Student: your medical expenditure coverage

27 juin 2018
Enrolled in higher education? All you need to know about your social security coverage, how to get the highest reimbursement rates, and who to contact.

If you are entering higher education in September 2018

You are entering higher education after your “baccalauréat” (bachelor’s degree) or an equivalent diploma.

1) Eligibility requirements for coverage

You will need to meet the eligibility requirements for universal health care coverage, which means you have a stable and regular residence in France.

You will not be required to pay Social security contributions.

a) You are already covered by the French social security system

No action is required from you: you will continue to be covered by the local health insurance fund you depend on, usually your parents’ one.

b) You are a resident of one of New Caledonia or Wallis and Futuna, or are a French citizen born abroad

You are not a member of one of metropolitan France’s health insurance schemes. When you arrive in Metropolitan France or one of France’s overseas departments or regions (Drom, i.e. Guadeloupe, Martinique, French Guyana, Reunion, or Mayotte) in order to begin or continue your higher education, you will need to register online on the soon-to-be-available website etudiant-etranger.ameli.fr for healthcare coverage during your studies (see : The French social security registration process for foreign students).

c) You are arriving in France and coming from a foreign country to begin or continue your studies

To be eligible for health care coverage in France, you will need to prove your stable and regular residence in France.

Such an evidence can be any document that proves your student status (e.g. an official certificate of university enrollment, a opy of your student ID, and so on.)

Documents to prove legal residence differ depending on your country of origin.

You are a citizen of a European Union (EU) country, Switzerland, or the European Economic Area (EU + Iceland, Liechtenstein, and Norway)

You have to submit a rights form (such as the European health insurance card, the S1 form or a provisional certificate). If you cannot do so, you have to submit an evidence of sufficient financial resources (see : The French social security registration process for foreign students).

You are a citizen of a country outside the European Union, Switzerland, or the European Economic Area

The legal residence requirement is met if you submit a valid residence permit (“titre de séjour”) (see : The French social security registration process for foreign students).

You come from Quebec, Andorra, or Monaco

You need to request forms from your country’s health insurance institution that will allow you to have your medical expenses covered in France. You will not be required to submit your residence permit (“titre de séjour”) to your French health insurance fund (see : The French social security registration process for foreign students).

2) How your medical expenses coverage works

If you are enrolling in a French institute of higher education for the first time beginning in September 2018, you will not need to change compulsory health insurance schemes for the reimbursement of your medical expenses.

Indeed, you will remain a member of your current social security scheme. This is usually the one your parents belong to.

You will be insured in your own right as soon as you are 18 year old, or from the age of 16 if you submit a request to your local health insurance fund.

3) The reimbursement of your medical expenses

You will be reimbursed for any medical or maternity care expenses by the health insurance fund (CPAM) of your place of residence.

Your “carte Vitale” is your health insurance card and is an evidence of your entitlement to health care coverage. Make sure to update it at least once a year using the terminals that are available in all of France’s local health insurance funds (CPAM), pharmacies, and certain health care facilities.

Always show it to any health care professional you see. When you use it, there is no need to fill in a reimbursement claim (“feuille de soins”) by mail: you will be reimbursed within 5 days.

If you have submitted your bank account identification details (RIB) to your local health insurance fund (CPAM), your reimbursement will be paid on your bank account.

From the age of 16, you are required to choose and declare a referring doctor. Without a referring doctor, you will have your medical expenses reimbursed at a lower .

Choosing your referring doctor

You can choose a general practitioner or a specialist, whether they see patients in a private practice or in a hospital setting. We simply recommend that you choose the doctor who knows you the best. As your referring doctor is the first person you go to for any health issues, you will receive coordinated follow-up and personalized preventive care.

If you have not declared a referring doctor or visit a specialist directly (not including those with authorized direct access), your health insurance fund will reimburse you at a lower .

For more information, please refer to the article on the Coordinated healthcare pathway (“Parcours de soins coordonnés”).

Once you have chosen your referring doctor, you will need to inform your local health insurance fund (CPAM) about it.

Is it better to choose a referring doctor near your home or in the town where you are studying ? There is no hard and fast rule. Choose the solution that works best for you. If you get sick when you are out of town, you can see another doctor, who will specify this on your reimbursement claim and you will be reimbursed at the usual .

Declaring your referring doctor (“médecin traitant”)

Once you have chosen your referring doctor, you will need to inform your local health insurance fund (CPAM) about it.

The process can be completed online if the doctor you have chosen as your referring doctor offers to do so and you agree. Practically speaking, during an appointment at his/her practice, you can give the doctor your “carte Vitale” insurance card and the doctor will make the report online and submit it electronically to your local health insurance fund (CPAM).

Otherwise, you and the doctor can fill in and sign the “Declaring a referring doctor”form (form No. S3704, entitled “Déclaration de choix du médecin traitant”) together and submit it to your local health insurance fund, or send it by post.

To be noted

There is no need to make a special appointment with your doctor to declare him/her as your referring doctor. Rather, you can complete the process during your next appointment or the next time you stop by his/her office.

Youths under age 18 need the agreement and signature of an adult with parental rights.

You will need to submit a new declaration if you change referring doctor or if the doctor you have chosen get retired, changes profession, or moves.

If you are a family member of an international civil servant and covered as such by the social security scheme established by the international organization, if you are a citizen of the EU/EEA or Switzerland holding a European health insurance card or provisional replacement certificate, or if you are a citizen of Monaco, you are not concerned by the choice of referring doctor.

 

4) If you have an industrial accident or occupational illness

As a student, you are insured for industrial accidents and occupational illnesses. This insurance covers accidents occurring:

  • during classes taught in a workshop or laboratory setting,
  • during company internships, assuming that these are part of your educational program and allow you to apply the course material, that an internship agreement has been signed, and that they are unpaid with the exception of an internship bonus.

5) Your supplementary coverage

To supplement your reimbursements from the French social security system, you can take out the supplementary health insurance coverage of your choice. Contact your parents’ supplementary insurance provider (“mutuelle”), a student provider (“mutuelle étudiante”), or another supplementary insurer, to bring your reimbursement rates up to the level you want: these vary depending on the contract you choose.

As a supplement to French Social Security reimbursements, you may also meet the eligibility requirements to receive supplementary health care insurance at no charge to you through the supplementary universal health care coverage (“couverture maladie universelle complémentaire”/ CMU-C). Otherwise, if you meet the financial resources requirement, you may be eligible for supplementary health care coverage affordability aid (“aide au paiement d’une complémentaire santé”/ ACS).

To be noted

If you are a family member of an international civil servant and covered as such by the social security scheme established by the international organization, if you are a citizen of the EU/EEA or Switzerland holding a European health insurance card or provisional replacement certificate, or if you are a citizen of Monaco, you cannot claim CMU-C or ACS.

If you were already enrolled in higher education in France for the 2017-2018 academic year and you are continuing your education in 2018-2019

1) Requirements for a medical expenditure coverage

Your supplementary student health insurance provider (“mutuelle étudiante”) will automatically extend your membership for a year without any application or paperwork requirements from you. From September 1st, 2018, the flat- health insurance charge (“cotisation forfaitaire maladie”) will no longer be payable.

2) How your medical expenditure coverage works

If you are enrolled in higher education and had already taken out coverage from a supplementary student insurance provider (“mutuelle étudiante”), that coverage will continue throughout the 2018-2019 academic year, even if you move.

As from September 2019

France’s student social security scheme will no longer exist from August 31, 2019. If you are still a student, you will become a member of the local health insurance fund (CPAM) of your place of residence from September 1st, 2019, at the latest.

3) Reimbursement of your medical expenses

Your medical or maternity-related expenses will be reimbursed by the supplementary student insurance provider (“mutuelle étudiante”) with which you previously registered.

Your “carte Vitale” is your health insurance card and is an evidence of your entitlement to health care coverage. Make sure to update it at least once a year using the terminals that are available in all of France’s local health insurance funds (CPAM), pharmacies, and certain health care facilities.

Always show it to any health care professional you see. When you use it, there is no need to fill in a reimbursement claim (“feuille de soins”) by mail: you will be reimbursed within 5 days.

If you have submitted your bank account identification details (RIB) to your local health insurance fund (CPAM), your reimbursement will be paid on your bank account.

From the age of 16, you are required to choose and declare a referring doctor. Without a referring doctor, you will have your medical expenses reimbursed at a lower .

Choosing your referring doctor

You can choose a general practitioner or a specialist, whether they see patients in a private practice or in a hospital setting. We simply recommend that you choose the doctor who knows you the best. As your referring doctor is the first person you go to for any health issues, you will receive coordinated follow-up and personalized preventive care.

If you have not declared a referring doctor or visit a specialist directly (not including those with authorized direct access), your health insurance fund will reimburse you at a lower .

For more information, please refer to the article on the Coordinated healthcare pathway (“Parcours de soins coordonnés”).

Once you have chosen your referring doctor, you will need to inform your local health insurance fund (CPAM) about it.

Is it better to choose a referring doctor near your home or in the town where you are studying ? There is no hard and fast rule. Choose the solution that works best for you. If you get sick when you are out of town, you can see another doctor, who will specify this on your reimbursement claim and you will be reimbursed at the usual .

Declaring your referring doctor (“médecin traitant”)

Once you have chosen your referring doctor, you will need to inform your local health insurance fund (CPAM) about it.

The process can be completed online if the doctor you have chosen as your referring doctor offers to do so and you agree. Practically speaking, during an appointment at his/her practice, you can give the doctor your “carte Vitale” insurance card and the doctor will make the report online and submit it electronically to your local health insurance fund (CPAM).

Otherwise, you and the doctor can fill in and sign the “Declaring a referring doctor”form (form No. S3704, entitled “Déclaration de choix du médecin traitant”) together and submit it to your local health insurance fund, or send it by post.

To be noted

There is no need to make a special appointment with your doctor to declare him/her as your referring doctor. Rather, you can complete the process during your next appointment or the next time you stop by his/her office.

Youths under age 18 need the agreement and signature of an adult with parental rights.

You will need to submit a new declaration if you change referring doctor or if the doctor you have chosen get retired, changes profession, or moves.

If you are a family member of an international civil servant and covered as such by the social security scheme established by the international organization, if you are a citizen of the EU/EEA or Switzerland holding a European health insurance card or provisional replacement certificate, or if you are a citizen of Monaco, you are not concerned by the choice of referring doctor.

4) If you have an industrial accident or occupational illness

As a student, you are insured for industrial accidents and occupational illnesses. This insurance covers accidents occurring :

  • during classes taught in a workshop or laboratory setting,
  • during company internships, assuming that these are part of your educational program and allow you to apply the course material, that an internship agreement has been signed, and that they are unpaid with the exception of an internship bonus.

5) Your supplementary coverage

To supplement your reimbursements from the French social security system, you can take out the supplementary health insurance coverage of your choice. Contact your parents’ supplementary insurance provider (“mutuelle”), a student provider (“mutuelle étudiante”), or another supplementary insurer, to bring your reimbursement rates up to the level you want: these vary depending on the contract you choose.

As a supplement to French Social Security reimbursements, you may also meet the eligibility requirements to receive supplementary health care insurance at no charge to you through the supplementary universal health care coverage (“couverture maladie universelle complémentaire”/ CMU-C). Otherwise, if you meet the financial resources requirement, you may be eligible for supplementary health care coverage affordability aid (“aide au paiement d’une complémentaire santé”/ ACS).

 
To be noted

If you are a family member of an international civil servant and covered as such by the social security scheme established by the international organization, if you are a citizen of the EU/EEA or Switzerland holding a European health insurance card or provisional replacement certificate, or if you are a citizen of Monaco, you cannot claim CMU-C or ACS.

 

If you work while enrolled in higher education

If you work while enrolled in higher education, you can join the general scheme based on your employment by submitting any documentation of your employment such as your employment contract, a pay slip, etc.

You will also need to prove legal residence in France.

If you complete your studies or withdraw from higher education in 2018

You are out of school and it is time for your first job. To still have your medical expenses reimbursed, you will have to cancel your supplementary student health insurance (“mutuelle étudiante”) and notify the local health insurance fund (CPAM) of your place of residence, or any other scheme based on your employment circumstances.

Contacting the local health insurance fund (CPAM) where you live

At the end of the academic year, you will need to contact the local health insurance fund (CPAM) where you live.

As a general rule, this is the fund that will handle your case as well as the reimbursement of your medical and maternity expenses from September 1st of the current year.

Contact information for your local health insurance fund (CPAM) is listed in the Contacts section.

You can also contact a French Health Insurance (“Assurance Maladie”) adviser by phone at 36 46 (toll charge 0.06 €/min + cost of the call). This service is available from Monday to Friday to answer your questions and help you through any required paperwork.

Keep your “carte Vitale” health insurance card. You will be able to update it when your local health insurance fund instructs you to do so.