Coordinated care system
Your first step to obtaining health care in France is to choose a primary care doctor, whom you will contact for your regular medical needs. They can be a generalist or a specialist who sees you for regular check-ups, keeps track of your medical care, and refers you to other health care professionals as needed.
Coordinated care
Before you can see a medical specialist (e.g., cardiologist, allergist, physical therapist), you must get a referral from your primary care doctor. This is called the coordinated care system (parcours de soins coordonnés), and it ensures that your medical expenses will be reimbursed.
If you see a specialist directly instead of being referred by your primary care doctor, you will be reimbursed a smaller amount by the public health insurance plan and will therefore be required to cover a greater percentage of your expenses. There are some exceptions to this rule. For example, you do not need a referral to consult ophthalmologists, gynaecologists, stomatologists, psychiatrists, dentists, or midwives.
Designating a primary care doctor
Once you have chosen a primary care doctor, you can declare your choice online, if your doctor is equipped to do so. During an appointment, you present your carte vitale to the doctor. They will submit the declaration online, and it will be immediately transmitted to your CPAM. The process is quick and easy: there are no forms to fill out or paperwork to send in. Your choice is recorded automatically.
If your primary care doctor is not set up to submit online declarations, you will need to submit your declaration by mail.
- Complete declaration form S3794 (Déclaration de choix du médecin traitant)
- Then, both you and your primary care doctor must sign it
- Send the form to your CPAM
Making an appointment
There are two ways to find a health professional and make an appointment with them:
- You can use the Ameli health directory to identify someone who meets your needs and make an appointment by phone
- You can use a website such as Doctolib or Allodocteur (in French)
You can also schedule a video consultation using sites such as Qare and Livi.
Cost of health care
The public health insurance plan has a set fee schedule for different categories of health care. For instance, doctors charge rates that vary according to their field of specialty and whether or not they respect the government’s established price caps. If they do respect the caps (i.e., they charge the conventional tariff), they are called conventionné. If they do not (i.e., they set their own rates), they are non conventionné.
Health professionals fall into one of three categories:
- Conventionnés de secteur 1: Health professionals who offer services at the government-established rate. For example, general practitioners in this group charge €30 for a consultation, of which €19 is covered by public health insurance (70% minus a €2 deductible).
- Conventionnés de secteur 2: Health professionals who offer services at a rate slightly above the government-established rate (dépassement d’honoraires). For example, general practitioners in this group might charge €35 for a consultation (€30 + €5 extra). Public health insurance still only covers €19.
- Non conventionnés: Health professionals who set their own rates. Regardless of the amount charged for a consultation or services, you will be reimbursed based on the government-established rate for this group (e.g., €0.43–0.61 for a consultation with a generalist practitioner or €0.85–1.22 for a consultation with a specialist).
If you have a long-term medical condition, then the social security office may cover 100% of any related care costs. To access this coverage, your primary care doctor must submit an application listing your specific treatment needs.
