Living in the Languedoc: The Medical System: Who Pays ?
The Sécurité Sociale deals with the reimbursement of medical expenses; medical fees and also with salary compensation in the case of maternity and invalidity. (It also covers pension costs in the case of retirement.)
Your Sécurité Social card is a form of medical insurance, but it only provides for a partial reimbursement based on a detailed scale.
The rate of reimbursement depends on the type of treatment received.
The spouse and children of the insured are covered automatically.
In most cases, additional coverage applies to people living in "concubinage" - partners who are often referred to in the UK as "common law spouses"
Others may be eligible to benefit from the coverage, as long as they are genuine dependants, living under the same roof as the insured person.
Medical services are reimbursed when prescribed by a physician, for example X-Rays, sonograms, MRI scans, therapies (eg physiotherapy , speech therapy) and lab work (such as blood and urine tests.), etc.
The majority of doctors and dentists are "conventionnés" (government-approved). This means they have signed an agreement with the Sécurité Sociale.
This agreement sets an upper limit to their consultation fees.
Doctors and dentists who have not entered into this agreement are "non-conventionnés". They are free to set their own fees (honoraires libres), which often exceed the limits defined by the Sécurité Sociale.
"non-conventionnés" doctors correspond to private doctors as opposed to NHS doctors in the UK. They represent only about 1% of all doctors in France.
Even so, it is a good idea to check the status of a doctor before making an appointment; otherwise you may not be able to claim reimbursement from the Sécurité Sociale for the doctor's fee.
To find your local Sécurité Sociale you should look in the yellow pages.
|
|
Back to: Medical Emergencies
|
|
Next page: Reimbursement of Medical Costs
|
|