Medicine & Veterinary France

Mandatory State Health Insurance

All residents of France have the right to state health insurance. This system provides basic coverage for most medical expenses, including doctor visits, hospitalization, medications, and some types of specialized medical care.

Under the system, medical expenses are partially reimbursed: usually 70% of the cost of a doctor's visit, 80% of the cost of hospitalization, and up to 100% of the cost of certain expensive drugs and procedures.

Private Supplemental Health Insurance

Private health insurance is used to cover expenses not reimbursed by state insurance. This includes copayments for doctor visits, hospitalization, dental services, and glasses purchases.

Private health insurance can be offered by an employer as part of a benefits package, or it can be purchased independently. Policies can vary in coverage and cost, so it's important to choose a policy that best meets your needs and budget.

Special Types of Insurance

Insurance for the self-employed: Self-employed individuals and freelancers may enter into special insurance contracts that include protection in case of hospitalization, accidents, loss of income, or death. These policies often include legal protection and income insurance.

Travel Insurance: All residents of France registered in the state insurance system are entitled to a European Health Insurance Card (EHIC), which provides access to medical care in EU countries under the same conditions as for citizens of those countries. It is additionally recommended to purchase separate travel insurance policies, especially for trips outside the EU, to cover medical expenses, repatriation, and other unforeseen situations.

Some of the popular and well-known insurance companies: AXA, Allianz, MAIF, Groupama, MACIF, Generali France, CNP Assurances, Harmonie Mutuelle.

Public Hospitals

Public hospitals provide a wide range of medical services, including emergency care, scheduled surgeries, diagnostics, and specialized consultations. They are funded by the state, which ensures accessible medical care for all residents and foreign citizens.

How to access services:

Foreigners residing in France must register in the mandatory health insurance system (PUMa) through a local CPAM (Caisse Primaire d'Assurance Maladie) center. You need to provide documents confirming identity, residence, and income.

To access services, a Carte Vitale health insurance card is required, which must be presented at each medical facility visit.

Private Hospitals

Private hospitals and clinics offer medical services with a higher level of comfort and shorter waiting times. They often cooperate with state insurance but may charge additional fees for services.

How to access services:

Foreigners can directly contact private clinics. Service fees can be partially reimbursed through the mandatory health insurance system and additional private insurance.

In large cities, such as Paris, there are private hospitals with English-speaking staff, for example, the American Hospital of Paris and the British Hospital Hertford.

Programs to Assist Foreigners

Permanences d’Accès aux Soins de Santé (PASS): These units, located in public hospitals, provide access to emergency and primary medical care for individuals without medical insurance.

La Comede: A national non-profit organization providing medical, dental, ophthalmological, and psychological assistance to undocumented foreigners.

Registration with a Family Doctor

In France, it is important to register with a family doctor to gain full access to medical services and maximum expense reimbursement.

Choosing a Doctor: Find a doctor near your home or choose one based on recommendations. You can use (https://annuairesante.ameli.fr) - the official portal of the French health system.

Making an Appointment: Schedule an appointment with the chosen doctor by calling their office or using an online platform like Doctolib.

Filling out a Declaration: During the visit, you and your doctor will fill out a form, which will then be sent to your local CPAM center. This procedure registers you in the system and ensures increased reimbursement for medical expenses.

Appointment with a Specialist

Getting a Referral: A referral from a general practitioner is usually required to see a specialist. This is necessary to receive maximum possible reimbursement from the state health system. However, some specialists, such as gynecologists, pediatricians, and ophthalmologists, can be seen without a referral.

Making an Appointment: Use online platforms like Doctolib to book an appointment with a specialist. Choose a specialist that suits you in terms of location and specialty, and check their availability. The platform also allows you to view the doctor's biography, qualifications, and patient reviews to help you make the right choice.

Preparing for the Visit: Bring your health insurance card (Carte Vitale) and, if necessary, documents proving your private health insurance. For online consultations via Doctolib, you'll need a device with an internet connection and a camera.

Main Emergency Numbers

SAMU (Service d'Aide Médicale Urgente): For medical help, call 15.

Pan-European Emergency Number: 112, which is available from any phone in Europe and connects to the necessary service (medical, police, firefighters).

What to do in an Emergency: In an emergency, you can go to the nearest hospital or clinic. In major cities in France, there are specialized institutions, such as the American Hospital in Paris and the British Hertford Hospital, that provide services in English.

Hospital Procedure

Providing Documents: When visiting a hospital, present your Carte Vitale (health insurance card) or other proof of insurance coverage. You may also need identification and private health insurance.

Admission and Examination: In the emergency department, you will need to explain your problem upon admission. If you do not speak French, mention it immediately so you can be connected to an English-speaking operator or translator.

Cost and Expense Reimbursement

Reimbursement of Medical Expenses: In France, the social insurance system covers most medical expenses (usually 70% for outpatient treatment and up to 80% for hospitalization). Additional coverage may be provided by private insurance.

Payment for Services: In public hospitals and private clinics, payment is made upfront, after which you can submit a claim for reimbursement. Prices and levels of reimbursement may vary depending on the institution and the presence of insurance.

Additional Services

Seeking Help in Non-Emergency Situations: For non-emergency medical care, you can contact SOS Médecins—a service providing 24/7 home doctor visits. If you need to find a specialist, you can use online services like Doctolib to book an appointment.

In France, the procedure for undergoing medical tests and examinations is simplified and accessible to everyone, including foreign citizens.

Tests

After a consultation with your general practitioner, you will receive a referral for the necessary tests. The doctor will indicate which tests you need to take and in which medical institution.

Test Laboratories: Tests can be done in any laboratory that cooperates with the public health insurance system. The most well-known laboratory networks include Biomérieux, Cerballiance, and Labcorp.

Test Procedure: Come to the laboratory with a referral from your doctor and your Carte Vitale. Most laboratories accept tests without prior appointment, but for some specialized tests, an appointment may be required.

Examinations

For specialized examinations (e.g., MRI, CT, ultrasound examinations), a referral from a doctor is required. The referral can be issued by both a general practitioner and a specialist.

Medical centers and hospitals: Examinations can be conducted in public and private medical centers and hospitals. Appointments for examinations are usually made by phone or through online platforms such as Doctolib.

Screenings

Cancer screenings: France has national screening programs for breast cancer, cervical cancer, and colorectal cancer. Screenings are provided free of charge for certain age groups and in the absence of symptoms. For example, a free colorectal cancer test is available for individuals aged 50 to 74.

Cardiovascular and metabolic examinations: Regular checks of blood pressure, cholesterol levels, and blood glucose levels are recommended for all adults as part of a preventive medical examination. These exams can be done in doctors' offices and specialized centers.

Obtaining results

Online access: Many laboratories and medical centers provide online access to test and examination results.

Consultation with a doctor: After receiving the results, schedule a follow-up appointment with your doctor to discuss the results and receive recommendations for further treatment.

Hospital registration: It is important to register at your chosen hospital as early as possible to secure a place. Your gynecologist or midwife will help you with this process. In major cities in France, there are both public and private maternity wards. Remember that expenses in private clinics may not be fully covered by public insurance.

Choosing a doctor or midwife: You can choose a doctor or midwife who will accompany you throughout your pregnancy and childbirth. Usually, your gynecologist can recommend a specialist or medical facility.

Insurance coverage: It is important to have valid medical insurance (Carte Vitale), which covers most expenses related to pregnancy and childbirth, including mandatory examinations, tests, and the childbirth process itself. Private supplementary insurance may cover additional expenses, such as private rooms or additional services.

Expense coverage: The public health insurance system in France covers the costs of childbirth, including epidural anesthesia and newborn examination, for up to 12 days of hospital stay. If you are discharged from the hospital within five days after childbirth, you are entitled to home visits by a midwife.

Attending maternity courses: In France, maternity courses are offered to help prepare for childbirth and newborn care. Courses may be available in French or English.

Documents and records: You will receive a maternal health card, which will list all your medical examinations and test results. This document is important for obtaining reimbursement and medical services.

Partner-assisted childbirth: Choose a medical facility that supports partner-assisted childbirth. When registering at the maternity ward, inquire about the possibility of partner presence. The partner may need to provide identification and, in some cases, a health certificate. The partner can stay with the woman and newborn in the maternity ward to help with the first few days of infant care. Some hospitals provide separate rooms for families.

Vaccination of newborns: Vaccination of newborns and children in France is mandatory. It is regulated by the country's legislation, and non-compliance may result in restrictions, such as the inability to enroll the child in daycare or school. Vaccinations can only be postponed or canceled for medical reasons, which must be confirmed by a doctor. Mandatory vaccines include hepatitis B, diphtheria, tetanus, whooping cough, haemophilus influenzae type B (Hib); measles; mumps; rubella; pneumococcal infection; meningococcal infection type C; poliomyelitis. Vaccines are generally not given in maternity hospitals, except in high-risk situations. Main doses are administered at 2, 4, and 11 months.

Medical death certificate: If the death occurred at home, the first step is to call a doctor who will confirm the death and issue a medical death certificate. In the case of death in a hospital, the certificate is issued by the attending physician.

Death registration: The death must be registered at the local town hall within 24 hours. This can be done by a family member, a friend, or a funeral service representative with the proper authorization. A medical death certificate, the deceased's identity document, and the applicant's identity document must be provided.

Funeral arrangement

Choosing a funeral home: A funeral home will help organize the funeral or cremation and handle all necessary documentation, such as obtaining a burial permit.

Funeral or cremation: The funeral must take place within six working days after death (excluding Sundays and public holidays). The body can be cremated after receiving a permit from the town hall. The ashes can be kept in an urn, scattered in a memorial garden, or in nature, but not in public places.

Body repatriation: If body repatriation is required, you must contact the deceased's country's consulate. The consulate will provide information on the necessary procedures and assist with transportation arrangements.

Funeral expenses: Funeral and repatriation expenses may be covered by the deceased's insurance if it was in place. Otherwise, the family bears the expenses.

Consulting a notary: A notary will help process the inheritance, contact banks and other institutions, and complete all legal formalities. They can also provide advice on inheritance taxation issues.

Notification of organizations: The family must notify the employer, pension funds, insurance companies, banks, and other organizations about the death. A copy of the death certificate will be required for this.

Mandatory vaccinations

Rabies: The rabies vaccine is mandatory for all dogs, cats, and ferrets. The first vaccination is given no earlier than at 12 weeks and must be done after a microchip is implanted.

Canine distemper, adenovirus, parvovirus: These vaccines are mandatory for dogs and are included in the combination vaccine (DHPPi). The vaccination is done at a puppy age and requires booster shots every 1-3 years depending on the vaccine.

Calicivirus, viral rhinotracheitis, panleukopenia: These vaccines are mandatory for cats and are included in the combination vaccine (RCP). The primary vaccination is done at the age of 8-10 weeks.

Identification and registration

Microchip: All dogs, cats, and ferrets must be identified with a microchip (or a tattoo made before July 3, 2011). Identification must precede the first rabies vaccination.

Registration: After the microchip is implanted, the information about the animal must be entered into the national database. This is important for tracking and finding animals in case they are lost.

Procedures for travel

European pet passport: For trips to other EU countries, a European pet passport is required, confirming all necessary vaccinations and identification. This document is issued by a veterinarian.

Health certificate: When traveling outside the EU, an additional health certificate issued by an official veterinarian may be required.

Pet hotels

In France, pet hotels are popular, where pets can be comfortably accommodated during their owners' absence. Such hotels offer various services, including feeding, walking, and veterinary care. Some of the most well-known pet hotel chains include Dog Holiday, Animalia, and Le Domaine des Remparts.

The site BringFido provides information about numerous animal-friendly hotels across France, including accommodation rules and available services.

Animal shelters

Animal shelters in France provide temporary or permanent refuge for homeless and abandoned animals. The most well-known organization is Société Protectrice des Animaux, which operates a network of shelters across the country. Alternatively, 30 millions d’amis. In shelters, animals receive necessary care, medical treatment, and support until a new home is found.

There are also regional and private shelters, such as Les Amis des Animaux and Dog Rescue Carcassonne, which actively work on rescuing and caring for animals.

Volunteering in animal shelters is popular in France. Volunteers help care for animals, organize fundraising events, and facilitate the process of finding them a home.

Registration and Identification

Microchipping: All dogs, cats, and ferrets must be identified with a microchip.

Municipal Registration: The owner must register their pet with the local town hall. This is required for all dogs and cats and helps manage the animal population at the local level.

Vaccinations and Veterinary Care

Mandatory vaccinations: required for all dogs, cats, and ferrets.

Regular veterinary checkups: Regular checkups with a veterinarian are recommended, including checks for fleas, ticks, and worms, as well as vaccinations and other necessary medical procedures.

Rules for Care and Walking

Leash Walking: In many public places, including parks and streets, dogs must be on a leash. However, there are specially designated areas where dogs can walk off-leash under the owner's supervision.

Responsible Cleanliness: Dog owners are required to clean up after their pets in public places. It is necessary to always carry waste bags for this purpose.

Living and Traveling with Pets

Living with animals: Many apartments and houses allow pets, but owners must comply with rules established by landlords or management companies. These rules may include restrictions on the number of animals and ensuring their well-being.

Traveling: For travel within the EU, pet owners need to obtain a European pet passport, which can be issued by a veterinarian. The passport confirms that all necessary vaccinations have been received and allows free movement with the pet between countries.

Restrictions on Certain Breeds

France has a strict classification of dangerous dog breeds. Owners of such breeds are required to obtain a license from the town hall of their residence; a certificate proving their ability to safely hold such dogs. Such dogs must always be on a leash and muzzled in public places. Owners are required to have insurance covering civil liability for any damage their dog may cause. In the absence of such insurance, significant fines are imposed.