Healthcare Costs in France

Health Care & Carte Vitale
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Hello all, I am new to here and to the French healthcare system. I hugely appreciate if you can shed some light on my understanding of French healthcare system if possible.

Until recently I thought children below 5 years old are fully covered by the state healthcare. I learnt that’s not the case when we needed to go to emergency for my 18 months old daughter. We first had a doctor appointment. Then he referred us to emergency and they continued checks at the pédiatrie department the next day. Then pédiatrie department sent us a letter asking either for a mutuelle/ top-up insurance or payment around 200 euros. We don’t have a top-up insurance at the moment. I asked pédiatrie Secretary by email an itemised receipt showing the total and reimbursement rate. They say it’s a package and it is 1000 euros at 80% rate. No explanation of what makes up 1000 euros.

At emergency first day:
They did quick blood test enough for CRP.

They did a quick échographie to check her hip, knee and ankle. Then emergency sent us to x-Ray.
They tried to take blood tests twice for more checks but failed. They told us to go to pediatrie department the next day with requests of:

Blood test to cover;

NFS plaquettes,
CRP, s
erologie EBV, CMV, mycoplasma pneumonia
Pose de KT

Scintigraphie osseuse

The next day above blood tests and scintigraphie were done. Results were good enough, they told us to go home and come next week to repeat blood tests ( they check white blood tests in her blood to see whether she has bacterial infection causing a damage/ inflammation on her ankle).

Next week they repeated blood tests at pediatrie and they were good. They discharged us telling doctor to check her improvement the other week.

As per emergency fees FPU, full package fee is 19.61 euros.

Link;

On our Ameli account there is payment of 210Euros paid by CPAM at 100% for Act d Imagerie on 23rd which should be scintigraphie.

I don’t understand what makes up 1000 Euros? Is there a way of getting a detailed invoice from them or the hospital or a health body? Aren’t such prices listed and public somewhere?

Is the A&E package fee different if you go to hospital again the next day? I don’t think we would be considered as hospitalised in our case? We didn’t stay in the hospital. We just went the next day and the week after but blood tests took ages on our third visit for instance since they failed to take blood from her hands, arms and they did it on her head in the end ( her arms and hands were heavily bruised from the tests of previous week so I understand it was hard for them).

I plan to write to hospital pediatrie department again to demand a breakdown of 1000 Euros. Is that the best approach? I just want to know what I am paying for. If the blood tests are so expensive how much other things cost; that also defines what level of top-up insurance we should buy for the future.

Thank you so much for your time and any help if possible.

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What led you to believe that? Only certain things linked to birth and the compulsory tests until they are 20, are free, and even then there is some jumping through hoops to be done.

What is your régime for healthcare? You need a mutuelle.

Any treatment in hospital is counted as hospitalisation, even as an out-patient.

I hope your daughter is better soon.

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I’m sorry you had an emergency, hope all’s well now.

No, children aren’t covered 100% and in fact consultations can be more expensive, not less, as small children are quite complex. Is your daughter on your carte vitale?

€1000 is quite a lot, although at least covered at 80%. However hospital costs can add up quickly. But was the €200 a payment in advance of treatment? If so it makes more sense as if you are not known to hospital and weren’t able to provide them with insurance details this can happen. We have no mutuelle for out patient treatment, but the hospital “knows”us so they send a bill or we pay as we leave if bill is ready (sometimes it isn’t).

A scintigraphie can cost up to €500 depending on the details of it
Echo, x-ray. Pose de KT and blood tests €50 to €150 each depending on the extent
You also pay for sundries. So €1000 is easy to reach.

I suggest you ask the hospital administration for a detailed facture, not the paediatrics dep’t. You will get it in due course, and if payment in advance of treatment may even get reimbursed for some of it.

French healthcare is very reasonably priced (ask any American!), but it isn’t free at the point of delivery like the UK. Any billing and reimbursement glitches are generally sorted out, but not quickly.

To work out what level of cover you might wish to get you need to consider what sort of things might be needed. Each medical act in France has a price, and a base de remboursement which is the maximum the social security will pay towards this act, and a % which says what will normally be provided.

So for a standard doctor’s visit the cost is 26,50 €, and the SS base de remboursement is the same, and they contribute 70% so you pay €8.95. If you have a 100% mutuelle they will reimburse the €8.95.

However, some medical acts are much more expensive than the SS base de remboursement, so the 70% they pay covers a much smaller amount. My classic example is my insoles. They cost €200! But the SS base de remboursement is only €50 and the % is 60%, so they will only give me €30 back. And a mutuelle at 100% will contribute €20 to get to the €50, and I have to pay the remaining €150.

I would need a top level and top price mutuelle that pays 300 or 400% to get more back.

It is for you to decide what you want.

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Jane, this is very very helpful and I hugely appreciate. Thanks for your advice on contacting hospital administration too.

Do you know whether emergency package prices (FPU) are different if you come or don’t come back to hospital ( hospitalised)? Doesn’t package rate apply if you come back to the hospital the next day?

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I think (don’t know for 100% sure) that the FPU €19 is for every admittance via urgences. If you return for planned appt it will be different through the normal route, ie via the accueil at entrance.

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Don’t expect a speedy response! My experience of French hospital care is limited, I’m pleased to say, but bills have always taken between 2 and 4 months to reach me (although Ameli seems to have the details rather more quickly).

I hope your daughter is well and that you’ll have no further need for medical intervention.

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You might get a breakdown from the admin offices, if you go and ask at the hospital.

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That sounds like about $30,000 cost in the US. So if it was me I’d pay the 200 euros quick and not push too much other than waiting the likely few months for any more detailed information available.

At least it’s a heads up to get a mutuelle or other coverage ensuring it covers all your family asap. The same mutuelle will also take away a lot of potential worry about many dentistry costs that could occur too.

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PS Welcome to Survive France!

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Many thanks for all your help and advice :pray:

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Hi Karen, Thank you so much. I know from my friends about US. We are British so not used to pay for healthcare :smile: . I just want to understand how the system works and whether there will be more to pay for this case. We received a letter from pediatrie only and they said there will be more bills as she has been to other departments ( again I don’t understand which other department. We were at emergency the first and at pediatrie afterwards for follow up). It’s all confusing and not clear to me and I expected a price list of procedures to be accessible but it seems like it is not. Many thanks again for your reply.

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There is of course a price list of procedures in the hospital computer but it is pretty incomprehensible as there are so many variables. And the doctors won’t necessarily know in advance what procedures are needed. I’m sure you prefer them to treat your daughter than wait until admin dept has produced a devis.

How is your French? As the other issue is that many medical staff know that the system is incomprehensible to foreigners so don’t even try. And doctors don’t concern themselves with costs, especially as 95% of people will have full cover. So it’s only in an elective situation that they will routinely produce a breakdown in advance. And generally people will not expect you to be considering costs in this situation.

The other thing I have tattooed on my hand now is that if you don’t ask the right person the right question you will get nowhere. So that’s the aim. Work out who is the right person and what is the right question. So admin re money, and doctors re any other follow up - and where it should take place.

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Dear Jane and everyone else who took time to reply. Many thanks, it got clearer for me. Your kind help is much appreciated :pray:

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