Travel costs for health treatment are, under certain conditions, covered in full or in part by the health system in France.
Who is Entitled?
You will not ordinarily get your transport paid for routine visits to
your GP, consultant or hospital, but there are a variety of circumstances when the system provides assistance with health travel
costs. Unlike the UK, this assistance is not means-tested.
As might be expected, transport by ambulance for emergency medical treatment, or where medical care is otherwise needed during the journey, is covered by the health system.
In addition, those who suffer from a major or long-terms illness (Affection de Longue Durée - ALD) and who present an incapacity or 'deficiency' that requires medical support during the journey are entitled to financial support, provided the treatment is for the ALD itself.
Similarly, where long-distance travel over 150 kilometres each way is necessary, then financial support is available.
Regular transport, equivalent to at least 4 journeys of over 50 kilometres for two months for the same treatment, is also eligible.
Finally, financial assistance is also available for accident at work or professional illness cases.
Where a child under 16 or an adult needs to be accompanied the costs for both are eligible.
In order to obtain assistance with travel costs, other than in the case of an emergency, you will need to obtain a medical prescription for transport from your doctor, either your GP or the consultant from whom you are receiving treatment.
Your doctor will specify the type of transport that is best adapted to your circumstances, which may be an ambulance, a taxi, taxi-ambulance (véhicule sanitaire léger - VSL), public transport, or your own vehicle.
If you are prescribed a taxi or taxi-ambulance, you are only entitled to use those who are accredited with the health authority - a taxi conventionné. Your doctor should be able to provide a list but if not contact your local health authority. There is a small excess of €2 per journey that applies on these vehicles.
You are obliged to use the transport prescribed, accept where you take a less expensive option, when you will then receive reimbursement for your costs. Strictly speaking, in the case of ALD patients an alternative form of transport (personal or public) is only reimbursable if you are accompanied by a friend or member of your family.
In certain circumstances, the authorisation of the health authority (accord préalable) is also required, although this may sometimes be obtained retrospectively.
Such prior authorisation from the health authority is required for:
- Long distance travel over 150 kilometres
- Regular transport, equivalent to at least 4 journeys of over 50 kilometres for two months for the same treatment.
- Transport by air or sea.
Where this applies your doctor will supply you with your request for authorisation, called a Demande d'accord préalable de transport valant prescription médicale (Form S3139), which you will need to send your to your health authority. If they do not reply within 15 days the application is deemed to have been accepted.
Level of Cover
As a general rule, the level of reimbursement for transport is at the rate of 65% of the regulated tariffs for taxi or a health vehicle, public transport or your own vehicle. If your costs are not being paid directly by the health system (tiers payant), you will need to produce receipts.
However, there are various groups from whom transport is reimbursable at the rate of 100%. They include emergency transport for hospitalisation, ALD patients, accident at work cases, and transfers between medical establishments. Those on a low income (CMU-C) or an invalidity pension are also eligible.
If you use your own vehicle you will be entitled to 65% reimbursement at the rate of €0.30 per kilometer. You will need to complete the form Cerfa 11162-*3 Demande de Remboursement des Frais de Transports (S3140), which you should send to your health authority, together with the transport medical prescription or, where it applies, the request for authorisation from the health authority.
If you have a complementary health policy then, depending on the terms of the policy, the balance of these costs may be covered by your mutuelle, to whom you should make application.