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Health Insurance

cpam

In France, health insurance is indispensable to cover various types of medical care (consultations, hospitalization, medicine...). To be well-covered, the scientist can:

  • according to his/her professional situation, country of origin and length of stay subscribe to French health insurance (CPAM/PUMA) – more information below  
  • Remain with the Social Security organization of one’s country of origin (verify coverage in France)               
  • Purchase private health insurance in one’s country of origin : this will not cover work-related  accidents            
  • Purchase private insurance in France : this will not cover work-related accidents.        

Note : Private insurance in France is generally more expensive than in other countries, the scientist should therefore compare with prices in his/her country.

 

How does it work in France ?

 

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 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.

 

Good to know : The Welcome Center has a partnership with the CPAM in Nice, allowing you to expedite the process. We can thus help you complete your files and submit them to the CPAM for faster service. Don’t hesitate to ask us.

 

The variation of procedures according to the situation of the scientist