Understand the French system
Unlike the English system, the French regime makes no difference between the public and private treatments (the reimbursement rates are identical).
On the other-hand, the ‘Sécurité Sociale’ alone does not cover the entirety of your expenses.
Frais Médicaux
The TOTAL amount charged for your treatment.
This can be a Fixed rate or an amount announced by a specialist.
Dépassement d'honoraire
Amount charged by a Doctor for time spent treating a patient.
A Doctor in "Secteur 1" will NOT charge over the"Tarif de Convention" and you will be totally reimbursed even on the lowest levels of Top-UP.
A Doctor in "Secteur 2" can charge over the "Tarif de Convention" and you will only be reimbursed if you have a higher level of "Top-Up".
You could be faced with "Dépassement d'honoraires" for a simple 15 minute Specialist visit or for 4 hours of Major Surgery.
Rates charged must be communicated in advance, get in contact with the administration if not.
Tarif de convention
Base rate given to medical treatment recognizable by a code that indicates its nature and tariff called “Nomenclature” fixed by the “CCAM”(Classification Commune des Actes Médicaux).
The “Tarif de Convention” fixes the 100% base rate that all medical professionals use but it does NOT limit their fees charged.
Top-Ups relate to the base rate and NOT to actual expenses
H.N.
Hors Nomenclature:
These are treatments that are NOT included on the “CCAM” list thus they do not have a base rate.
These treatments are often in addition to ongoing treatment.
The “CCAM” tend to exclude preventative medicines, "Médecines douces“ that have not been accepted by the “Académie des Sciences”.
Some Top-Ups reimburse thing like osteopathy and homeopathy using Fixed rates set by the companies called “Forfait Annuel”.
PART
Régime complémentaire
"Part Mutuelle". This is the amount paid on your behalf by a Top-Up.
"Dépassement d'honoraires" can be reimbursed by a Top-Up.
Top-Ups starts at 100% and can go up to 600% or more depending on your needs and especially what area you live in.
SOFICA’s sugests middle cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for the rest as some base rates are very low.
Ticket Modérateur
This represents the difference between your “Régime Obligatoire” reimbursements and the "Tarif de Convention".
This amount, normally reimbursed by a Top-Up will be reimbursed by your “Régime Obligatoire” in case of long-term illness, handicap or maternity.
The “100%” or the "TM" referred to on "Tiers Payant“ slips from Top-Ups will guarantee payment of the "Ticket Moderateur" to any professional accepting to use this facility without having to advance any money. .
PART
Régime Obligatoire
The Percentage of the "Tarif de Convention" that is covered by your “Régime Obligatoire”.
Usually these reimbursements come from "CPAM" or “RSI” if you are self employed.
Reimbursements range from 35% to 100% but are commonly referred to as 70% of the "Tarif de Convention".
Once fully into the French system you will receive a “Carte Vitale”.
This card replaces payment to medical professionals equipped with the “System Noemi”.
Examples of reimbursement:
Welcome Abroad clients benifit fully from the French system as we use French companies that know thier subject.
« Télétransmition »: Automatic reimbursements using only your « Carte Vitale ».
« Tiers Payant »: No money to be advanced at the chemist / lab / x-ray and more.
« Prise en charge »: Possible on demand even for Optical and Dentistry.
Hospitals stay expenses can be paid directly by your « Top-Up ». « Frais de séjours and chambre particulière »
Hospitalization / Hospitalisation:
The question of payment will come after your wellbeing
In an emergency situation, you will be taken care of regardless of your nationality, professional, or financial situation.PEC (Prise en Charge)
If you have a planned hospital stay or after emergency care, you may be asked for a “PEC.”- This document allows the hospital or clinic to claim the amounts due for your treatments directly from your « Régime Obligatoire » and potentially from your « Top-Up. »
European Health Insurance Card (EHIC)
- If you are in France on holiday, you may present your EHIC.
Required medical documents and information:
- Blood group card: « carte de groupe sanguin »
- Allergies: « Avez-vous des allergies? » or « Êtes-vous allergique? »
- Medical and surgical history: « antécédents médicaux ou chirurgicaux »
- Current treatment: « Quel est votre traitement actuel / courant / en cours? »
- Special diet: « Avez-vous un régime spécial? »
- No salt: « Sans sel »
- No sugar: « Sans sucre »
- Gluten-free: « Sans gluten »
KEY WORDS
USEFUL PHRASES
| ENGLISH | FRENCH |
|---|---|
| Aching | Douloureux |
| Ambulance | Ambulance |
| Anaesthetic | Anesthésique |
| Anaesthetic | Anesthésie |
| Ankle | La cheville |
| Appendix | L'appendice |
| Arm | Le bras |
| Assistant nurse | Aide soignante |
| Back | Le dos |
| Back of the neck | La nuque |
| Bedpan | Un bassin |
| Bell / buzzer | Sonnette |
| Bladder | La vessie |
| Blood | Le sang |
| Blood test | Prise de sang |
| Blood test (results) | Résultat sanguin, Bilan sanguin |
| Blood test to be taken fasting | Prise de sang à jeun |
| Body | Le corps |
| Bone | L'os |
| Bottle | Une bouteille |
| Bowels | Les intestins |
| Brain | Le cerveau |
| Breast | Le sein |
| Bruise | Un bleu / une contusion / un hématome |
| Burn | une brûlure |
| Burning sensation | Sensation de chaleur / douleur cuisante |
| Buttocks / bottom | Les fesses |
| Calf | Le mollet |
| Capsule | Gélule |
| Car accident | Accident de la route |
| Casualty / A&E | Urgences |
| Change your dressing | Faire votre pansement |
| Cheeks | Les joues |
| Chest | La poitrine |
| Chin | Le menton |
| Collarbone | La clavicule |
| Contraceptive pill | La pilule |
| Cough / a cough | Tousser / une toux |
| Covered in bruised | Être couvert de bleus |
| Crushed | Ecrasé / broyé |
| Crutches | Les béquilles |
| Cut | Coupe |
| Dizziness | Le vertige |
| Doctor | Médecin |
| Drawsheet | L’alèse |
| Dressing gown | Robe de chambre |
| Drink (A) | Une boisson |
| Drink (To) | Boire |
| Ear | L'oreille |
| Eat | Manger |
| ECG | Electrocardiogramme (électro) |
| Elbow | Le coude |
| Exhausted | Épuisé |
| Eye (eyes) | L’œil (Les yeux) |
| Face | Le visage |
| Face flannel | Un gant de toilette |
| Feel sick | J'ai des nausées / J'ai mal au cœur |
| Feel unwell / faint | J'ai un malaise / j'ai la tête qui tourne |
| Finger | Le doigt |
| Fingernail | L'ongle |
| Foot | Le pied |
| Forehead | Le front |
| Gall bladder | La vésicule biliaire |
| Get undressed | Déshabillez-vous |
| Grazed | Écorché |
| Gum | Gencive |
| Hand | La main |
| Have a wash | Faire sa toilette |
| Head | La tête |
| Heart | Le cœur |
| Heel | Le talon |
| High temperature | La fièvre |
| Hip | La hanche |
| Hospital gown (open at the back) | Casaque / blouse opératoire |
| Infection | Infection |
| Injection | Piqûre |
| Intensive care | Soins intensifs |
| Jaw | La mâchoire |
| Joint | L'articulation |
| Kidney | Le rein |
| Knee | Le genou |
| Leg | La jambe |
| Lip | La lèvre |
| Local anaesthetic | Anesthésie locale |
| Lump | Une masse / un nodule |
| Medicine | Le médicament |
| Midwife | Sage-femme |
| Mobility aid | Aide à la mobilité |
| Neck | Le cou |
| Nurse | Infirmier / Infirmière |
| Operation | Opération |
| Ovaries | Les ovaires |
| Pain | Douleur |
| Painkiller | Antidouleur |
| Paracetamol | Paracétamol |
| Patient | Le patient |
| Pharmacy | Pharmacie |
| Plaster | Un plâtre |
| Prescription | Ordonnance |
| Put the bandage on | Mettre le bandage |
| Put the dressing on | Mettre le pansement |
| Raise your arm | Levez le bras |
| Redness | Rougeur |
| Relax | Se détendre |
| Respiratory rate | Fréquence respiratoire |
| Results | Résultats |
| Scalp | Le cuir chevelu |
| Scales | Balance |
| Scent | Une odeur |
| Shaking | Tremblements |
| Sick | Malade |
| Sleep | Le sommeil |
| Sniff | Renifler |
| Stethoscope | Stéthoscope |
| Sugar | Sucre |
| Surgeon | Chirurgien |
| Sweat | La sueur |
| Sweaty | Transpirant |
| Symptoms | Les symptômes |
| Take blood pressure | Mesurer la tension |
| Take your temperature | Prendre votre température |
| Throat | La gorge |
| Thump | Un coup |
| Toes | Les orteils |
| Tongue | La langue |
| Trauma | Traumatisme |
| Twisted | Tordu |
| Vomit | Vomi |
| Wound | Une plaie |
| Wrists | Les poignets |
| ENGLISH | FRENCH |
|---|---|
| Adhesion | Adhésion |
| Back pain | Douloureux au dos |
| Bad breath | Halitose |
| Blood in the urine | Du sang dans les urines |
| Bleeding | Saignement |
| Bleeding nose | Saignement de nez |
| Body aches | Douleurs corporelles |
| Breathless | Essoufflé |
| Burning sensation when passing urine | Sensation de brûlure en urinant |
| Choking | Etouffement |
| Colic | Colique |
| Cold sweat | Transpiration froide |
| Constipation | Constipation |
| Cramping | Crampe |
| Cramps | Crampes |
| Diarrhoea | Diarrhée |
| Dizziness | Vertige |
| Fainting | Évanouissement |
| Fatigue | Fatigue |
| Fever | Fièvre |
| Flu symptoms | Symptômes de la grippe |
| Headache | Mal de tête |
| Heart palpitations | Palpitations cardiaques |
| Hot flushes | Bouffées de chaleur |
| Injury | Une blessure |
| Insomnia | Insomnie |
| Nausea | Nausée |
| Painful periods | Règles douloureuses |
| Pinched nerve | Nerf coincé |
| Rash | Une éruption cutanée |
| Shortness of breath | Essoufflement |
| Stiffness | Rigidité |
| Swelling | Gonflement |
| Thirsty | Assoiffé |
| Vomiting | Vomissements |