The forfait patient urgences (emergency patient fee) is a new flat fee of €18 for treatment in hospital A&E departments. It was originally intended to be introduced from September 1st, but has now been postponed until January 1st, 2022.

Here’s how it works.

Who is charged?

The fee applies to anyone who receives treatment at an A&E or emergency room in a French hospital and is not admitted to hospital afterwards. So it would apply to people with less serious conditions that need treatment but don’t require a stay in hospital such as being patched up from an injury or getting on-the-spot treatment like an anaphylactic injection for an allergic reaction.

It is charged to everyone, French or non-French, residents or tourists.

However there are some groups who are exempt – child victims of abuse, victims of a terror attack and people treated during a declared health emergency (such as a pandemic).

Women who are more than six months pregnant, newborn babies, military veterans, those on invalidity benefits and people with a long-term illness or medical condition are charged at a reduced rate of €8.

People who have more serious problems that require admission to hospital are charged depending on the treatment they need and the length of their hospital stay.

Can I get reimbursed?

The standard model for medical treatment in France – whether it is getting a prescription at the pharmacy, visiting the doctor or getting hospital treatment – is that you pay up front and then some or all of the cost is reimbursed to you.

How you are refunded for the FPU, however, depends on where you live and what level of medical cover you have.

French residents – if you live in France you would usually be registered in the French medical system and have a carte vitale – if you have not already done this, here is about to go about it. In most cases, the State refunds a proportion of the cost of treatment, usually around 80 percent. The remaining costs are either paid by the patient or by their mutuelle.

A mutuelle is private health cover that most French people have, which picks up the rest of your medical costs (depending on your cover level) so that you don’t end up out of pocket if you fall ill. They are a lot cheaper than UK private medical insurance (and in a different league to health insurance in the US) and if you are an employee, your employer must pay at least half of the cost – find out how to get a mutuelle here.

The FPU is different in that none of it is covered by the carte vitale, but virtually all mutuelle providers will reimburse the cost in full. So whether you end up €18 down after a trip to the ER depends on whether you have a mutuelle.

Visitors from the EU – if you are resident in an EU country and registered in their health system you are entitled to use the European Health Insurance Card, which reimburses costs for medical treatments should you fall ill abroad. You pay the FPU up front and will have the money reimbursed to you. As a general point, travellers are reminded that the European card is not a substitute for travel insurance and will not cover everything. It almost never covers the cost of repatriation.

Visitors from the UK – since Brexit, UK residents are no longer covered by the EHIC, although people who have an existing card can use it until it expires. The UK is bringing in a new system known as GHIC to cover medical costs abroad. UK nationals who are resident in France can still register with the French health system for a carte vitale, if they haven’t already.

Visitors from outside the EU – Visitors from non-EU countries do not benefit from French or European health cover and will have to pay the FPU upfront and then claim back costs via their travel insurance or health insurance.

In good news, French hospitals are required by law to treat people in medical need, so you cannot be turned away from an emergency department if you need treatment, but you may end up with a bill for the treatment that you do get.

Why the change?

There is already a cost attached to treatment in A&E departments but it varies more depending on the type of treatment received. The standard fee for emergency department attendance is €25, plus a fee for treatment, of which 80 percent of the cost is reimbursed by the State. The remaining 20 percent is covered by some mutuelle schemes, but not all. Patients who do not have a mutuelle pay the remaining cost themselves.

The aim is to streamline the system and make a simple flat fee applicable to everyone.

Any other charges to be aware of?

Yes, if you need a stay in hospital or admission to a ward for extra treatments or further investigation – such as MRI scans or blood tests – you will be charged for those. For residents, most of the cost will be covered by the carte vitale, visitors will need to claim on their respective insurance.

The standard charge for a hospital stay (excluding treatments) is €20 per day, or €15 per day for a psychiatric hospital. There are exemptions to this including pregnant women, newborn babies and victims of terror attacks.

If you need to call an ambulance the callout itself is free but you may be charged for the trip to hospital. Being taken to hospital by the pompiers (emergency fire and rescue workers who have extensive medical training and are regularly called to incidents such as car crashes or falls) is free but prank calls to emergency services can lead to a fine of more than €400.

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