In order for a person to receive medical treatment in France using the health insurance system they will need to have a ‘carte vitale’. This is also known as a green card and is given to all eligible residents who are aged 16 and over. This gives the holder the right to have health care costs refunded and will cover a range of medical services including treatment and examinations by doctors, fertility and maternity treatments, surgeries, hospital treatments, lab tests, physiotherapy, dental care and ambulance services.

This card does not have any personal medical information on it but it will need to be presented every time you have a doctor’s appointment or hospital appointment. Payments are made for medical treatment and you can expect your refund to come through within 5 days. It is paid directly into your bank account. Reimbursements are calculated according to your income level and the approved cost of treatments. There is no expiry date on the card but you need t ensure that it is updated once a year. There are terminals in town halls, hospitals and some pharmacies for this. If you do not have a carte vitale then you are given a receipt known as a ‘feuille de soins’. This is a legitimate receipt and can be posted off to the CPAM for reimbursement.

Finding a doctor in France that speaks English is fairly easy in the larger urban areas, although not so common in rural areas. Doctors work in practices and in larger towns and cities there will be several doctors working in the same practice. Doctors are not allowed to advertise in any way in France but they will be listed in the local yellow pages. Everyone who is registered with the social security in France needs to have a doctor as their medical practitioner (medecin traitant). This is advised but it is not compulsory. There are financial benefits to having a nominated doctor treating you. This is the equivalent of the British GP. If you should need further medical treatment from a specialist at a hospital you do not need to have a referral from your GP.

The doctor needs to agree to be the nominated attending practitioner. An individual can choose a general practioner, a specialist or a doctor at a private hospital or clinic. You must nominate an individual doctor though, and not the whole practice. When the doctor has been chosen both he and the patient need to complete the relevant parts of the Cerfa form ‘Declaration de choix du medecin traitant’. Both sign the form and it is stamped by the doctor and passed on to the CPAM. It is not compulsory for an entire family to have the same doctor. If you are under 18 years of age your parents will need to agree to your choice of doctor.

There are exemptions which will not bring any penalties when you see a different doctor. If your nominated practitioner is away then you can see a nominated substitute, specialist treatments do not require a visit to the nominated practitioner before each appointment or if you are away from home on holiday and need to consult another doctor. In these circumstances you should still get the standard rate of reimbursement.

There are not normally waiting lists for joining a health practice and appointments with specialists can also usually be arranged very quickly. If you need an appointment to see a doctor you simply phone the surgery and request one. You can normally get an appointment the same day if you call in the morning but at larger practices you may need to wait until the next day unless you are considered to be an emergency, due to the number of people who will be trying to get an appointment.

Doctors have to list their fees clearly and post them on the wall in the surgery. Some consultations will be reimbursed in full depending upon the circumstances. If you have dental treatment this is reimbursed at 70%. Children’s check-ups will qualify for a complete refund. You should be aware that children’s orthodontic treatments have to be approved in advance otherwise they will not qualify for a refund and reimbursements are only given when the complete course of treatment has ended.

The telephone number to contact a duty doctor out of hours is 15 (this is the same number used to call for an ambulance - Service d'Aide Medicale d'Urgence/SAMU - in an emergency).

Useful Resources

Alcoholics Anonymous – France
www.aa-europe.net/countries/france.htm

Drogue/Alcool/Tabac Info-Service (national 24-hour help-line for problems to do with drugs, alcohol or smoking)
Tel: 113

MILDT (the Inter-departmental Mission for the fight against drugs and drug addiction)
www.drogues.gouv.fr/bas-de-page/english-version/

Mission Interministerielle de Lutte contre la Toxicomanie (offers details of regional organisations offering treatment for substance abuse)
7 rue Saint George
75009 Paris
Tel: 01 44 63 20 50

Drug Info Services telephone help-line (free info on drug-related problems)
Tel: 08 00 23 13 13