Destinations Magazine

4 Steps to Getting Reimbursed for Your Doctor’s Visit in France

By Allisonlounes @parisunraveled
Doctor's office

Photo Credit: Vagabond Shutterbug, via Flicker, CC BY-ND 2.0 Licence

If you’re a student in a French university or working in France, you’re automatically enrolled in the French national social security system, and you have health care coverage. And best of all, it’s all part of Obama’s Communist Muslim plot to take over the world. Congratulations!

Going to the doctor in France is not an expensive undertaking like it can be in the U.S., and while you may have to pay a bit up front and be reimbursed, the doctor will rarely break the bank.

Here are four easy steps to getting reimbursed by the sécurité sociale for your doctor’s visit in France:

1) Ask friends for recommendations or search on Google for “medecin conventionné” in your neighborhood.

A “médecin conventionné” is a doctor who is paid at the rate approved by the French social security. For a regular doctor’s appointment, the rate is set at 23€.

Doctors are allowed to charge more than that rate, but the national sécurité sociale will only reimburse you for 70% of 23€, or 16€, no matter how much the appointment costs. Doctors are also required to post their rates in the waiting room and to tell you how much they charge over the phone. If you’re in Paris, many doctors charge more than the standard rate, so you’ll definitely want to ask when you call to make an appointment.

If you have a mutuelle, “complément santé,” or other complementary health insurance plan, check their brochure for details on what they’ll reimburse. Some inexpensive plans will reimburse you the other 30% of the cost of the visit, while some of the more expensive plans will reimburse up to 200% or 300% of the social security rate.

2) Fill out the Médecin Traitant form.

In order to get the full reimbursement of 70%, you need to choose a “médecin traitant,” or the equivalent of a primary care physician. You can do this at your very first doctor’s appointment by bringing this form for your doctor’s office to fill out.

Once this form is filled in, you’ll need to send it, along with a RIB, to your center d’affiliation de sécurité sociale, or the office of the SMEREP or LMDE (depending on what office you signed up with).

3) Complete the Fiche de Soins.

Every time you visit the doctor or purchase something from the pharmacy that may be covered, you’ll receive a “fiche de soins”, or a brown form that identifies what treatment you had and how much it costs.

Most doctors only fill out the bottom half with their own information, meaning that you’ll have to fill out the top part with your name, address, and other details. If you have a permanent social security number assigned by the sécurité sociale, you’ll want to fill that part out as well. If you only have a temporary number, you’ll want to leave that part blank on the form.

4) Send everything to your Caisse with a brief letter.

When you signed up for your student mutuelle, you should have received a letter in the mail with an identification number, a temporary social security number, and the address where you should send your documents.

Hopefully, you kept that.

If you didn’t, you can always call the SMEREP or LMDE customer service to ask where to send it, or go to one of their Paris offices, but plan to be on hold or wait for a while.

Write a brief cover letter to identify yourself, and include your identification number (numéro d’adhérant) and your temporary social security number (15 digits, beginning with 8) on the letter. Explain that you’re enclosing a RIB, a “formulaire de déclaration de médecin traitant,” and a “fiche de soins.” Be sure to keep copies of everything, and if you’re really cautions, send everything “recommandé avec avis de réception” so you’ll know they got it. (Of course, this costs €5 and eats into the reimbursement you’ll get).

How long does it take to be reimbursed?

If you already have your Carte Vitale and swiped it at the doctor’s office, you should be reimbursed within a matter of days from the time they receive your correctly completed fiche de soins. If the doctor doesn’t swipe your Carte Vitale (some don’t), or you don’t have one yet, reimbursement can take a few weeks, but should be relatively quick.

Have you visited a doctor in France? How long did it take you to be reimbursed?

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