The system is pretty much the same for all expatriate health insurance plans: for routine medical expenses, yes, you'll have to pay in advance; for expenses related to hospitalization, no.
The healthcare payment system in France, where the "Carte Vitale" works in conjunction with supplementary insurance plans, does not apply to expatriate plans, even those that complement the CFE.
The automated reimbursement system (which you may be used to for routine care) cannot be implemented here. In France, Social Security and supplementary insurance providers have agreed on computing standards that allow for data to be exchanged and payments to be made directly to professionals. Such a system is impossible on an international scale.
For all routine medical expenses (e.g., doctor's appointments, prescriptions, examinations), you must pay in advance and send the invoices to the insurer to be reimbursed. In general, insured persons are free to consult the practitioners of their choice.
The same applies for routine medical expenses performed in a hospital (as is often the case abroad), or so-called "outpatient care."
If you are hospitalized, you are not required to pay in advance. This is true for all insurers once the hospitalization exceeds 24 hours (inpatient care). In practice, it works in one of two ways:
- You go to a facility approved by your insurer. A list of these facilities can be found on your insurer's website. Upon admission, you present your insurance card and all the rest is taken care of automatically.
- You go to a facility that is not approved by your insurer. Most of the time, this is no problem. If you have time, you might want to contact your insurer beforehand. They will contact the hospital and pay your bill directly. In the case of an emergency hospitalization, the hospital will contact the insurer for the payment.
It's a good idea to contact your insurer before any hospitalization as they can help you choose the best facility for your illness or condition.
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