Reimbursement for medical treatment fees in France

Are you going to see a healthcare professional? Presenting your health insurance card will simplify payment and reimbursement procedures. Carte Vitale, the French insurance card, is embedded with a microchip that makes proof of entitlement to health insurance. You get a rebate for the cost of the examinations and the treatments ordered by the doctor. If you want to be paid back by the local sickness insurance fund, then you need to make sure that your health insurance card is up to date. You have the possibility of determining which social security contributor you can apply to by doing a department-by-department search. 

No, you do not have to claim a refund

Carte Vitale entitles you to medical treatment without having to complete any formalities and it directly affects the reimbursement for medical treatment. Therefore, if you have not received yours yet, you should call numero CPAM 93 and find out what has happened. Thanks to the insurance card, it is no longer necessary for you or healthcare professionals to send them over to the Caisse Primaire Assurance Maladie (CPAM). The electronic chart is sent over the Internet to the local sickness insurance fund and you get the money back in a matter of 5 days. What is more, you do not have to pay great amounts at the end of each consultation/hospitalization. Since the system is automated and, depending on your situation, the expenses are charged to the social security system. If you are in need of urgent treatment, then you should request the local health authority to fax you over proof of your insurance.

The French health system does not cover all medical expenses

Unfortunately, the French health care system does not cover all expenses related to medical treatment. Are you curious to know what charges are at your expense? Well, if you get sick and need to see a medical practitioner or a specialist, you have to pay €1for the consultation. Let us not forget about the laboratory tests and X-ray exams. Charges are also applied when you receive healthcare from allied health professionals. If the medical procedure is an extensive one, then you are lucky because the reimbursement rate is 100%. Moreover, doctor and dentist’s fees are reimbursed at 70%, while laboratory tests are reimbursed at 60%.

Reimbursement of healthcare expenses: What delays?

You are waiting to get your money back from the social security system. As stated previously, Carte Vitale simplifies the procedure, so you will not have to wait very long. But what if you do not have an insurance card or the healthcare professional’s card reader does not work? Well, you are going to have to wait a little bit longer. The doctor has no option but to send the chart to the CPAM. You can do that yourself and it is important to provide information like your name, social security number (if you have one of course), birth date or indicate the insured person you depend on. The setback can last anywhere between a week to 10 days. Practically, it all depends on the Assurance Maladie.