In the past if you received medical treatment in France patients had to pay at the end of each consultation/hospitalisation and later receive reimbursement from the social security system (as well as your voluntary insurer if you had one).
This still remains the case with some doctors, but increasingly the system is becoming automated so that at least those costs charged to the social security system (and increasingly top-up health insurers) are recovered by the doctor from the health authority. Hospital costs are also generally recovered in this way.
This is called the 'tiers payant'.
The process of recovery by the patient used to require that they submit a receipt for the treatment (feuille de soins) to the local Caisse d'Assurance Maladie. This is still the case with some medical professionals and chemists who have not moved on to the new system, although it is now rare.
In recent years the paper based process has been streamlined and automated with the issue to everyone of a plastic health insurance card.
The card is called the Carte Vitale.
The card is embedded with a microchip and contains your social security insurance details.
It does not include medical information, although some pilot studies are being undertaken with such cards. The cards have photo identity on them.
Everyone aged 16+ years of age is required to have one. Children under 16 years are included on the card of their parent or guardian.
The card is presented to your French doctor and chemist who places it into a card reader enabling you to later obtain direct reimbursement from the insurance fund, rather than having to submit a feuille de soins.
As we state above, increasingly, no payment by the patient is required, as the whole process is automated between the medical profession and the health authority.
If you have voluntary insurance the system will also (normally) deal directly with your reimbursement via the 'tiers payant'.
So make sure you bring it with you when you seek medical treatment and it is always a good idea to carry it around with you.
If you do not have your card with you this does not prevent you obtaining medical treatment, but it means you would need to pay for the treatment, be given a feuille de soins, which you would then need to send to your CPAM and voluntary insurer for reimbursement.
You should normally expect to receive reimbursement directly into your bank account within a week.
Where there are excess medical charges (called dépassements) over the official tariffs you may be able to get reimbursement from your voluntary insurer. If not, the costs fall to you and will not be picked up by presentation of your insurance card.
Until you are fully installed in the French health system you will need to use the feuille de soins, as you will not be provided with a carte vitale.
The process of issue of the carte vitale normally takes a few weeks, but can sometime drag on due to local inefficiencies or work pressures.
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