Description:

Before you can receive any medical treatment, other than in an emergency, you will need to register with a doctor.  There are two types of general practitioner in France;

- A doctor may work entirely within the state scheme and keep to the agreed fees set by the government

- A doctor who keeps to the agreement but also set his fees freely

In both cases the reimbursement made by the CPAM (local sickness insurance fund) will be based on the state scheme’s tariff but not on any extra additional fees above the set level which may be charged.

You will need to pay for your treatment at the end of each appointment and, if you have one, you can pay the doctor with your Carte Vitale.  However if you do not have a Carte Vitale your doctor will issue you with a brown receipt form 'Feuille de Soins' which you can then send off to CPAM to receive a refund of what you have paid.  You will receive reimbursement through the social security system at the standard rate of 70% less a 1 € surcharge paid by you.

The doctor may issue a prescription which can be taken to a Pharmacist to fulfil.  Your doctor will also need to issue you with a referral in order for you to see many other medical specialists.  A referral is not needed to see a dentist, ophthalmologist or gynaecologist.

You are able to register at any doctor and are not restricted by location.

Most dentists work within the same system as doctors so general dental treatment is reimbursed in the same way, i.e., patients will receive reimbursement from the social security system at 70% of official rates and your voluntary health insurance policy will pay for balance.  However, there is no 1 € surcharge as is the case with doctors treatments.

You are able to register at any dentist and are not restricted by location.

The eye care system in France is different to that in the UK in that Opticians are not part of the French health service and so do not offer eye tests.  Instead, Opticians are more of a retail unit and can sell you a pair of spectacles.  However, unless you have a medical prescription from an ophthalmologist, you will not be eligible for any financial assistance from the social security system for the cost of the glasses or lenses.

In France you will need to see an Ophthalmologist to receive a medical eye examination and to get a medical prescription for glasses.  The set fee for an Ophthalmologist appointment in 2009 was 40 € of which 15 € will be reimbursed by the social security system. 

Please note that in many areas there seems to be a shortage of Ophthalmologists in France and so it is advisable to book an appointment far in advance of when you are actually likely to need an appointment.  It is illegal to buy spectacles on the internet in France, however, many UK based opticians do offer this service and may be preferable if you already have a prescription and need glasses urgently.

There are both public and private hospitals in France;

• Private hospitals (cliniques privees) are usually similar to a public hospital with only a few truly operating outside of the public sector.

• Public hospitals which may be a general or local hospital (CH), a regional hospital (CHR), a specialist hospital (CHS) or one linked to a university (CHU).

French hospitals are often different from many UK hospitals and patients will usually find clean, spacious, modern facilities with private rooms and facilities. 

The admission procedures to hospital will depend on your status;

If you are admitted to hospital you will need to provide your Carte Vitale, the notice or 'attestation' you will have received confirming your entitlement to health care and proof of your voluntary or private insurance policy.

If you are admitted to hospital when you are visiting France you will need to produce either your European Health Insurance Card or private health insurance policy.

If you have no health insurance, and it is an emergency, you will still receive treatment.  However, you will be responsible for the costs and will be expected to pay before your are discharged.

If it is not an emergency and you do not have health insurance you will most likely be asked to pay before you receive the treatment.

In France you will only be able to get prescription drugs from a pharmacy.  Over the counter medicines are also only available in pharmacies and you will not find them for sale in supermarkets as you would in many other countries.

The rate of reimbursement for prescriptions ranges from 15% up to 100% and will depend on the type of drug and how essential it is perceived.  Medicines not considered essential will get the lowest rate of reimbursement with very few drugs reimbursed in full.

Most chemists now use computerised systems which are connected to the state system and the main voluntary or private insurance funds.  This means that once you have registered with your local chemist you should only need to provide your Carte Vitale to the pharmacist and will not need to pay anything else.

If your chemist does not have a computerised system or you do not have a Carte Vitale you will need to pay up front.  You can get a brown receipt form 'Feuille de Soins' from the pharmacist who will attach sticky labels from your medicine box on to the form.  You will then need to send off to CPAM to receive a refund of what you have paid.

The level of reimbursement which you can expect for each medicine will be indicated by the colour of the detachable slip that is attached to each prescription;

• Orange - 15%
• Blue - 35%
• White - 65% 
• White/Barred - 100%