There have been progressive increases to doctor’s fees in France over the past few years. Here is a brief summary of the main fees you will be expected to pay during your visit, to be reimbursed by the health insurance and your top-up or mutuelle.
As of May 2017 the visit to your primary care physician, known as médicin généraliste, has been raised to €25.00. With regard to children’s consultations, there are no longer age brackets to define the tariff applied. The fee for a consultation for a child under six years old is €30.
The increase in fees for medical consultations also concerns specialist doctors. Since June 2018, a classic consultation within the framework of the coordinated care path has increased to €50.
The new medical convention also created two new tariffs that came into effect in November 2017, distinguishing complex and very complex pathologies from others. Thus, in the context of a treatment for a complex disease, the consultation is billed at €46, and amounts to €60 for very complex diseases. Epilepsy is considered a complex disease in the same way as multiple sclerosis or a number of other chronic conditions. Pathologies such as cancer, heart malformations, neurodegenerative diseases are considered very complex diseases.
For simple consultations, the reimbursement system remains the same. The health insurance régime reimburses 70% of the basic fee. The rest of the charge is covered by the patient, and later reimbursed by their complementary health insurance or mutuelle, as applicable.
For complex and very complex diseases, reimbursement is carried out in full in certain cases such as long-term conditions, known as affection de longue durée (ALD), pregnant women and infants.
Beneficiaries of the Complémentaire santé solidaire system, formerly known as CMU, are exempted from paying for the doctor’s visit upfront, provided they have declared the practitioner as their médecin traitant or main doctor. The same applies for a direct visit to a gynaecologist, ophthalmologist, psychiatrist, dental surgeon or midwife, without the need from a referral from their general practitioner.