Costs Of French Healthcare: Your Carte Vitale, Mutuelle, And Tiers Payant

 

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Costs Of French Healthcare: Your Carte Vitale, Mutuelle, And Tiers Payant

The French healthcare system (or L’Assurance maladie) is pretty good, and it’s one of the reasons why France has such high tax brackets. Although it may seem daunting, the system can be simplified into three main elements. Take a look at this beginner-friendly overview of how the system works.

1. Carte Vitale

The most important thing you need is the Carte Vitale. This famous green card gives you access to the French healthcare system. Here are some essential points to know about the Carte Vitale:

  • You are eligible for a Carte Vitale after 3 months of residency in France.
  • The card gives you state medical coverage, which generally pays around 70% of essential and emergency healthcare.
  • When you receive treatment, you may have to pay the cost upfront (for example, at a doctor’s appointment) but are usually reimbursed within 5 working days.

The application process for a Carte Vitale can, at times, be long, but don’t worry – you will receive a temporary number which you can use when receiving medical treatment. Make sure you also ask for a feuille de soin (receipt) for any treatments so that you can request a reimbursement from the state.

Example of how the Carte Vitale works:

Imagine you need to visit the doctor, which costs around €25. When you are at the doctor’s office, give your doctor your Carte Vitale. You will then pay the €25, but within 5 days, you will receive €16.50 in your bank account. (This reimbursement takes into account a €1 fee you will pay for each medical treatment/visit).

For more information on how to apply for a Carte Vitale, take a look here.

2. Mutuelle or Top-Up Health Insurance

So, you’ve now got your Carte Vitale and can access the French healthcare system with a large part of the cost reimbursed by the state…great! So let’s move on to the mutuelle.

  • A mutuelle in France is essentially complementary health insurance.
  • It often covers the 30% that the state does not cover, as well as covering all, or part, of non-essential treatments.
  • Most people have a mutuelle, either because they have to (like salaried workers or self-employed workers), or because they have long-term health issues which could become very expensive without a mutuelle.
  • You usually pay a monthly fee for a mutuelle, which varies greatly depending on the level of coverage you’d like.
  • A mutuelle is fantastic when you have certain medical needs, like glasses or physiotherapy.

It’s important to do some research before choosing a mutuelle: this article has very in-depth information on how to go about this.

3. Tiers payant

The last element to be aware of is the tiers payant, which is applicable once you have a mutuelle.

  • Your mutuelle company will send you a card or piece of paper with your personal information and insurance policy on it.
  • When you receive treatment, if you give this (along with your Carte Vitale) to the doctor, your mutuelle will cover the costs directly. This means you do not need to pay upfront, as it is already covered.
  • Tiers payant can also be used to cover patients who are pregnant or suffering from long-term health conditions, meaning you don’t need to pay for all your appointments up-front.
  • Note that for certain treatments (often dentists and some specialists), you may still be required to pay up-front – check in advance if you are unsure.

And that’s it, folks! It may seem complicated, but despite the sometimes overwhelming administration/paperwork, the French healthcare system is well-designed. It often appears in the top 10 lists of the best healthcare systems in the world.

Once you have the above elements set up, you can enjoy living your life in France, safe in the knowledge that your healthcare coverage is in place.

Everything You Need to Know About Healthcare in France

From understanding the French state healthcare system and visiting a doctor to choosing a mutuelle insurance and dealing with your and your family’s health concerns—FrenchEntrée is here to help. Follow our Essential Reading articles for everything you need to know about healthcare in France.

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Clara is a writer, translator and interpreter, working with French, Italian and English. She lives in the South of France.