8. Long-Term Illness in France - Affection de Longue Durée – (ALD)

If you suffer from a long-term or major illness then, as a general rule, all costs are fully reimbursable by the social security system, provided the fees and charges are made at the official rate.

You will be responsible for excess consultant charges (depassements) and you will continue to remain responsible for the patient surcharges. These surcharges were discussed in Section 7.

The official list of illnesses classified as ALD is reviewed annually by the government.

As well as the official list of major illnesses, it is also possible for the health services authority to accept an illness not on the list if they consider that it is prolonged and serious.

If your doctor determines you suffer from a long-term illness they will advise your local health authority (CPAM), or your employment/business insurance fund, who will then send you a notice you can use giving you exoneration from any charges.

Since 2011, the cost of transport for patients suffering from an ALD are no longer automatically reimbursable, as each case will be considered on its merits.

The period for which you will to entitled to ALD status is not indefinite, but is renewal at intervals of 5 years or less, depending on the assessment made by your doctor, in collaboration with the local health authority.

Those entitled to ALD status include those in France under an E106 (S1) or E121 (S1), as well as those fully registered with the French health system through the CMU, or employment/business.

All treatment not connected with the long-term illness will receive reimbursement at the normal rate, so will not be fully reimbursable.

It seems that the number of patients being granted ALD status by their doctor is on the increase, perhaps because it is a method of circumventing the charges being incurred by patients. It may also help that the doctors themselves receive a premium rate from the social security system for treating patients with a long-term illness!