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"Health care is expensive!" False! With the right information you can have affordable health care
How are health costs determined?
No matter which health professional you see, from general practitioners to specialists, hospitals and pharmacies, this will involve health expenses, and aside from some cases of hospitalization which are 100% covered by the Assurance Maladie, health expenses are almost always split in two parts:
- The so-called "mandatory" portion
("part obligatoire"): this portion is covered by the Assurance Maladie;
- The co-payment, also called "ticket modérateur": this is the portion you will have to cover yourself, so be sure to read the following paragraphs!
100% health care offer
What is it?
An offer that gives you access to quality prescription glasses, hearing aids and dentures, fully covered by the Assurance maladie and your mutual health plan.
Who can benefit?
All people with complementary health care or complementary health responsible (i.e. almost 95% of market contracts). If in doubt, do not hesitate to question the complementary organization that covers you.
Prescription glasses fully supported
Since 2020, all opticians in France should offer you:
• At least a choice of 17 glasses frames in several colors,
• And treating glasses for all visual corrections,
100% reimbursed by the Assurance maladie and mutual health plans.
Options to cover or help you cover your co-payment, the "ticket modérateur"
► If you are seeing a health professional (gynecologist, ophthalmologist, optician, dentist, etc.), you may take out supplementary health insurance with a supplementary health insurance plan or a health mutual: you will pay an annual contribution to these organizations, and in return they will cover the co-payment, in part or in full, depending on the plan you have chosen.
► If you regularly see a health professional but you cannot afford supplementary health insurance within your budget, you have two options:
Complémentaire santé solidaire
Starting on November 1, 2019, the CMU-C and ACS merge to give way to a simpler device: the Complémentaire santé solidaire (financial help to cover your health expenses if you are on a tight budget). This allows access to quality care without dependents, for no or limited financial participation.
Find out more (FR)The choice of a “Sector 1” or “Sector 2” contracted physician will determine your costs
Health professionals who are sector 1 contracted charge the fees set by an agreement with the Assurance Maladie, also known as the “tarifs de la Sécurité sociale”. Physicians who opt to set their own fees are sector 2 contracted, which means that they can charge excess fees (“dépassements d’honoraires”) which are not reimbursed by the Assurance Maladie (but which may in some cases be covered by your health insurance company or your health mutual, depending on the plan you have selected).
Good to know!
Before scheduling an appointment, check which sector the health professionals have contracted on the ameli.fr health directory.
The "M'T Dents (Love your teeth) scheme
“M’T Dents” is a meeting of oral prevention offered, every three years until you reach 24. During this visit the dentist:
• Checks the health of your teeth and gums,
• Gives you advice on how to take care of your teeth,
• Offers one or more new appointments if your teeth need to be treated.
This oral examination and preservative care is covered by the Assurance maladie and is free of charge for you.
► Find out more