Understanding the French healthcare system

Dumbing down the key steps to get your healthcare expenses covered

One of the particularities of the French healthcare system is the social security: a universal health coverage program. Social security is based on the principle of solidarity; each citizen is protected and everyone participates to the extent of their means so that each person benefits from this protection. Thus, through their contributions, people in good health stand in solidarity with the sick and employed work force stand in solidarity with the unemployed and retirees.

Living, studying or working in France for more than 3 months?

➡️ Any medical or maternity care expenses are partially or completely covered! ⬅️

Summary

  1. Healthcare coverage
    a. How do I benefit?
    b. How does it work?
    c. The importance of a general practitioner
  2. Complementary health insurance
    a. What is a complementary health insurance?
    b. The supplementary universal health care coverage program

1. Healthcare coverage 🩺

a. How do I benefit?

🇪🇺 European* student

  • Apply for your European Health Insurance Card. The European Health Insurance Card is a free card that gives you access to medically necessary, state-provided healthcare during a temporary stay in Europe*. And this under the same conditions and at the same cost (free in some countries) as people insured in that country.

🌍 European* student without a European Health Insurance Card or student from outside Europe

b. How does it work?

Practically speaking
You pay the mandatory share, covered by social security and the additional share, which you're responsible for.

Then, your medical expenses are reimbursed, depending on what they are. The amounts reimbursed will vary from 15% to 100% of what you paid. The complementary part for which you're responsible can be reimbursed by your complementary health insurance if you have one.

Some amounts however will not always or are never going to be reimbursed:

  • The flat-rate charge (mandatory franchise fee for all over 18: 1€/medical act) and medical deductibles (small amounts deducted from your social security reimbursements for medication, use of the paramedics and medical transportation ≤ 50€/yr.)
  • Additional fees: medical consultation rates are determined by social security. However, some healthcare professionals are free to set their own rates and therefore charge additional fees.

c. The importance of a general practitioner

If you don't state who your general practitioner is to the social security or if you go straight to an appointment with a specialist without seeing them first, you'll have penalties when reimbursed.

You have to pick a referring doctor and state who they are to the social security. Once you have chosen your general practitioner, you have two options:

  • You can authorize your doctor to submit your declaration online. Practically speaking, during an appointment at his/her practice, you can give the doctor your “carte Vitale” insurance card and the doctor will make the report online.
  • Otherwise, you and the doctor can fill out and sign this form together and submit it to your health insurance fund, or mail it.

2. Complementary health insurance 👩‍⚕️

a. What is a complementary health insurance?

Complementary health insurance makes it possible to totally or partially cover health expenses which remain at your expense after social security reimbursement. This includes the costs for a general practitioner or specialist, dental costs, vision costs, additional fees, hospital packages, etc.

Bonus: If you're covered by the social security and have a complementary health insurance 'Third-party payment' is a way to avoid paying upfront all or part of your healthcare costs.

🌍 You're an European student and you want to subscribe to a complementary health insurance in order to be covered at the highest possible rate?

  • If you stay in France for at least 90 days, even if you have a European Health Insurance Card, you need to register to the French social security to be able to do so!

b. The supplementary universal health care coverage program

If you are on a low income, you may qualify to receive supplementary health insurance at little to no charge to you through the supplementary universal health care coverage program ('Complémentaire santé solidaire'). To qualify, your resources for the past 12 months mustn't go over a certain amount. This program can be free or cost you 1€/day/person maximum.

This program helps a household as a whole. To apply on your own you have to be separated from your parents on 3 levels:

  • you must have a different home
  • you have to not receive any financial aid from them
  • you have to declare your revenues on your own

See if you are eligible with this official tool: ameli.fr - Simulateur d'aide financière

If you benefit from this program, your medical expenses will be 100% covered and you won't pay for:

  • going to the doctor, dentist, hospital and even going to see nurses
  • hospital packages in their entirety and without any time limit
  • medication
  • medical devices such as dressings/bandages, crutches, splints or wheelchairs
  • most of eye wear, dentures and hearing aids
  • medical test and analyses, X-rays, etc.

Plus, no one can ask you to pay additional fees if your visit is justified!

You can apply directly from your account on ameli.fr or by filling in and mailing this form.

⚠️ applications are dealt with within a 2-month timeframe.

*includes the 27 EU countries, Iceland, Liechtenstein, Norway, Switzerland and the United Kingdom

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