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Social security - how does it work in France?

There is a lot of paperwork to be taken care of when you first arrive in France! To make your arrival easier and guide you through the jungle of the French administration, here is some information on the French health care system “Sécurité Sociale”:

Publication : 30/11/2018
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The CPAM (Caisse Primaire d’Assurance Maladie) is the organization to which the scientist can request social security benefits. With this organization, a part of medical costs will be covered. The rate of reimbursements varies according to the medical service practiced, but in general, coverage is usually around 60 %. For medicine purchased in pharmacies, coverage can vary from 15 to 65%.

Once the registration request has been made, the CPAM sends a form to the applicant to create the Vital Card (la Carte Vitale). This form must be returned with an official photograph and a copy of proof of identification. With this card in hand the holder is guaranteed reimbursement within five days. One simply needs to show the card to the health professional or pharmacist.

While waiting for this card, the scientist can see a doctor and ask for a receipt (feuille de soin) which will then need to be sent to the CPAM for reimbursement.

For the best reimbursement, the scientist must declare the doctor to the CPAM. Not all general doctors practice the same fee rates and this depends also on which sector they practice. For example, the CPAM reimburses 16,50 € (or 70% of the official rate of 25 € miuns 1€ ticket modérateur) per consultation with a general doctor, whether he/she is registered in Sector 1 or sector 2. The registered doctor in Sector 1 applies the conventional rate fixed by Social Security, that is, 25 €, while Sector 2 doctors apply their own fees. Any over charge is not covered by the CPAM which calculates the reimbursement based on the conventional rate. Therefore it is important to declare the doctor at the CPAM and to refer to the health guide to find a Section 1 conventional doctor near one’s domicile in order to avoid higher rates.