Reader question: What are the costs of hospital stays in France?
Substantial fees can be payable in the case of a hospital or clinic stay, which is one of the reasons it is important for residents in France to register with the French healthcare system and also to apply for a top-up mutuelle.
For a stay in a public hospital or a clinique privée conventionnée (private clinic that has signed an agreement with the state) there will be certain set fees depending on the type of care you receive.
These are usually covered through the state and with a top-up via your mutuelle insurance policy, if you opt to have one.
Note that in state hospitals and approved private clinics the tiers payant system operates, meaning you do not have to advance upfront the state-reimbursed part of your care as long as you are in the French system.
For remaining elements you would formerly be given a bill to pay on leaving hospital, however now in state hospitals you also do not need to pay the part covered by your mutuelle. This is gradually being extended to other establishments.
Whether there are any out-of-pocket costs otherwise will depend on the terms of your mutuelle and for example whether you opt for a high level of extra comfort on top of the basic services.
What is a forfait hospitalier?
The forfait hospitalier is a daily €20 charge towards accommodation and laundry etc.
This is not state-reimbursed but most mutuelles cover it.
What are the frais d’hospitalisation?
The frais d’hospitalisation is a bill for services of the hospital’s medical staff and costs of medicine and equipment.
They vary by hospital and department and can sometimes mount up to as much as €3,000 a day in intensive care.
These are state-reimbursed at 80%, although certain specific procedures with a tariff of at least €120 individually are reimbursed at 100% but with a fixed €24 fee left to pay by the patient (this is only charged once if there are several of them).
However Féreuze Aziza, an adviser at France Assos Santé, a body representing patients, said many of the items totted up under ‘hospitalisation fees’ do not come under this category, so this is where problems can arise for patients who do not have a top-up policy.
There can also be extra fees for additional comforts, such as a private room or TV. These may or may not be covered by your mutuelle, depending on the level of cover and the options you choose.
Do I have to pay dépassements d’honoraires in hospital?
Dépassements d’honoraires are the extra fees charged by some doctors above and beyond the standard fixed state rates; they are often reimbursed by mutuelles.
Ms Aziza said dépassements d’honoraires are not usually the issue in hospital, apart from where a hospital doctor is performing an operation on a private basis – and he or she should always specify if this is the case.
When does 100% cover for the frais d’hospitalisation start?
In hospital, state cover at 100% for the frais d’hospitalisation starts after 30 days’ hospitalisation or in certain cases such as treatment for an ALD.
‘Hospital’ care at home
Note also that there is an option called hospitalisation à domicile (hospitalisation at home) that can be suitable to some healthcare conditions.
This involves a high-level of regular care from visiting professionals while you stay in your own home, and aims at reducing pressure on hospitals.
Reimbursement is the same as for hospitals apart from there is no forfait journalier.