Many foreigners ask themselves the question: How is such an agreement applied, and which institutions can you contact if you need qualified assistance? Let’s try to understand what public and private health care in France is, as well as consider other nuances of the French health care system.
Overview of the French medicine system
French medicine covers both public and private hospitals, the services of specialized doctors and other medical specialists. This policy makes French medicine accessible even to foreigners visiting the country for medical treatment or permanent residence, business, or study.
Aetna International is one of the largest international healthcare providers with comprehensive health management solutions around the world, including France.
The French jurisdiction has a high-quality healthcare system that offers universal coverage for all citizens, regardless of age or economic situation. It consists of an integrated network of public and private services, including doctors, hospitals, and specialized providers.
Residents are covered by the compulsory health insurance premiums in France. Optional private insurance is available for those wishing to receive additional services.
The Ministry of Social Affairs and Health (Ministere de Solidarites and de la Sante) administers public health in France, including primary and secondary health care, provided by various providers.
Medicine in France is ranked 11th in the European Consumer Health Index for 2018 and has been praised for its effectiveness and results achieved. For example, the country has the lowest death rate from heart disease in Europe, although it has been criticized for over-dependence on prescription drugs.
Who can access medicine in France?
Public health care in France is available to all residents through health insurance premiums. Since 2016, a new healthcare system for foreigners, known as the Protection Universelle Maladie (PUMA), provides access to state French medicine after three months of residence in the country.
If your household income falls below a certain threshold, you may be eligible for free medical coverage (CMU-C) or assistance with complementary private health insurance (Aide pour une Complémentaire Santé or ACS).
For foreign citizens applying for medical services in France, it is important to know the following nuances:
- if your application for legal residence has not been completed, foreign nationals are eligible for public health care (Aide Médicale d’Etat or AME);
- temporary visitors to France from the EU / EEA / Switzerland can access public health care if they have a European Health Insurance Card (EHIC);
- EU / EEA / Swiss retirees moving to France can access health care by completing an S1 social security form in their country.
Medical expenses in France plus health insurance
Medicine in France is partly funded by compulsory social security contributions (sécurité sociale), which are usually deducted from residents’ salaries. In 2019, workers themselves paid about 8% of wages, and employers – about 13%.
Health care in France is also partly funded by the government, and the patient also contributes little to health care costs. Government health insurance covers 70-100% of the costs of doctor visits and hospital expenses. Patients with low income and long-term rehabilitation receive 100% coverage.
According to the latest data, medicine in France is considered the largest health care expenditure in the EU as a percentage of GDP. The country currently spends about 11.5% of GDP on medical services, and only Switzerland is ahead of France (12.3%), which spends the most among the EU / EFTA countries. In terms of per capita expenditures, medicine in France ranks 11th among the EU / EFTA countries.
Medicine in France – important aspects for foreign citizens
Regarding French compulsory health insurance in France, non-residents need to remember:
- French citizens are required to conclude a health insurance contract. Foreign residents can use the PUMA system if they have been living in the country for three months;
- citizens who earn below a certain threshold can apply for additional coverage called CMU-C (Complementary Solidarity Health);
People who are not eligible for government health insurance or who want a higher level of coverage must take out private health insurance from local insurance or other health care company;
non-residents will need to submit:
- CERFA form (questionnaire);
- identity card (passport);
- place of residence and proof of address;
- birth and marriage certificates translated into French;
- confirmation of a three-month residence in France;
- bank details, proof of income;
- application for the services of a specific doctor (registration of a specialist). During registration, you can add beneficiaries or dependents.
- If you have lived in France for more than three months (and applied to PUMA), you can register for French health care through your local CPAM (Caisse Primaire Assurance Maladie) office.
Foreigners will also have to choose a primary medicine with the submission of a declaration for primary health care to a specific insurer – in this case, medicine in France becomes fully accessible.
Once a non-resident is registered with the French health system, you will be issued with La carte Vitale, a green plastic health insurance card with a photograph of the applicant and a chip. The electronic chip contains the patient’s name, address, social security information, and details of the benefits for medical payments. However, there is a complete lack of information on diagnoses or case histories.
La carte Vitale is an invariable attribute in French medicine for receiving any medical services or reimbursement of funds paid for them. Medicine in France – the situation with private (non-governmental) institutions
Medicine in France primarily provides funding from public insurance for private doctors and specialized specialists.
The services, again, are provided through the state system, so residents and non-residents with state insurance in their hands receive full, unlimited access to a large number of private clinics and doctor’s offices. The only difference is that the amount of uncovered costs may increase due to additional services.
A similar situation with private medicine in France forces citizens of the country and foreigners to receive additional private insurance, which allows them to cover all costs. This category includes:
- specialized treatment;
- additional therapeutic methods;
- long-term rehabilitation;
- other services that are not available in government agencies.
Non-residents are required to obtain a private medical policy within three months from the date of arrival in France (except for citizens covered by the European Health Insurance Card (EHIC) or other forms of insurance).
In the list of the most famous medical insurers in France:
- ACS Assurance is the most popular company, especially among students (the prefecture takes insurance when applying for permanent residence in France);
- Aetna International with comprehensive healthcare packages worldwide;
- Allianz Care with 24/7 access to professionals;
- Bupa Global with premium packages to cover in France and abroad;
- Cigna Global is the representative office of the American healthcare organization.
Medicine in France – system hierarchy
First of all, foreigners in France should seek medical help from a family doctor (the system is almost identical to that used in Germany). These specialists are called Médecins Généralistes and can work in groups or alone. At the same time, foreign citizens are not limited in their choice, however, it is necessary to register as a patient with a specific specialist, who will be the traitant médecin (main doctor).
It is the primary specialist who refers patients to other doctors, and only through his referral, it is possible to receive up to 0% reimbursement of medical expenses in France. However, the French system allows you to directly contact certain specialized specialists – ophthalmologists, gynecologists, pediatricians.
The following information will be useful to foreigners and businessmen arriving in France for tourist or business purposes. The following are ways to get emergency help in an emergency:
- contacting A&E or ER (les urgences) – emergency centers;
- call to the short, pan-European number 112;
- free calls to one of the following services:
- 15 – assistance service with medical personnel (SAMU) and ambulances;
- 116, 117 – extracurricular doctor services;
- 17 – police commissariat;
- 18 – emergency service;
- 112 – to get help on the water.