SHARE
COPY LINK
For members

HEALTH

Why medical costs are rising in France in 2024

The French government is increasing two types of healthcare expenses, with one of them going up starting on May 15th.

Why medical costs are rising in France in 2024
A pharmacist works at the Delpech pharmacy in Paris (Photo by Mehdi FEDOUACH / AFP)

In January, the French government announced plans to double two healthcare expenses, the ‘franchise médicale’ and the ‘participation forfaitaire’.

Both of these are fees are deducted from the reimbursement of medical costs such as prescription charges and appointment fees, but they are applied in different circumstances.

The franchise médicale already was increased in April 2024, and the participation forfaitaire will increase starting on May 15th.

How the fees work

France’s healthcare system works on a reimbursement model – you pay the doctor, pharmacist or other medical professional up front and then some or all of the cost is reimbursed to you by the French state.

But the exact amount that you are reimbursed is worked out according to a complicated formula that takes into account your personal circumstances, the type of treatment you are having and the status of the doctor who is treating you.

You can find a full explanation of how it works HERE.

However, after the reimbursement is calculated a small amount is subtracted from the total cost – the franchise médicale and the participation forfaitaire. These costs (usually around €1) are therefore not reimbursed.

Generally, any costs that are not reimbursed by the state will be covered by the ‘top-up insurance’ known as a mutuelle, if you have one.

However the franchise médicale and the participation forfaitaire are not covered by a mutuelle either, so you pay them out of pocket.

Franchise médicale

The franchise médicale is applied to prescriptions, visits to ‘paramedical’ professionals (including appointments with nurses, physiotherapists and masseurs, speech therapists and eye specialists), and non-emergency medical transport.

On April 1st, the franchise médicale was doubled from €0.50 to €1 for prescriptions and ‘paramedical procedures’ and from €2 to €4 for patient transport.

There are also caps on the amount that can be charged in franchise médicale in one day, which increased in April.

The maximum amount that can be charged in one day in franchise médicales for paramedical appointments rose to €4, instead of €2 previously. Meanwhile, for medical transport, the maximum went up to €8 in one day, instead of €4 previously.

There is currently a cap of €50 on the total amount you can pay in franchise médicales per year. This will remain in place despite the increased charges, according to the French government site Service-Public.

Does everyone have to pay this?

Some groups do not have to pay franchises médicales;

  • children under the age of 18;
  • beneficiaries of complementary health insurance (Complémentaire santé solidaire) or state medical aid (Aide Médicale de l’Etat – AME)
  • pregnant women from the first day of the sixth month of pregnancy until the 12th day after giving birth;
  • minors purchasing contraception and/or the morning-after-pill without parental consent;
  • victims of terrorism

What about the participation forfaitaire?

This is the same principle as the franchise médicale, but is applied to different types of healthcare –  specifically any appointment with or procedure carried out by a general practitioner or specialist, as well as X-Rays, scans and lab tests.

Previously, it was set to a flat rate of €1 across the board. However, starting on May 15, 2024, it will increase – the exact amount is still to be clarified, but it will not be more than €3, according to the government decree.

Like the franchise médicale, there will be a €50 annual cap on costs.

How does this work?

As with the franchise médicale, you will pay the same price for appointments and treatments, but the reimbursement will be slightly less.

Let’s take as an example an appointment with a GP who is ‘sector one’ – the standard charging rate for GPs – which are reimbursed at 70 percent.

Assuming that the new charge is €2, you would pay the standard appointment fee of €26.50 and will be reimbursed at €16.55 – 70 percent of the €26.50 (€18.55) minus €2.

If you have a mutuelle, it would cover €7.95, leaving you to pay €2. 

How does it work in practice?

You will continue to pay the same price for prescriptions, appointments and transport, but the reimbursement amount you receive will be slightly less.

So let’s take a prescription as an example; you pay the pharmacist €10 for a box of tablets that have a reimbursement rate of 65 percent – you will be reimbursed €5.50 (65 percent of €10 is €6.50, minus €1 franchise médicale equals €5.50). 

If you have a full-cover mutuelle, you will receive €3.50 from the mutuelle, leaving you to pay €1.

Why raise rates?

The French healthcare system is currently in deficit and the government is hoping that the charges will allow it to raise additional funds – although the vast majority of healthcare funding continues to come from the public purse, via taxes and social charges.

According to RTL, increasing these charges will allow the state to add take in about €800,000 million in funding. 

Member comments

Log in here to leave a comment.
Become a Member to leave a comment.
For members

COST OF LIVING

What is considered a good salary in Paris?

The higher-paying jobs are heavily concentrated in the French capital, but set against that is the high cost of living - especially the cost of renting or buying a home. So what is considered a 'high-earner' in Paris?

What is considered a good salary in Paris?

Centrist Renaissance candidate Sylvain Maillard, running for re-election in France’s snap parliamentary elections, was trying to highlight the high cost of living in the capital in a debate on RMC Radio 

“You have extremely expensive rents [in Paris], between €1,500 and €1,700, and then there are all the charges and taxes to pay,” he said.

But what most people seized on was his comment that anyone earning €4,000 a month after tax would not be considered rich in Paris – he predictably was accused of being out of touch with French people’s lives.

There’s no doubt that €4,000 a month is good salary that most people would be happy with – but how much do you need to earn to be considered ‘rich’ in Paris?

National averages

Earlier this year, the independent Observatoire des Inégalités calculated poverty and wealth levels in France.

READ ALSO How much money do you need to be considered rich in France?

According to its calculations, to be considered ‘rich’ in France, a single person with no dependants needs to earn more than €3,860 per month, after taxes and social charges. Around eight percent of single workers have this sum deposited into their bank balance every month, it said.

A total of 23 percent of workers take home €3,000 or more every month, while the top 10 percent clear €4,170. 

To be in the top one percent of earners in France in 2024, one person must bring in at least €10,000 per month. After taxes and social charges.

The median income – the median is the ‘middle value’ of a range of totals – of tax households in mainland France is €1,923 per month after taxes and social charges, according to INSEE 2021 data, which means that a ‘rich’ person earns about twice as much as a person on the median income, according to the Observatoire.

Paris situation

About 75 percent of people living in Paris earn less than €4,458 per month, according to Insee data – so according to those calculations, 25 percent of Parisians earn the equivalent of the top 10 percent in France. 

But that city-wide average still hides a wide degree of variation. In the sixth arrondissement, the median income is €4,358 per month, after tax. In the seventh, it’s €4,255.  Further out, those bringing home €4,600 a month in the 19th and 20th arrondissements are among the top 10 percent in wealth terms.

But still, the median income in Paris is €2,639, significantly higher than the €1,923 France-wide median.

That would mean – using the Observatoire des Inégalités’ starting point for wealth – that a Paris resident, living on their own, would have to bring home €5,278 per month to be considered ‘rich’. 

France is a heavily centralised country, with many of the highest-paying industries concentrated within the capital, meaning there is much more opportunity to secure a high-wage job if you live in Paris.

Cost of living

Even these figures should all be taken with a pinch of salt because of the relatively high cost of living in the capital, compared to elsewhere in France. Paris is objectively an expensive place to call home.

In 2023, France Stratégie published a report on the disposable income of French households, after housing, food and transport costs were deducted. It found that, on average, people living in the Paris region had more left to spend, due to higher incomes and despite the fact that housing costs more.

It’s the income paradox in action. A person with a take-home salary of €4,000 per month has more money to spend if they live and work outside Paris. But they’re much more likely to earn that much if they live and work in Paris, where it’s not as valuable. 

Someone who earns a ‘rich-level’ salary in Paris might not appear rich – because they live in an expensive area, and a surrounded by very wealthy people in property that’s out of reach all-but the fattest of wallets. But they’re still earning more than twice the median income in France.

And that’s what Sylvain Maillard was getting at, clumsily as he may have expressed it.

SHOW COMMENTS