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What are the social health insurance systems in France?
France has a universal health insurance system.
As former President Nicolas Sarkozy said, France has “the best health insurance in the world”, which guarantees everyone the right to health care. Regardless of age, income, and personal health status, all legal residents of the law, if they do not have other forms of medical insurance, can participate in universal health insurance to obtain medical coverage.
If you study in France for more than three months, those under the age of 28 must participate in student medical insurance, which is a social security system specially set up for students. If you are over 28 years old, you need to apply for French national health insurance or social insurance.
To participate in the student medical insurance, in addition to the age requirements, the following conditions must be met: the school is a French higher education school recognized by the student social security department; the legal residence certificate in France must be obtained; the course must be longer than three months.
If you are studying in a private school in France, such as a language or literary school, or another school that is not recognized by the student social security department, you can buy medical insurance through a private insurance company.
If you meet the conditions for participating in student medical insurance, you must pay both tuition fees and student medical insurance premiums at the time of school registration, and choose a student medical insurance company recognized by the social security department as the management agency for reimbursement of medical expenses. When registering, you need to provide documents such as passport, personal bank account number, residence permit in France, and birth certificate.
After registering with the insurance company, you will get a certificate of participation in medical insurance, and you will reimburse the insurance unit for medical expenses with this certificate when you see a doctor. After passing the application, you will also receive a social insurance medical card. Show the card when you see a doctor and buy medicine, and the Medical Insurance Bureau will automatically remit the reimbursement to your bank account.
Under normal circumstances, you must live in France stably for more than three months and obtain a French residence permit before you can apply for national medical insurance. Those who have lived in France for five consecutive years automatically obtain the right to enjoy national medical insurance. Until then, the approval of applications for universal health insurance was up to the regional social health insurance bureaus.
Universal medical insurance is divided into basic universal medical insurance and universal medical supplementary insurance for low-income people.
The basic universal medical insurance CMU-B is not completely free, and premiums are paid based on income, which are usually paid quarterly.
The French government has specially set up preferential insurance for low-income people, namely the universal medical supplementary insurance CMU-C. If your income is below the standard, you can get Medicare Supplement for free, and post-visit medical expenses are 100% reimbursed according to the approved reimbursement price set by the Bureau of Insurance.
The application requirements for CMU-C are more complicated. You’d better consult your local health insurance bureau about how to assess your family income and whether you meet the application criteria.
Under normal circumstances, after the application is approved, you can use CMU-C insurance to see a doctor and buy medicine within one year. The Medical Insurance Bureau will review your income and insurance eligibility within 12 months after you obtain this qualification, and decide whether to extend the insurance. The government adjusts the standard line of income for participation every year.
In France, about 80% of people participate in the general health insurance system through work.
If working in France, employers must take out social insurance for their employees, regardless of whether they are French citizens.
General employees pay about 60 to 70 percent of their salary income as social insurance funds, of which individuals pay 25 percent and employers pay about 35 to 45 percent. These expenses are deducted directly from wages.
Social insurance includes various benefits such as medical treatment, work-related injury allowance, maternity allowance, family allowance, unemployment, pension, etc. Medical insurance is one of the important benefits. Medical insurance premiums are shared by the individual and the employer.
Employees need to pay about 0.75% of the total salary, and then the employer pays 12.8% of the total salary as medical insurance premiums.
After participating in social insurance, you can get the protection of medical insurance, and part of the medical expenses will be reimbursed by the Social Medical Insurance Bureau when you see a doctor. But participating in social medical insurance does not mean that you can see a doctor for free. The Bureau of Medicare sets charges and reimbursement rates for each medical service.
For example, GP clinics are reimbursed 70% by the Bureau of Medicare and 65% for most prescription drugs. Expenses that are beyond the scope of Medicare reimbursement must be paid by you.
After participating in social medical insurance, family members (spouse, children, parents, etc.) living together can also participate in social insurance as dependents if they meet the conditions.
If you open your own company in France or you are freelancers such as artists, you can join the insurance organization for freelancers and private business owners, which is managed by the Social Security Administration for independent practitioners. You must withdraw the corresponding amount from your income to pay social insurance.
If engaged in agricultural work, agricultural business and employed persons and their families join the basic medical insurance for farmers of the Agricultural and Rural Social Security Bureau. In addition, personnel and their families in special industries such as coal mines, railways and military personnel can join the basic medical insurance for special industries.
After registering with the French Social Insurance Agency, you will receive a social insurance medical card, which contains your personal medical insurance information. Show your health insurance card every time you go to a doctor’s office or hospital, and every time you go to the pharmacy to buy medicine.
Most clinics, hospitals and pharmacies in France have established a network with the Social Health Insurance Agency. After the patient sees a doctor, swipe the card on the medical insurance card reader, and the consultation information will be automatically sent to the CPAM, and the CPAM will directly transfer the reimbursed expenses to the bank account.
When using a medical insurance card, you still need to pay the medical expenses yourself first. The main function of the insurance card is to simplify the reimbursement procedures. After swiping the card, the expenses that belong to the reimbursement part of social medical insurance are usually automatically transferred to the bank account in a short period of time.
If you do not receive your own medical insurance card, or you do not bring your medical card when you see a doctor, you need to have a medical certificate issued by a doctor or pharmacist after seeing a doctor or buying medicine, and apply for reimbursement to the Medical Insurance Bureau with this certificate.
Social medical insurance and universal medical insurance can reimburse general outpatient, specialist, dental, hospital medical, maternity, laboratory examinations, imaging examinations, prescription drugs, physical therapy, as well as long-term care, psychiatric treatment and other medical expenses.
According to the medical service items, the Social Medical Insurance Bureau stipulates the charging and reimbursement standards, such as 70% reimbursement for outpatient clinics, 80% reimbursement for inpatient expenses, and 35% to 100% reimbursement for prescription drugs.
In France, all public medical institutions and most private medical institutions participate in the national public health system , and they agree to provide medical services at prices agreed with the government, called contract medical institutions.
A small number of private medical institutions set their own prices for medical services and are not subject to government restrictions. These institutions are called non-contracted medical institutions.
The cost of seeing a doctor in a non-contracted medical institution is often not reimbursed by social medical insurance, and only the medical cost of seeing a doctor in an agreed medical institution can be reimbursed by the Social Medical Insurance Bureau.
Before seeking medical treatment, it is best to first determine whether the doctor or hospital is a medical institution that is contracted by the Medical Insurance Bureau.
In addition, medical consultations are subject to the Coordinated Treatment Procedure for Disease in order to maximize reimbursement of medical expenses.
The French government implements a procedure for the coordinated treatment of diseases. Those who participate in French social medical insurance, national medical insurance or student medical insurance must choose a fixed family doctor as the first choice for medical treatment.
This role is typically undertaken by a GP who acts as a public healthcare ‘gatekeeper’, diagnosing and treating patients, and then the attending physician is responsible for referring you to other specialists or hospitals as needed.
CSR is a French medical institution that mainly serves Chinese people. It aims to help improve the quality of medical treatment, solve various medical and health-related difficulties caused by language communication and other problems, and help strengthen their health awareness and improve their health level.
The center is located in the Place de la République in Paris, with general practice, specialty and dentistry, and is adjacent to a professional medical photo studio and medical laboratory, which is convenient for various medical examinations. The institution also provides free medical and health consultation, insurance application, and appointment of expert physicians
