Does trying to figure out the French healthcare system give you a headache? Expatica's handy guide to healthcare in France will soothe those aches and pains.

Everyone has access to public healthcare in France, one of the best in the world

France offers a vast choice of general practitioners and healthcare specialists, part of its mammoth social security system which, although very expensive and a constant source of funding worry, is one of the finest anywhere.

French employees see about 20 percent of their gross salary, deducted at source, to fund the social security system, referred to as Sécurité sociale. A large part of this goes into public healthcare, to which every legal resident of France has access under the law of universal coverage, la Couverture maladie universelle. Indeed, this right to healthcare is a highly prized value of the French social model.

Anyone in France can consult any doctor or specialist, regardless of whether the patient is affiliated to the French social security system or has private medical insurance.

There are more than 3,000 hospitals in France, generally of the highest quality. Everyone has the right to emergency hospital treatment, regardless of their health insurance coverage, and for those who subscribe to Sécurité sociale it is partly reimbursed. In the case of minor injuries, you can also choose your own hospital and or emergency service.

Medical coverage: the State

If you subscribe to the French social security system, whether as an employee or self-employed, most of your healthcare needs will be partially reimbursed, albeit at different rates.

Generally speaking, Sécurité sociale refunds 70 percent of medical fees. Under new legislation, however, aimed at cutting health service costs, all patients are now required to register with a médecin traitant, a general practitioner or family doctor, in order to receive the full reimbursement.

You are free to choose any general practitioner you want and change them for any reason; the same is true with any specialists although if you want to be reimbursed for visits to any kind of specialist, your médecin traitant must first make the referral. (See "Picking a primary doctor in France" for more on how this works.)

The fees are set by the government for all doctors who have signed a contract with the Social security system, médecins conventionnés. (A médecin conventionné à honoraires libres is part of the system but is approved to charge different, that is, higher fees; these are usually specialists. A médecin non-conventionné is not part of the system and his or her fees will not be reimbursed.)

Gynaecologists, dermatologists, ophthalmologists, psychiatrists and dentists are all also covered by the state without referral by the médecin traitant; minor children can also visit any doctor without a médecin traitant.

If you have a medical problem that may need specialist treatment, it is generally necessary to be referred for this by the médecin traitant in order to be eligible for are reimbursement, for example with physiotherapy, laboratory examinations or X-rays. It's always best to check first about coverage for any non-emergency treatment.

Medicines and drugs are refunded by Sécurité sociale on varying scales, from 35 to 65 percent; many pharmacies will now offer you generic versions of brand-name drugs that may not be covered by Sécurité sociale.

Medical coverage: private insurance

To make up the difference of what the State does not cover, it is common in France to also subscribe to a private medical insurance policy, mutuelle.

Medicines and drugs in France are refunded from between 35 percent to 65 percent

There are dozens of mutuelles, some of which are specific to types of profession and some of which cater to English speakers. If you're an employee of a company, most likely you will be able to join the company's policy as part of your benefits package.

Most of these companies will reimburse the remaining 30 percent of your general healthcare costs, including emergency hospital treatment. Consult your policy, however, to verify the details of what is covered and at what rate.

If your income falls below a certain ceiling and do not have a mutuelle, you are also eligible to complementary state-funded healthcare, CMU complémentaire, that will pick up what regular reimbursements do not.

There is no state coverage for consultations with psychologists and psychoanalysts, osteopaths or chiropractors; again, consult your policy for coverage for any of these kinds of treatments.

For prescriptions, your mutuelle may also offer partial or total refunds depending upon your specific policy.

UPDATED September 2006

© Expatica France

Subject: Life in France, Survival Guide, healthcare in France, medical coverage in France, Sécurité sociale