topics
tools
editor's choice

Lost in Cheeseland: How to become an expat in France

Top myths about Paris

Is an international MBA the right degree for you?

Childcare in France

Relocation programmes remain small, focused and consistent

Expatica countries
Index Last Var.(%)
BEL 20 2270.63 -0.42
DAX 6788.8 0.59
IBEX 30 8902.1 0.60
CAC 40 3424.71 0.43
FTSE 100 5895.47 0.33
AEX 325.12 -0.06
DJIA 12890.46 0.05
Nasdaq 2927.23 0.39
FTSE MIB 16653.83 -0.09
TSX Composite 12497.94 -0.18
ASX 4322.6 -0.79
Hang seng 20756.97 -1.20
Straits Times 2961.12 -0.67
ISEQ 20 503.71 0.33
You are here: Home Health & Fitness Healthcare Picking a primary doctor in France
Enlarge font Decrease font Text size


03/01/2006Picking a primary doctor in France

Picking a primary doctor in France For those eligible for French Social Security, we explain how to make sure you're signed up with a médecin traitant.

Everyone with a carte Vitale must choose a primary doctor, or a médecin traitant or be reimbursed at a lower rate, or possibly not at all in the case of visits to a specialist without a referral.

The requirement is new as of January 2006, one of the most visible and significant of a package of reforms passed in 2004. If you're covered under French Social Security, the process is relatively simple.

Before and after

Until this law kicked in, anyone covered by French Social Security could go to any doctor at any time.

The system had the virtue of simplicity, but encouraged abuse by letting patients consult with several doctors at a time without any coordination of treatment, prescriptions, etcetera.

The new law is intended to reduce costs by requiring patients to pick a primary doctor whose responsibility is three-fold: to draft a plan, parcours de soin, for a patient's treatment, both preventative and curative; to maintain records of that treatment; and to refer the patient to specialists as needed.

As of the end of December 2005, roughly 34 million people had already picked their primary doctor; almost all of the chosen doctors are general practitioners, although this is not a requirement.

As of now, everyone is supposed to have filled out a form naming their médecin traitant to continue to continue to be reimbursed at the normal 70 percent level; EUR 1 of every reimbursement payment is also now set aside as a kind of national health tax, with a cap of EUR 50 per person annually. (This means your reimbursement payments should equal 70 percent minus EUR 1.) Woman pregnant beyond the six month and children under 18 are exempt from this EUR 1 tax.

Anyone who does not signed up with a primary doctor is eligible for only 60 percent reimbursement (minus EUR 1); but, watch out, you may not be reimbursed at all by either Social Security or even private insurance for treatment by a specialist without a referral.

Any treatment by a specialist, médecin correspondant, must be coordinated by your primary doctor. While the floor for an office consultation with your primary doctor is still EUR 20, this increases to EUR 27 for a médecin correspondant, but this will still be reimbursed at normal levels if you have a referral.

A hospital visit now costs EUR 15 a day (up from EUR 14 in 2005) or EUR 10 a day in a psychiatric facility; expect this figure to go up by another EUR 1 day in 2007.

The exceptions

There are some cases when it's permissible to skip the call to your primary doctor:

  • for emergency medical care either at home or while travelling
  • when you're travelling in France or abroad or your primary doctor is unavailable (on vacation, for example)
  • an appointment with a gynaecologist, ophthalmologist, psychiatrist, neuropsychiatrist, neurologist or dentist. These doctors can refer your records back to your primary doctor, but only with your consent.
  • parents do not need to fill out forms for children under 16

The paperwork

If you still need to take care of this, first you must pick a doctor, any doctor, as long as he or she is conventionné, which refers to a kind of licensing system that doctors voluntarily enter into with the state. Most doctors have signed a convention, but it's worth asking the question if you want a non-general practitioner as your primary doctor.

The form you need is S3704, which you can download from the Assurance Maladie en Ligne website. It must be signed by both you and your doctor and submitted to your local CPAM office.

The Assurance Maladie en Ligne website explains the law thoroughly; you can also download more information in English.

You have the right to change your primary doctor at any time for any reason but, of course, will have to fill out the form again with your new doctor.

 

For the time being at least, this change does not involve trading in your carte Vitale; your records will automatically be updated after the form is processed.

Next up: the new carte Vitale

With the primary doctor system instituted as the first step in a more general reform, the next phase will start mid-2007 with the creation of dossier médical personnelle.

Your carte Vitale is already used to track all of your medical expenses, but the personalised medical record will go the next step to creating an electronic medical history documenting all of your conditions, allergies, prescriptions, tests, etcetera.

Since the key to accessing all this information will be, again, the carte Vitale, there has been much concern about possible invasions of privacy; to address these concerns, next year you'll be asked to obtain a new, ostensibly more secure version of the carte Vitale.

Your medical history will not actually be stored on the card but in databases on government computer servers; the card will simply give the code to your file and contain some basic medical information for emergency treatment like your blood type or if you have any chronic conditions that an emergency room should be aware of, like diabetes. 

UPDATED April 2008

Copyright Expatica

:



0 reactions to this article

0 reactions to this article

Discussion Forums

Jobs in France

IFAs / FSIs / Country Managers / Confidential Introducers

Immigration and Legal Problems

Blocked Sewer Line outside property boundary - who pays ?

Sporting Events in France

Counter Strike!

Community Noticeboard France | Expat Events

migration to belgium!

Americans in France

Expatriate Events in Paris

participate in the forums

ask your question
find the business you need
Inside Expatica
Management culture in France

Management culture in France

This handy guide from Expertise in Labour Mobility includes information on business hierarchy, negotiations, and etiquette.

American associations and clubs in Paris

American associations and clubs in Paris

A listing of organizations in the Paris area that cater primarily to Americans living in France. Updated April 2011.

British associations and clubs in Paris

British associations and clubs in Paris

Our handy guide to the British community in Paris, from cricket clubs to Scottish country dancing lessons to where to find a jar of Marmite.

Anglophone services in France

Anglophone services in France

Here's a short introduction to our Banking section for those living in France, from how to open a bank account to Islamic banking and investments.