The French National Health service works by patient payment and state reimbursement plus voluntary insurance.
What is a Carte Vitale?
If you are an expat in France and qualify to register with the French National Health service you will be issued with a Carte Vitale, a plastic “payment” card together with an “attestation” – a certificate of your medical entitlements. The Carte Vitale is a State health insurance card.
How long does it take to get a Carte Vitale?
Technically you should receive your Carte Vitale within a few weeks of registering but frequently it takes longer. It depends on where you are registering and can take several months and in extreme cases over a year and even longer.
While you are waiting for it you will need to keep all of your medical receipts (feuille de soins) in order to claim reimbursement.
If you are moving to France and know that you will need medication, try to get additional supplies from your own doctor before you leave your home country. Also when you register for French National Health service care at the CPAM (the organisation which administers state health care in France via a network of local offices), tell them that you need medication and they may try to help you with processing your card.
You may be issued with an “attestation” whilst waiting for a Carte Vitale. The “attestation” is a paper record of your medical rights and entitlements and can be used in place of the plastic card. The temporary “attestation” will have an expiry date – make sure that you renew it before it runs out. A visit in person to your CPAM office will often mean that you get a replacement quicker than if you make a phone call or send an email or fax. You can claim reimbursement with the “attestation” through the post.
When you receive your Carte Vitale proper, you should also receive an updated “attestation”.
How does a Carte Vitale work in France?
A Carte Vitale will need to be presented to your doctor, consultant, pharmacist etc and contains your social security insurance details. They may also ask to see your “attestation” (as above).
Children under the age of 16 will not be issued with a personal Carte Vitale – they will be included on their parent’s card.
The card has a microchip embedded and when you present it to your doctor, pharmacist etc. they will swipe it enabling reimbursement to you without a paper based claim. You will still need to pay the doctor’s fee at the time.
If you have voluntary (“top-up”) insurance, using the Carte Vitale will mean that reimbursement from your insurer will be automatically made as applicable.
You need to take the Carte Vitale with you for all medical treatment.
Reimbursement of funds normally takes around 5 working days.
Sometimes there may be a shortfall in reimbursements from the State insurance system due to “dépassements” – excess medical charges. You can check with your insurer to see if they will cover the costs but this isn’t always the case and patients sometimes have to carry the cost personally. This is happening more often as the French Government attempts to pass costs on.
If you do need to make a paper based (postal) claim then you will need your attestation. If for any reason you do not have your Carte Vitale, the attestation can be used instead and some specialists will not accept a card without it. The Carte Vitale acts like a payment card but the paper attestation is confirmation of your existing rights and entitlements and the card is worthless without it.
CPAM, the administration offices of the French National Health service arm that includes expats has an English speaking helpline and they may be able to help you if you have difficulties or questions: 08 11 36 36 46
The English language CPAM helpline office is based in Normandy and staff have access to local records but outside of the region they may need a few days to access paperwork in order to help you.