to charge higher rates.
Most practitioners in France are conventionné, recent estimates show that less than 1,000 physicians across all of France are 'sector 3'.
Reimbursements
The category the doctor falls into will also determine how much you can expect to pay out-of-pocket.
Appointments with Sector 1 physicians are reimbursed at the standard rate of 70 percent by French social security. If you have a mutuelle (top-off private health coverage), then your plan may cover the remaining fees. You can check your mutuelle plan to see the fixed contribution they offer.
While appointments with Sector 2 doctors are also reimbursed at the same 70 percent rate as Sector 1 practitioners, the reimbursement does not take into account any extra fees (dépassement honoraires) added on. The amount you will end up paying afterward will depend on how much your top-up insurance covers, which will vary plan by plan.
Visits with doctors who are not conventionné are reimbursed using a special rate called a tarif d'autorité calculated by France's Assurance Maladie. Reimbursement is usually minimal. You should also verify with your mutuelle to be sure they cover visits with doctors who are not conventionné.
What about specialists? Are there any exceptions?
The rate per visit also depends on whether you are seeing a generalist or a specialist.
For Sector 1 general practitioners, appointments cost €25, which is expected to go up to €26.50 before the end of 2023.
This means that at the current standard rate of €25, 70 percent - or €16.50 - would be reimbursed by the French government, and the remaining amount (€7.50) is typically covered by complementary health insurance (mutuelle).
For many people employed in France, the remaining amount (€7.50) is covered by complementary health insurance (mutuelle).
For specialists, you would apply the same 70 percent reimbursement rate to the cost of a standard visit, which was €30 as of 2023, but was also set to increase before the end of the year to €31.50.
'Complex’ consultations with a specialist are more expensive. The current rate is €46, which will be raised to €47.50. You can find examples of which consultations count as ‘complex’ here.
Dentistry is also an exception - starting in October 2023, reimbursement rates will decrease for all conventionné dentists from the standard 70 percent to 60 percent.
How will I know what 'sector' a doctor is in?
When you book an appointment by phone you can ask the doctor's office which sector they fall into, as well as their normal rates.
If you make your appointment on Doctolib, you should see whether the doctor is conventionné and which sector they fall under on their appointment page.
READ MORE: How to use: French medical website Doctolib
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When you visit the doctor in France, the final price at the end will depend on whether your doctor is what is known as conventionné and what sector they fall into.
If they are conventionné - meaning they have signed an agreement to charge rates in line with the state's health insurance system - then they are either 'secteur 1' (sector 1) or 'secteur 2' (sector 2).
READ MORE: Healthcare in France: The essential French vocabulary you'll need if you're ill
Sector 1 doctors have agreed to rates in line with those set by France's state health insurance system L'Assurance Maladie. They have also agreed not to charge any extra fees.
Sector 2 physicians charge the official health insurance rates, but they can also add extra fees on top. Technically they are only meant to charge more for their services "with tact and moderation". This extra cost known as dépassement honoraires.
The third category of doctor is non-conventionné. These medical professionals have not signed the mutual agreement to charge state-regulated pricing, so they can decide their own prices. As such, non-conventionné (sometimes called 'sector 3') doctors tend to charge higher rates.
Most practitioners in France are conventionné, recent estimates show that less than 1,000 physicians across all of France are 'sector 3'.
Reimbursements
The category the doctor falls into will also determine how much you can expect to pay out-of-pocket.
Appointments with Sector 1 physicians are reimbursed at the standard rate of 70 percent by French social security. If you have a mutuelle (top-off private health coverage), then your plan may cover the remaining fees. You can check your mutuelle plan to see the fixed contribution they offer.
While appointments with Sector 2 doctors are also reimbursed at the same 70 percent rate as Sector 1 practitioners, the reimbursement does not take into account any extra fees (dépassement honoraires) added on. The amount you will end up paying afterward will depend on how much your top-up insurance covers, which will vary plan by plan.
Visits with doctors who are not conventionné are reimbursed using a special rate called a tarif d'autorité calculated by France's Assurance Maladie. Reimbursement is usually minimal. You should also verify with your mutuelle to be sure they cover visits with doctors who are not conventionné.
What about specialists? Are there any exceptions?
The rate per visit also depends on whether you are seeing a generalist or a specialist.
For Sector 1 general practitioners, appointments cost €25, which is expected to go up to €26.50 before the end of 2023.
This means that at the current standard rate of €25, 70 percent - or €16.50 - would be reimbursed by the French government, and the remaining amount (€7.50) is typically covered by complementary health insurance (mutuelle).
For many people employed in France, the remaining amount (€7.50) is covered by complementary health insurance (mutuelle).
For specialists, you would apply the same 70 percent reimbursement rate to the cost of a standard visit, which was €30 as of 2023, but was also set to increase before the end of the year to €31.50.
'Complex’ consultations with a specialist are more expensive. The current rate is €46, which will be raised to €47.50. You can find examples of which consultations count as ‘complex’ here.
Dentistry is also an exception - starting in October 2023, reimbursement rates will decrease for all conventionné dentists from the standard 70 percent to 60 percent.
How will I know what 'sector' a doctor is in?
When you book an appointment by phone you can ask the doctor's office which sector they fall into, as well as their normal rates.
If you make your appointment on Doctolib, you should see whether the doctor is conventionné and which sector they fall under on their appointment page.
READ MORE: How to use: French medical website Doctolib
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