Will French healthcare cover medical costs for a holiday to America?

Reader question: I am planning a visit to my daughter in the US soon. A French friend has told me I do not need to take out full medical insurance as any medical costs will be covered by my French health insurance. Is this true?

This is not necessarily the case, it depends on the situation.

For travel to an EU or EEA country, Switzerland or the UK, you can use a European Health Insurance Card to cover the costs of any emergency medical procedures. In France, this card is called a Carte Européenne d'Assurance Maladie (Ceam) and it is available to most people who are in the French system (but not British pensioners whose healthcare is paid by the UK).

Read more: How French residents can access healthcare in UK on trips

For travel outside of these countries, a Ceam does not apply.

There are different scenarios to think about. The first is whether you are travelling to your ‘home country’ and whether France has a medical care agreement (une convention de sécurité sociale) with that country.

France does not have this accord with the US, the French health insurance website Ameli shows. See here for a full list of countries that have a medical care agreement with France, under the section ‘Vous partez dans votre pays d’origine’.

If France does have an accord with a country you are a citizen of, medical fees can be covered up front without the need for later reimbursement.

Our reader does not specify if they are a US citizen or not. If they are, it is recommended that they contact their local health insurance office to inform them of their trip to the US and to check if any coverage is provided, including whether it is possible that the fees are covered up front. We believe this to be unlikely as France does not have an agreement with the US.

In any case, Ameli notes that medical care in the US can be extremely expensive and advises people to take out private health or travel insurance when visiting the country.

This is because even if French social security can provide reimbursement, it will only do so within the current standard French medical rates. This means that it may only cover 80% of hospital fees, for example, leaving you with 20% to pay.

With the cost of US medical care, this 20% could amount to thousands or even tens of thousands of dollars.

If our reader has a top-up insurance policy, commonly known as a mutuelle, which usually covers the remaining costs not covered by France’s standard medical insurance, then this policy may also include trips abroad – as long as standard French health insurance agrees to cover the majority of the costs. Our reader should check with their insurance provider if they have a mutuelle.

In the case that our reader is not a US citizen, then again Ameli advises that they take out private health or travel insurance for trips to the US.

French health insurance may cover medical fees, but only in the case that it is an emergency and unforeseen situation. These fees will not be covered up front but will be reimbursed at a later date.

This means that, in a worst case scenario, if our reader is involved in an accident while in the US they could be liable to pay several hundreds of thousands of dollars in medical payments before possibly being reimbursed by the French social security.

Again, as above, standard French medical insurance will not cover 100% of the costs.

Another factor is that Ameli states that if reimbursement is refused - for example if the medical costs were not due to an emergency or unforeseen situation - then there is no recourse to an appeal.

Ameli states several times that travellers to the US are recommended to take out private health or travel insurance to avoid being hit with high medical bills.

Finally, French health coverage does not cover the costs of repatriation in case a person dies while travelling abroad.

Read Ameli’s recommendations here (in French).

To get an idea of insurance costs we did a quick search for travel insurance including medical fee coverage on Axa’s website.

We entered the following details:

• Single trip for one person

• Traveller is aged 60

• Three-week trip lasting from August 1 to August 22

• Cost of trip: €2,000

We were given three quotes. The cheapest was a basic package costing €134.93 that includes coverage for foreign medical costs. The most expensive, costing €259.87 includes other elements such as covering the costs of cancelled transport or covering expenses for accidents that you may cause.

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