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.

Check here for the official list of those illnesses classified as ALD. The list is also provided in English from a expat health campaign group, which you can find here.

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.

Those entitled to ALD status include those in France under an E106 or E121, 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!