Health Treatment Charges 2025
26th Nov 2024
The government has announced a reduction in the reimbursement rates for health treatment.
To read the article you can take out a premium subscription for €25/YEAR at Subscribe to France Insider.
A premium subscription will also give you unrestricted access to the complete back catalogue of our articles.
You can see the full catalogue at France Insider News.
If you no longer wish to hear from us simply unsubscribe using the link below.
Enjoy your reading,
The Team at France Insider
Health Treatment Charges 2025
26th Nov 2024
The government has announced a reduction in the reimbursement rates for health treatment. UPDATE: The government have since announced they will not proceed with this measure. 2nd Dec 2024
Although France has a national health service, the State does not cover all the costs of health treatment.
The system is complicated, but, broadly speaking, most routine costs are reimbursable at the rate of 70%, hospital costs at 80% and prescriptions normally 65%. Major illnesses (Affection de Longue Durée - ALD) are covered 100% and low-income households can also obtain 100% health cover. For a full description you can read our guide below.
For those costs not covered by the State, most households have complementary insurance cover (mutuelle, complementaire santé). Those who do not have a health insurance policy meet the costs directly.
With the public purse in a parlous state, the government has been obliged to find budgetary savings for next year.
As a result, last week the Health Minister Geneviève Darrieussecq announced that the reimbursement rate for medicines and medical consultations will fall by 5% percentage points in 2025.
In concrete terms, this means that the coverage by the State for routine medical consultations will be reduced from from 70% to 65%. For a consultation with a general practitioner at €30 (the rate from 22 December 2024), next year the social security system will reimburse €17.50 (€19.50 – €2 flat-rate patient contribution), instead of €19 (€21 – €2 flat-rate contribution) and the share to be paid by the the complementary health insurers will increase from €9 to €10.50. For patients who do not hold a health insurance policy, the amount directly payable will be €12.50 (€30-€17.50).
Only patients with long-term illnesses (ALD) will continue to be fully reimbursed, beyond the flat-rate contribution of €2 on each consultation that is payable by all patients. Hospital rates also remain unchanged.
For prescription medicines, the main three existing reimbursement rates – 65%, 30% and 15%, depending on the medical efficacy – will be reduced by the same proportion, to 60%, 25% and 10% respectively.
For example, for a medicine that is currently reimbursed at 65%, costing €7.95, the social security system will reimburse €3.77 (60% minus the €1 patient contribution). That leaves €3.18 to be paid by the complementary insurer, or €4.18 to be paid directly by the patient.
As these changes can be implemented by decree, there is no need for parliamentary approval.
The anticipated savings are estimated at €900 million.
As the reduction in reimbursements levels will lead to a transfer of the burden to complementary health insurance companies it is inevitable the insurance premiums will increase, in addition to any increase that would otherwise have occurred. The association of mutual insurres, the Fédération nationale de la mutualité française (FNMF), have warned that complementary health insurance companies will "automatically increase their contributions and, at the end of the day, it is the health users who will pay".