9. Receiving Medical Treatment in France
- 9.1. General Practitioners
9.2. Consultants
9.3. Prescriptions
9.4. Emergency Treatment
9.5. Hospital Treatment
9.6. Maternity Care
9.5. Hospitals in France
9.5.1. Admission
There are both private and public hospitals in France.
Most private hospitals (cliniques privées) are accessible on broadly the same terms as a public hospital, with very few operating completely outside of the public sector.
Public hospitals may be a general or local hospital (CH), a regional hospital (CHR), a specialist hospital (CHS), or one linked to a university (CHU).
If you are admitted to hospital then they you will need to produce your carte vitale, the notice you will have received confirming your entitlement to health care (attestation) together with proof of your voluntary insurance policy or CMU complémentaire .
If you are hospitalised as a result of an accident at work then your employer should have provided you with an accident report form, which you should also present to the hospital.
The hospital will use this to provide you with a letter (bulletin d’hospitalisation) that will then secure your entitlement to sickness/accident pay during your absence from work.
In general, if it is necessary for you to be provided with transport to receive your medical treatment these costs are reimbursable provided it is authorised by your doctor or specialist.
The rate of reimbursement for transport is 65% under the national insurance scheme, with the balance reimbursable from your voluntary insurance if you have one.
You do not have an automatic right to a private room, but you are entitled to ask for one, and to be offered one if space is available. The social security system will not pick up the additional cost of the room, unless required for medical reasons, but you may find your voluntary insurance policy covers the extra cost.
9.5.2. Charging Policies
Public hospitals will charge the official rate but the charging policy of private clinics is similar to that of doctors and consultants.
That is to say, some have agreed to operate the official tariffs, whilst others impose rates in excess of those prescribed by the government.
In addition, there are also public hospitals where consultants have been granted the right to take private patients, and where the fees will be in excess of the official rates.
Clearly, whichever consultant or establishment you choose, (or need) to attend will have an impact on the charges for which you may be responsible.
As a general rule most hospitals and clinics recover the eligible fees directly from the social security system and the voluntary insurers, so you are only faced with having to pay non-eligible costs at the end of your stay.
This process of recovery is called le tiers de payment.
9.5.3. Reimbursement Levels
Sadly, the system of reimbursement is becoming ever more complex as the government tries to eek out ways of pushing more of the costs onto the patient or insurers.
It is, therefore, only possible to give an overview of reimbursement levels, as there are so many variables it is unwise to generalise too widely.
The basic rule is that hospital treatment costs are reimbursable through the social security system at rate of 80% of official rates, although there are a number of ineligible costs that you must pay or which may be paid by your voluntary insurer.
The main ineligible cost is that of the forfait hospitalier, a daily charge of €18 that is the responsibility of the patient. If you have voluntary health insurance then these costs will be met by them.
In addition, the social security system does not cover the costs of a private room (unless required for medical reasons), telephone calls, television or those charges in excess of the official rates. If you have a voluntary health insurance policy, then these costs may be covered by that policy.
There are several circumstances where the level of reimbursement from the social security system is at the rate of 100% of eligible costs.
The main beneficiaries of ‘full’ reimbursement are those suffering a long term or major illness, pregnant women, those benefiting from CMU Complémentaire and those hospitalised as a result of an accident at work.
Once again, however, there needs to be a health warning about ‘eligible costs’ because the same exclusions as those above apply.
In addition, patients benefiting from 100% reimbursement are also obliged to pay a basic charge of €18 where the costs of hospital treatment exceeds €90.
You will need to read your voluntary insurance policy to see if these costs are covered.
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Public Services in France