The National Health service in France is based on a pay-as-you-are-treated regime with reimbursement of some or all fees according to various circumstances:
For instance a Doctor’s visit will be reimbursed to 70% of the cost (if the cost is what the Government tariff sets) and you can get the other 30% reimbursed if you take out voluntary, also called “top-up”, insurance.
Doctors are self-employed in France but the Government sets the official tariffs (called Tarif de Convention) that health professionals can charge.
However – some health professionals (and the number is increasing) have the right, granted by the Government – to charge more than the officially recommended rate.
These excess charges are called dépassements and they are mainly charged by consultants and specialists. Unlike a standard doctor’s fee, the excess charges of these consultants may not be reimbursed by your voluntary health ‘top-up’ insurer – it depends on the level of cover you take out and you may find that the option for full reimbursement is not always available.
Although you have the right to go directly to a consultant by doing so you will not be entitled to the full level of reimbursement that you will get if you have a referral from your primary care doctor (Médecin Traitant).
Typically excess charges for routine consultations are around €5 and €35 above the official rate. If you need more than a routine consultation the charges for ensuing treatment can become a lot higher than the official rate.
Doctors or dentists who are registered with the state healthcare provider in France are called “conventionné”.
‘Conventionné’ practitioners can fall into either of the following two categories:
Secteur 1: practitioners who charge the official social security rate
Secteur 2: practitioners who charge an extra fee on top of the official rate. They operate as part of the health service but have been given the right to impose their own ‘reasonable’ charges.
Some specialists have agreed to operate the official rates on condition that the patient is referred to them by their doctor; where the patient is not referred then an excess charge will normally be applied.
Those who operate on a completely private basis (and there are only a very small minority) are called non-conventionnés. Medical professionals in this sector are completely free to set their own charges.
Doctors and specialists are required by law to display their charges and charging policy – you should ask if you’re not sure what sector they are in or what their charges are.
