When you consult a medical specialist referred by your personal doctor “Médecin traitant” in France, the French Health Insurance “Social Security” will reimburse 70% of the consultation charges, after deducting 1€ as a standard fee.
The remaining 30% will be reimbursed by your private health insurance “mutuelle”.
If you have not added a Médecin traitant in your Ameli account, Social Security will only reimburse 30% of the charges instead of 70%.
This is deliberately done to encourage people to have an attending doctor. So, the doctor can follow your health regularly and provide personalized care.
What are the responsibilities of a Médecin traitant?
The primary duties of your attending doctor or physician are to:
- Ensure a 1st level of healthcare and coordinate the medical follow-ups.
- Guide you and refer to specialists whenever required.
- Establish a care protocol for a long-term illness “affection de longue durée” (ALD).
- Provide personalized prevention services like vaccination, health advice according to your lifestyle, etc.
How to declare a Médecin traitant?
When you visit your local doctor,
- If you have a Carte Vitale, your doctor can easily update it directly online. You do not have to do anything.
- If a Carte Vitale is not available, then you have to do it offline. Your doctor will give you a signed form and you have to complete it with your details. Once completed, the form must be sent to your local health insurance organization like CPAM, MSA, etc.
How to change your Médecin traitant?
You are free to change your doctor whenever you want and without any proof.
- The process is the same as explained earlier and this update will cancel the previous registration.
- There is no obligation to inform your previous Médecin traitant.
Other relevant information
You will be reimbursed normally, even if you consult the following physicians without going through your attending doctor.
- A temporary replacement of your Médecin traitant.
- Another doctor known as “médecin correspondant”, at the request of your doctor.
- A doctor in case of emergency.
- A doctor while you’re away from home.
- A gynecologist, ophthalmologist, psychiatrist, or stomatologist (oral medicine).
- A doctor in the hospital for a substance abuse problem (alcohol, tobacco, drugs).
- A doctor in a humanitarian medical facility.
- A doctor in a family planning or education center.
- A generalist installed for less than 5 years.
- A general practitioner working in a health center located in an area lacking in care provision.
- A doctor following a diagnosis of a genetic abnormality in a member of your family.
