In France, as elsewhere in the world, the Covid-19 epidemic has affected a significant proportion of the population. The costs of treatment linked to the virus can be substantial, especially in the event of hospitalisation in the event of a serious form. But then, how can you be reimbursed in case of contamination? What do the CPAM and the mutual insurance company cover? What reimbursement of expenses when returning from abroad?
For you expatriates in France or French residents, we answer these questions to understand how health insurance continues to play its role despite these unusual circumstances.
What does the French health insurance system cover?
The Covid-19 epidemic involves, in general and in case of infection, the following costs:
- Masks and hydroalcoholic gel
- Screening tests (PCR, self-test, serological)
- Visits to the general practitioner
- Hospitalisation in case of severe disease
The CPAM undertakes to reimburse you for the majority of the costs associated with the Covid, although the coverage is not yet complete. The role of your complementary health insurance or mutual insurance company is therefore important because it will enable you to cover the remaining costs.
Mask and hydroalcoholic gel
This protection, which is still compulsory for outdoor use, can easily be bought in supermarkets, shops and pharmacies. Prices vary depending on the store, from €1.99 to over €9.99 for a box of 50 masks. These prices are not regulated by the Health Insurance. However, it is possible for you to receive free masks if you have tested positive in a Covid-19 screening test, if you are identified as a contact case or a home help.
The hydroalcoholic gel is not reimbursed, its price being set at a maximum of €1.76 including tax for a 50ml volume, following the decree of 10 July 2020.
Screening in France has been 100% reimbursed since 25 May 2020 for any individual who performs a Covid-19 antigen test. Self-tests are available over the counter in pharmacies at a price of €5.20 and are not reimbursed by the French health insurance. Professionals and employees working with the elderly can receive it free of charge upon presentation of a professional document
Consultation with the general practitioner
Consulting a doctor in the event of Covid-19 symptoms is reimbursed in the same way as any other consultation, i.e. a reimbursement of €16.50 by the CPAM for a consultation with the general practitioner and €6.50 for a consultation with a non-general practitioner (price including the fixed contribution of €1)
The teleconsultation service is becoming more and more widespread and is also reimbursable at 100% during the pandemic. You are still required to contact your GP first.
If you have a prescription, 65% of the cost of your medication will be reimbursed by the public health insurance. It is then the role of your complementary health insurance to cover the rest.
This is the most expensive category of treatment costs for a Covid-19 positive patient, as it is not covered at 100%. Reimbursement is 80% as usual, plus the €20 hospital fee. The remainder may be covered by the mutual insurance company.
As far as vaccination is concerned, there is no cost to you as it is completely free.
You can consult all the rules of the CPAM here.
What about compensation for Covid-19-related work stoppages?
Depending on your situation (employees, self-employed), the conditions for compensation for work stoppages are different from the usual system. A person who has symptoms or tests positive for Covid-19 can directly receive daily benefits without conditions or time limits.
For more information, please consult the section dedicated to work stoppage related to the Covid-19 on the Health Insurance website.
Reimbursement of health costs incurred abroad
If you were travelling abroad and crossed several borders, it is highly likely that you were tested in one of the countries where you were. These tests carried out abroad may be covered, depending on several conditions:
- If the test was carried out in the EU zone or in Switzerland, it will be immediately covered by social security by presenting the European Health Insurance Card. If the insured person was unable to present his or her card, he or she can fill out a “treatment received abroad” form once back in France.
- If the test was carried out outside the EU/Switzerland, then only tests that are deemed medically necessary and urgent will be reimbursed at 27% of the cost. The same form must be completed and accompanied by a medical prescription.
If you are planning to travel abroad, remember that some countries require proof of insurance to show that you are covered for Covid-19-related treatment or hospitalisation. Find out more and check the terms of your insurance policy to make sure you are covered for Covid-19.
Would you like to know what types of health insurance cover your health costs abroad? If you are travelling for a short period of time (a few weeks), a travel insurance may be sufficient. For a stay of a month or more, or a longer expatriation, an expatriate health insurance will allow you a more complete coverage and full reimbursement of treatment costs related to Covid-19.