The tarif for an adult consulting a médicin traitant is 23€ for children aged two-six years old it is 24€; and for children under two it is 25€. On top of this, for most people there is a one euro charge that is not reimbursed by either the state or police complémentaire. For more information on the level of reimbursement see Healthcare France FAQ
There is a maximum payment per day for medical acts of 4 euros maximum payment per day.
What does this mean? In the past if you had a consultation with a doctor who then, say, recommended an X-Ray only one euro was payable although two medical acts (doctor’s appointment and x-ray) are involved. Now, however, up to four medical acts from one consultation will each attract a forfait of one euro. So now the same consultation and an x-ray, for example, will cost two euros.
The overall annual maximum contribution by the individual via this forfait remains at 50€.
At the end of your consultation you pay with cash, by cheque, or occasionally with a carte bancaire (debit card). Today, thought, increasing numbers of practitioners are linked via computer to the CPAM and therefore do not require the full charge to be paid up front if you have a carte vitale.
If you do not have a carte vitale but have a social security number, you will be given a feuille de soins-médecin that you then forward to your local Caisse primaire d’Assurance Maladie (CPAM). It will reimburse you the approved amount and, if a complement is also due, forward the paperwork to your police complémentaire.
The tarif for a referral to most practitioners in Secteur 1 is 27 euros. Specialists in Secteur 2 are free to set their own terms, but these should be clearly displayed.
Most treatment is channelled through the doctor with whom you are registered – the médicin traitant. This channelling is known as the parcours de soins. If you seek treatment outside the parcours de soins – going direct to a specialist without a recommendation from a médicin traitant – means your rate of reimbursement will be reduced from 70% to 50%.
The exception is seeking direct consultations with an opthalmologist or gynaecologist. For these, there is no penalty.
You may find that there is a considerable difference in price from one pharmacy to another, so if you are a regular user of non-prescribed medicines it may be worth shopping around.
A one-surface filling is 16.87€; an extraction 33.44€. The rate of reimbursement from the CPAM remains at 70 per cent.
From 2007, children are eligible for a free dental check at age six, nine, 12, 15 and 18 (at the moment it is yearly between 13-18). Parents will receive a form the month before their child’s birthday, and it will be valid for three months.
The renewal of spectacles, for those over 16, is possible without a prescription
Excess payment for actes medicaux in excess of E91
An excess of 18 euros will be payable by the patient for such actes. However, there are many exceptions including laboratory tests and X-Rays.
Currently, the daily ‘hotel’ charge for a hospital stay (forfait journalier) is €16 per day.
In keeping with the general anti-smoking movement nicotine substitutes, for example patches, are covered up to €50 per year.