STATE HEALTH SYSTEM in France
While there may be universal health cover in France, the social security ( CPAM or RSI/TNS ) will only reimburse a percentage of your medical bills. The percentage level of reimbursement will depend on the type of treatment received and from whom. The GP and basic health care fees and reimbursement levels are straightforward; however specialist services can be more expensive and complicated. The social security will normally pay 70 percent of GP fees and 60 percent of prescribed medicines. Major illness or someone on a low income covered by CMU it will reimburse almost 100 percent of the costs. ( It doesn’t mean that you will be fully reimbursed )
If you want to be fully insured and have most of your medical bills reimbursed, you will need to take
out a “Top up “health insurance cover.
This additional cover depending on the level of cover you choose will reimburse that part of the cost not paid for by the social security system. The more expensive the bills are, the more important it is to have a Top up health insurance or Mutuelle in French.
DOES IT MAKE SENSE TO TAKE OUT SUCH A POLICY?
In considering this question, remember that whether you are retired or you run your own business in France, the French social security system reimburses only a proportion of your health charges, around 70% for routine treatment. However, in the case of major or long term illness, your costs are covered at the rate of 100%. Moreover, not all major illnesses are covered at the rate of 100%.
The list of such illnesses is strictly defined in law and there are many costly medical treatments not on this list. There is also a need to consider your age and medical circumstances. Most expats who relocate to France are aged 50+, with medical needs that are likely to reflect this level of seniority.
You may also find it more difficult to get voluntary insurance the older you become.
Accordingly, it is by no means self-evident that not taking out a top-up health policy makes economic sense. Aside from the cost, you also need to consider the psychological benefits of having full cover, giving you the peace of mind you may need to enjoy your life in France.