Is my operation in a French private clinic reimbursable?

Question:

My doctor has suggested I have an operation in a private clinic – will this be reimbursed by the French social security system? G.F.

Answer:

This depends on whether or not the private clinic has a partnership with the state assurance maladie system. If it does, it is referred to as a clinique privée conventionnée and your hospitalisation costs will be covered on the same basis as if you have the operation in a public hospital.

This is a common arrangement and many French “hospitals” come under this banner. Strictly speaking, the term hôpital refers only to state-run establishments. In this case, the assurance maladie covers 80-100% of basic hospitalisation costs, minus €20/day called the forfait journalier. Where someone is in the clinic for a procedure normally costing €120 or more (un acte lourd), the reimbursement is at 100% minus a set figure of €24.

Apart from the forfait journalier, you may have to pay any dépassements d’honoraires – amounts over and above the usual state tariff – practised by your doctor/s and for any extras you asked for, such as having a private room. Some of these costs may be covered by your mutuelle top-up insurance, if you have one. Check the clinic’s status with your doctor to avoid ending up paying in full.

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