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HEALTH

Reader question: Do you have to pay if you call an ambulance in France?

In a medical emergency, the expense of calling an ambulance to transport you or a loved one to hospital should be the least of your concerns. Here’s what you need to know about the financials of falling ill in France.

Reader question: Do you have to pay if you call an ambulance in France?
An ambulance arrives at a hospital's emergency department. (Photo by SEBASTIEN BOZON / AFP)

In France, urgent emergency care is run centrally by the Service d’Aide Médicale Urgente, known to almost everyone as Le SAMU (pronounced sam-oo), which is a coordinated service to call in case of any serious medical emergency.  

Samu

You can call SAMU by dialling 15 – you should only do so in serious medical emergencies, such as loss of consciousness or chest pains.

Some operators speak English but if you’re worried about speaking French you can call the central European emergency number on 112. Although it’s not guaranteed, most of their operators speak English.  

Importantly, you should not worry about being sent away for financial reasons if you need emergency medical care – under French law, hospitals and emergency services must treat any patient in an emergency. 

You may, however, receive a bill later.

Calls to SAMU are free but you will be billed for their services, with prices for consultations and call-outs varying greatly according to the département you are in. 

If you are resident in France and either have, or have applied for, a carte vitale, the costs will be covered by state system and your complimentary health insurance (mutuelle), if you have one – in the same way as other medical costs (eg GP visit, prescription).

READ ALSO How to get a carte vitale in France and why you need one

Be aware, however, that, in France, a doctor must confirm you are really in need of an emergency ambulance service, otherwise the cost of the ambulance might not be reimbursed.

In urgent situations, prescriptions for transport costs can be written afterwards. 

If you’re visiting France you will receive the bill the same bill for the cost of the ambulance, and will then have to claim back the cost from either your EHIC or GHIC card (for EU or UK residents) or via your own health insurance or travel insurance.

Sapeurs Pompiers (fire brigade)

This takes some getting used to for new arrivals, but, in France the sapeurs pompiers (fire brigade) can also be called out (dial 18) to medical emergencies, including traffic accidents and accidents in the home.

They receive extensive medical training and are more than simply ‘first-aiders’, but if the situation is very serious the pompiers may request help from the SAMU or the SMUR – these last are highly-trained medics whose role is to provide urgent care on the ground if the patient is in a life-threatening condition.

It is free to call the French fire brigade from any number, including for visitors and tourists. But unlike SAMU, you will not be billed for their services – unless, that is, you abuse the system.  

READ ALSO What to do if you have a medical emergency in France

Firefighters will bill anyone who makes a false call anywhere between €200 and €1,000 – and there’s no option to claim this cost back from anywhere.

In hospital

If your condition is serious, either the SAMU or the pompiers may take you to the nearest hospital for treatment.

In 2022, France introduced a new flat fee of €18 for treatment at hospital emergency departments known as the forfait patient urgences (FPU). This applies whether you are taken to the emergency department by emergency services or whether you get yourself to the hospital.

It applies to most people – there are exceptions – who receives treatment at an emergency room in a French hospital who does not then need to be admitted to hospital. 

Everyone is liable, whether they are French or not, whether they’re residents or tourists.

Anyone resident in France who has a mutuelle should be covered for this fee, but it is not reimbursable via the carte vitale.

READ ALSO What you need to know about France’s fees for emergency medical treatment

If your condition is serious enough that you are admitted to the hospital for further treatment, the bill depends on what treatment you receive and how long you stay.

Transport

What if you just need transporting to hospital for non-emergency appointments? Some patients are entitled to have the cost of transport covered by social security, including public transport, taxis, or ambulance – but in this case you would need to be living in France and registered in the French system.

Each area also has its own ambulance service – in most places these are white vehicles with a blue star and the name of the local authority that they are controlled by.

You may also be able to claim back fuel costs if you use your own vehicle.

The first step, in this instance, is to get your GP to fill out a prescription converting transport costs. This should also state what means of transport you should use.

You can be reimbursed for:

  • Trips to and from hospital out-patient care;
  • Care for a recognised long-term condition if you cannot get to the appointment by yourself;
  • If you have a serious condition where you need to be under surveillance or lying down during the journey;
  • Care linked to a work accident or work-related illness.

You will need approval from your local CPAM if your medical needs require the following:

  • Long-distance transport (more than 150km each way);
  • For treatment which requires at least four trips of more than 50km each way, in a two-month period;
  • If treatment requires you to travel a flight or boat trip.

Retain all receipts to send them, with a copy of the prescription authorising transportation to your local CPAM office for reimbursement of up to 55 percent of the total cost. 

READ ALSO Prescription fees and sick notes: What’s in France’s 2024 budget

Be aware that taxis you use must be ‘conventionné’ – ie licensed to transport patients. They will have a blue ‘C’ sticker in the back window.

Full reimbursement

The full cost of transportation is covered for the following: 

  • Pregnant women (six months or more);
  • Newborns less than 30 days old;
  • People who have suffered a work accident or occupational disease;
  • People suffering from a long-term illness (Affection longue durée or ALD);
  • Children and adolescents in centres d’action médico-sociale précoce (CAMSP) and centres médico-psycho-pédagogiques (CMPP);
  • Anyone entitled to complementary health insurance (Complémentaire santé solidaire or CSS) or state medical aid (Aide médicale de l’État or AME).

READ ALSO Explained: Who has to pay France’s annual healthcare charge

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HEALTH

How serious is the threat from dengue fever in France?

As tiger mosquitoes are now present in over 80 percent of mainland France, health authorities are worried that local transmission of tropical diseases, like dengue fever, will increase.

How serious is the threat from dengue fever in France?

As of January 2024, tiger mosquitoes – known for their ability to carry diseases such as dengue, chikungunya and Zika virus – had been detected in 78 of France’s 96 mainland départements, including the Paris region.

This has left public health authorities concerned about the spread of dengue fever in France, particularly this summer as large crowds are expected amid the Olympic Games.

READ MORE: MAP: Tiger mosquitoes reach northern France

How common is dengue fever in France?

In the first four months of 2024, 1,679 cases of dengue fever were identified in mainland France, a number that is 13 times higher than the same period last year, Le Parisien reported.

Crucially, however, none of these are believed to have been contracted in mainland France – they were all reported among patients who had recently travelled from the tropical regions where dengue fever is common.

The majority of cases were from people who had visited the Caribbean islands of Martinique and Guadeloupe – where the disease is endemic.

These islands are for administrative purposes part of France – so often show up in French health data – but they are roughly 7,000km away from Paris.

So far, there have not been any indigenous cases (autochtone – or people infected on mainland French soil) yet this year.

Local transmission of the disease remains relatively rare. In 2023, nine separate outbreaks of indigenous dengue transmission were identified, one of which occurred in the Paris region. These led to 45 cases of local transmission (in mainland France).

Most were in southern France – in the Provence-Alpes-Côte d’Azur, Occitanie and Auvergne-Rhône-Alpes regions – though one outbreak occurred in the Paris region, according to French public health authorities.

This is less than 2022, which was a notable year with 66 total cases of indigenous dengue fever were recorded. In comparison, between 2010 and 2021, only 48 cases (total) were recorded.

What to expect for 2024

Experts believe that the number of cases in France, including indigenous ones, will grow this year, as tiger mosquitoes now occupy more territory in mainland France.

On top of that, the number of cases has increased significantly in Martinique and Guadeloupe.

“What we see in France is a mirror image of what is happening in the French Caribbean, and more widely in Latin America and the rest of the Caribbean, where dengue fever has been circulating since the start of the year at unprecedented levels”, the head of Santé Publique France, Dr Caroline Semaille, said during a press conference.

The Olympic Games will also bring an influx of tourists from all over the world, and weather conditions are expected to be conducive to mosquitoes – a year with a lot of rainfall, and potentially high temperatures. 

What is dengue fever?

The disease is spread to people from bites by infected mosquitoes.

The most common symptoms are high fever, chills, abdominal, joint and muscle pains, and vomiting. It can also cause a skin rash that resembles measles, according to France’s Institut Pasteur.

Symptoms usually begin three to 14 days (with an average of four to seven) after being bitten.

However people are asymptomatic in 50 to 90 percent of cases (depending on the epidemic), which can make monitoring difficult.

At-risk groups include the immunocompromised, children and the elderly, who are more likely to suffer from severe forms of the disease.

Deaths from the disease are very rare, occurring in around 0.01 percent of all cases, almost all in countries that have poor healthcare systems.

How can I avoid tiger mosquitoes?

Female tiger mosquitoes lay their eggs in water, and they can lay several hundred eggs at once. Therefore try to avoid having any standing water outside your home and be aware of the items that might collect rainwater.

This includes regularly emptying vases, flower pots, as well as watering cans and pots. If you want to collect rainwater, you could cover water butts with mosquito nets or fabric to keep the mosquitoes from getting inside.

READ ALSO 5 plants that (allegedly) repel mosquitoes

You can also keep your gutters clean – this helps to keep the water flowing when it rains, and it avoids any stagnant pools from building up.

To protect yourself, try to wear long, loose and light-coloured clothing, in addition to insect repellent. You might also consider wearing a mosquito net head gear.

The main difference between tiger mosquitoes and other species would be getting a bite during the day, and the fact that tiger mosquitoes are likely to bite several times. You can tell for sure if it was a tiger mosquito by seeing the insect itself. They are also silent.

There is no immediate cause for alarm if you are bitten, in almost all cases the bites are just itchy and annoying. In very rare cases, tropical diseases can be spread by the mosquitoes – seek medical help if you develop a high fever and rash.

READ MORE: How to prevent the spread of tiger mosquitoes in France

What do tiger mosquitoes look like?

They are very small, about 5 mm, and they have a highly contrasting colour, with black and white stripes on their body and legs.

If you believe you have spotted a tiger mosquito, you can report it to public health authorities online.

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