Sophia Antipolis - Health Insurance
The Sécurité Sociale: http://www.securite-sociale.fr
The French national health system is managed by the Caisse Primaire d'Assurance Maladie (CPAM). Each area has its CPAM. To find out which one you belong to, call the council of your town.
In order to obtain your number of "sécurité sociale" and your "carte vitale" you need to fill out a form called "la demande d'immatriculation d'un travailleur". You also need these documents:
- your resident card
- the E111 or E106 (for European) form, or private medical insurance
- your birth certificate
- relevé d'identité bancaire (RIB), which is all the information on your bank account in order to be reimbursed.
The number and the "carte vitale" will enable you to be reimbursed for any health costs incurred by you, your spouse and children under 16 or under 20 if they are students.
The French social security system covers only partly for medical treatment:
- hospital fees: 80 %
- medical fees (surgery): 70%
- pharmacy fees: 35 à 65 %
- nurse, physiotherapist fees: 60 %
- dentist fees: 70 %
- optician fees: 65 %
Many people in France pay an additional "mutuelle", which is a private health insurance, which is organised through your employer or an insurance broker. The cost of the "mutuelle" depends on the cover you require.
When you see a doctor, you have to pay and give him your "carte vitale". See http://www.sesam-vitale.fr The doctor transmits electronically the cost of the visit to the CPAM and you will be reimbursed on your bank account. If you have the complementary insurance, called "mutuelle", CPAM will have all your details, and you do not need to pay anything. You will receive a receipt from the CPAM and from your "mutuelle".
If your doctor is not "conventionné" (which means he cannot be reimbursed by the CPAM), he is free to set his own fees and they often exceed the rates defined by the social security.
Otherwice prices of the doctors ("conventionné") are fixed:
- 25 euros for a consultation with a general practitioner
- 40/45 euros to see a specialist