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The health insurance system in France: Carte Vitale, Mutuelle and Prévoyance

Have you ever been to the jungle? Then you will definitely think back to it when you find yourself take out health insurance as a newcomer to France want. So that you don't get stuck in the lianas, stumble over roots and afterwards between all of them Mutuals and Prévoyances, the CPAM, the RSI and a thousand other abbreviations completely lose their bearings, we explain the jungle of the in detail and clearly to you French health insurances.

1. The health insurance system in France

First of all, let me say something encouraging: If you are in the French health insurance system everything is straightforward, and the The quality of the services is very good.

To yourself as a German in the French health insurance system To get your bearings, you should first find the institutions that are relevant to your case before you set out to work your way through the, unfortunately, fairly common one Mountain of forms to rummage. So make sure you start in the right place too.

French health insurance includes several state institutions. This is primarily about that Régime General, the Régime Agricole for the Employed in agriculture and the Régime Social des Indépendants (RSI) for freelancers.

They are three main categories, and one of these routes you will most likely choose when you ins French social security system enter. The umbrella term for these categories is Régime Obligatoirebecause it is legally compulsory to join one of these health insurances (or one of the separate Regimes e.g. for employees of SNCF) to be.

The Régime General in the French social security system

In all likelihood it will Régime General concern how almost 90% of the French. It includes all persons who are are employed and reside in France are.

But it is not like in Germany that you are opt for health insurance, There deposit and afterwards from this - according to your contract - the Services get reimbursed. Instead, you get the Régime General of the CPAM (Caisse Primaire d'Assurance Maladie) - depending on the performance - as a rule 70% of medical costs and expenses Refunded for prescription drugs. In exceptional cases (dental costs, operations, hospitalization, ...) this can be Régime General up to 100% of the cost take.

Both prescription drugs there is a division into different categories leading to the following Principle of assumption of costs to lead:

  • White vignette: 65 %
  • Blue vignette: 35 %
  • Orange vignette: 15 %

The Employer and employee contributions for the Régime General are deducted directly from the gross salary as a percentage. You will be sent to the URSSAF (Union du recouvrement des cotisations de sécurité sociale et d'allocations familiales) paid.

The Own contribution, which may not exceed € 50 per year in total, is included € 0.50 per medication package, 1 € per treatment, € 2 per ambulance and 18 € per day for a hospital stay.

Source: CNAMTS - GIE SESAM-Vitale

2. The key to French health insurance: Carte Vitale

As a foreigner without a French health card you get when you visit a doctor for the first time in France form (fiche de soins), which you have to sign and send to the health insurance company. Do you have to do that every time? No! One can Carte Vitale apply for, on this one stands Your social security number, and it is used in medical practices - as in Germany too. Of the Application until receipt However, up to two months can pass ... In the jungle, you don't get ahead that fast.

If you are under that Régime General fall, you can die Carte Vitale at the responsible CPAM, i.e. at the CPAM Of your department, request. To do this, you need to submit a completed application form and several documents.

"Will you give me your social security number, please?" The question you get asked very often in France ... So when it comes to your health insurance, you should Have your health insurance card readythat has this number on it. She will give you individually assigned and remains the same throughout her lifeas in Germany.

3. Mutuelle Santé, Prévoyance and automatic co-insurance

The Mutuelle Santé

So now you come as a freshly baked, but slightly cold owner of one Carte Vitale with a runny nose to your new French family doctor and of course assume that you no longer have to pay anything. But there are still the mysterious percentages mentioned above, which are usually not covered by the statutory health insurance become. Usually it is for general practitioners around 40%.

At this point you should get his Attestation du tiers payant from his Mutuelle pull out. You are free to choose these, and they are not obligatory. Common ones Mutuelles Santé are for example:

But there are numerous other such institutions. In the real sense it is not about insurance, but about non-profit partnerships.

The choice of Mutuelle

Depending on the contract concluded takes over Mutuelle the remainder of the cost of your visit to the doctor in part or in full. You can use your Mutuelle Choose yourself or take the ones that your company offers you (APICIL e.g.). Your employer is legally obliged to do so. You are again obliged to choose this, unless you have already done one Mutuelle or another exceptional case applies to you. A Complémentaire Santéis the same as oneMutuelle Santé.

While the Contributions to the Régime General depend on salary, will be the amount of payments for that Mutuelle usually ever according to age and selected health services set.

You might be surprised in that list ofMutuelles Santé unable to find the following well-known names:

These belong to one other category ofMutuals on, namely the Mutuelles d'Assurance. These originally offered exclusively Vehicle and home insurance at. Little by little, however, they have expanded their range and are now also offering Supplementary health insurance, Savings accounts etc. at. You, too, are non-profit institutions that differ from the Mutuelles Santé through their wider range and their different legal basis (Code of Assurances) differ.

The Prévoyance

A another type of insurancewho have favourited you voluntary You can also take out additional insurance to complete your French health insurance as a foreigner Prévoyance. This includes the Payments into pension schemes in the event of death or disability. Again, the Employer one Prévoyance complete for you, or you can choose yourself. Both Mutuelles d'Assurance the offer often also includes Prévoyances.

Automatic co-insurance

As a holder of a French health insurance, you can have certain Co-insure people, namely the Spouse, a person with whom you can be in one marriage-like relationship lives together (PACS) or people with whom you can has lived together for over 12 months. Also other family members or household members can also be insured.

4. The European health insurance card

An important Difference to the German system of health insurance is that you will not find the European health insurance card on the back of your insurance card - as in Germany - but this one separately at a switch or at a machine in the entrance area apply for have to. If you want to go to a counter, you should plan a little more time, as there are often longer waiting times. You will receive one straight away provisional document, which you can present when you visit a doctor until you receive your card in the mail.

5. General practitioners in France

your Family doctor (general list) You can also choose freely in France, but in the French health insurance system you have to fill it in with your statutory health insurance Déclaration du médecin traitant notify. This is very important as the refunds otherwise not or only to a limited extent become. The form must signed by your GP and yourself become.

Don't be surprised if your family doctor answers the phone himself when you call and none of his employees: Usually do Doctors in France no medical assistants or receptionists.

You might even want to Keep your German doctor? It is possible to get his expenses for Refund treatments in other European countries allow. All you have to do is present your European health insurance card when you visit a doctor, e.g. in Germany. For your doctor, however, this means extra effortwhich is why it is best to speak to him about this matter in advance. Of course it can very advisable in emergencies to have a doctor you trust on site.

For your choice of doctor, it is useful to know that in France there are two categories of doctors in France:

  • Médecin conventionné: bound by collective agreement
  • Médecin non conventionné: French health insurances will not, or only to a very small extent, cover fees

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