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European Card for Sickness Insurance
In case of medical care need when abroad in Europe, it allows European members to get refund for their medical expenses, according to the legal arrangement in the visited country.
It replaces the E111 form and other European forms (E110, E119, E128) used for short term visits in European countries. It is an individual card with your name, and each family member should have one (including children under 16). It is valid 1 year and free.
The card is not given automatically: you will need to ask your social security centre a few weeks before the departure.
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Operation of the French health insurance system is
based in the following two important principles:
1- You
are free to consult the health professional of you choice:
general practitioner (médecin généraliste), specialist,
dentist, laboratory, medical auxiliary, nurse (infirmier)…etc.
2- The patient will generally
pay for the treatment and the health professional gives
him a treatment form (feuille de soins). However, in
some cases, national or local agreement grants exempt
from paying treatment in advance, particularly in the
case of hospitalisation.
Therefore, when you ask for a benefit
either you show your insurance card and you will only
pay the minimum amount at the doctor visit, or you will
pay the global amount (20 € for a GP) and
will ask for a refund later.
In order to obtain medication prescribed
by your physician, you must give the pharmacist your
prescription and the treatment form. The adhesive stickers
(vignette) from the medication boxes must be stuck on
the treatment form as proof of purchase. You
will then post the request to you social security centre
(CPAM – Paris from your area). It takes usually about
1 month to get the refund.
For hospital benefit, you might pay only the minimal
amount by giving you insurance number.
Below is a short indication of some refund rates:
| |
Basic Cost |
Refund /direct payment by CPAM |
| GP, dentist |
20 € for a GP visit |
70% - 14 € |
| Specialist |
23 € |
- |
| Medicines |
|
65% (white sticker) / 35% (blue sticker) |
| Hospital |
|
80% |
| Dentist care |
|
2.3 € |
| Glasses |
|
2.8 € |
There are physicians or hospital centre who have signed
agreements with the Social Security, whose fees are
fixed by the agreement, and other practitioners, also
bound by agreements, who are authorised to exceed the
fixed rates (the surcharge is not reimbursed by the
Social Security). Additionally, there are physicians
or private hospital that have not signed agreements
and the refund is very low.
The ticket modérateur is the
basic part paid by the patient and non-refundable, and
varies according to benefit and personal situation.
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