Healthcare coverage and out-of-pocket costs in France

In France, supplemental health insurance (complémentaire santé) is used to cover medical expenses not fully reimbursed by the national health insurance system. When selecting a plan, it is important to note that coverage percentages, such as ‘100% optique’, are calculated based on the Social Security reimbursement rate rather than the actual price charged by professionals. This can result in significant out-of-pocket costs if providers charge above the standard rates.

Certain expenses, such as medical deductibles (franchises médicales) and flat-rate contributions (participations forfaitaires) for medications and consultations, are generally not reimbursed even by high-end ‘responsible’ contracts.

During hospitalization, additional costs often include the daily hospital fee (forfait journalier), private room charges, and physician fee surcharges. The daily hospital fee, which covers accommodation and maintenance, is not covered by national health insurance and typically costs €20 per day in medical or surgical services and €15 per day in psychiatric services.