Patients in France will soon have to pay double for the ‘franchise médicale’ - the non-refundable portion of payments per box or treatment - will increase from 50 cents to €1 from spring this year.
The rise is set to come into force from the end of March, while the cost for a medical transport trip will also double from €2 to €4.
President Emmanuel Macron confirmed the change during a press conference on January 16, with government ministers confirming the ‘road map’ for the change on January 22.
The government had been suggesting the move was necessary for months, to help increase the social security budget, but Mr Macron did not bring up the increase during the discussions for the health budget 2024.
The new cost is set to bring in €800 million to the Sécu (Sécurité sociale), to help fill a gap in funds, and is also intended to send a message to make healthcare professionals and patients “more responsible” and reduce needless or excess prescriptions.
What is the franchise médicale?
The franchise médicale is the amount each patient must pay per prescribed medicine or medical treatment. It goes to help fund the state healthcare provision.
It is not charged for medicine given during hospital treatment, paramedic care, or emergencies.
It only applies to prescription medication (as opposed to a box of medicine you can buy over the counter) that is otherwise reimbursed by the Assurance Maladie. It also only applies to medicine prescribed to people aged 18 and over.
For example, you buy a box of medicine that costs €10, which is reimbursed at 65% by the Assurance maladie.
You receive €6 back, not the full 65% (€6.50) because €0.50 is your franchise médicale charge.
You can see your franchise médicale charges itemised in your Assurance maladie online account at Ameli.fr.
They are not usually reimbursed by top-up health insurance policies.
The new cost will not apply to certain people, including those who need regular medication or treatment, and those who already hit the €50-per-year cap.
The government stated: “Patients who make the greatest use of healthcare, whose deductibles are already capped at €50, will not pay any more.”
It also announced that people under the age of 18, “women covered by maternity insurance" and "beneficiaries of the complementary health insurance scheme", who are on modest incomes, will not need to pay extra.
Despite these exceptions, some healthcare unions have criticised the change.
Patient association federation France Assos Santé, and the main GP union, MG France, said that the change will have a negative effect on vulnerable members of society.
The president of the association, Gérard Raymond, told FranceInfo: “This is not the way to make patients and people in need of care more responsible.”
He said that the change could lead to a “double penalty”: firstly, being ill, and secondly, “paying twice as much”.
Jean-Christophe Nogrette, deputy secretary general of MG France, told AFP: "The chronically ill, the elderly, all reach the cap very quickly.”
They “will reach it even more quickly by doubling the stakes,” he said, adding that “€100 per year [if the two ceilings are reached] on a small pension is not insignificant”.