Other medical costs: from blood tests to psychologists

Medical transport options 

Transport that is required for medical reasons can be refunded if it is prescribed by a doctor. For some more costly or repeated journeys you will also need agreement from your Cpam.

As a general rule, if you need to be lying down or need oxygen, you need an ambulance, if you can sit but need help, you need a taxi or véhicule sanitaire léger (light medical vehicle); otherwise you are expected to use private or public transport. Transport to a hospital for surgery or for pre or post-surgical appointments is included. 

The doctor would agree on what fits your needs. If you are using a taxi you must use one from a firm that has an agreement with the Cpam, known as being conventionné – they will have a blue ‘C’ sticker in the back window.

If you visit ameli.fr and click Remboursements then Transport, you may (depending on your department) find contact details for taxis. You can also ask your Cpam on 36 46 (or the English-speaking line on 08 11 36 36 46) or with a written message via the Ma Messagerie option in your personal space at ameli.fr.

Medical transport is usually reimbursed at 55%. However 100% reimbursement is possible for, under certain conditions, attending appointments related to an ALD or for people on low incomes who have the CSS. It is also 100% in the case of emergency transport followed by hospitalisation. Transport for those with a French military disability pension is reimbursed 100%.

Mutuelles often contain cover for medical transport, often up to 100% of standard tariff rates. You obtain reimbursement by sending the prescription and a receipt for the trip/s to your Cpam and/or mutuelle.

Blood test laboratories

A laboratoire d’analyses carries out blood tests, usually on prescription from a doctor. Blood (or other similar) tests are referred to as actes de biologie médicale and are typically reimbursed at 60%.

The sites often open early and close late for convenience and there is usually no need for an appointment, although if they are busy you may need to wait. Depending on the test and how efficient the lab is, it may produce the results the same day, or in most cases no later than the following day. You can collect them, request them be emailed to you (you may need to ask specifically for this) or obtain them on a secure internet site. A copy of the results is also sent to the doctor if the test was prescribed.

Labs will usually also carry out tests on your request without prescription (these are not reimbursed).

Nurses, speech therapists, kinés, chiropodists...

Reimbursement for care from a nurse is reimbursed by the state at 60%. The rate also applies to visiting similar paramedical professionals, such as a physiotherapist, orthoptist, speech therapist, or chiropodist. Top-up insurance often covers the rest of the fee (minus franchise charges).

Many nurses work on a home visit basis, while others are based in their own permanent premises (cabinet). Physiotherapists are known as a kiné – short for masseur-kinésithérapeute. Most operate in their own practices or as employees of a private clinic, others in hospitals. Most kinés charge standard tariffs, although some, especially in areas such as Paris or the Riviera, charge dépassements (which many mutuelles will reimburse, partially or in full). They help with issues such as back problems and recovery from injury or surgery.

To see a professional such as a speech therapist, nurse, or physiotherapist, a patient should generally first obtain a prescription from a doctor. However, a reform called the loi Rist gave the possibility of ‘direct access’ as long as the professionals work in hospitals, clinics, or multidisciplinary health centres (maisons or centres de santé).

In the case of nurses, ‘direct access’ is only possible for infirmiers en pratique avancée (IPA, advanced practice nurses), who fall between a traditional nurse and a doctor in terms of areas of competency. Trials are being done also including professionals who are part of a communauté professionnelle territoriale de santé (CPTS), local schemes where independent professionals sign up to support good healthcare in their area.

The Rist law states that IPAs can write first prescriptions for some drugs, and nurses generally, where working in health centres or as part of a CPTS, can take charge of wound care and prescribe complementary examinations and medicines. Chiropodists can now prescribe orthopaedic insoles without referral. They can also examine diabetic patients, decide which patients are most at risk of foot-related complications, and prescribe suitable care sessions.

Reimbursements for consultations with psychologists 

Visiting a psychologist is a common way of accessing ‘talking therapy’ for help with emotional and psychological issues. The Assurance Maladie is reimbursing consultations with psychologists via a service called MonSoutienPsy.

While the first session must be in person, certain psychologists also offer remote sessions for subsequent appointments. This first visit will involve an evaluation. Up to 12 sessions can be reimbursed based on a rate of €50, and if need be, this can be continued under the same conditions for up to 12 sessions per year.

It will be reimbursed at 60% (mutuelles should cover the rest), or 100% for certain groups including people on the CSS or for care linked to a chronic illness (ALD). Everyone over age three who is registered with the Assurance Maladie is able to use the service. The sessions typically last from 40 to 55 minutes.

See here for more information and to find participating psychologists. To locate a psychologist who speaks English use your browser’s search function (Ctrl+F) and search for anglais.

Initially you had to go via your own GP in the first instance to obtain this service, but as of 2025, the government states it will be possible to go directly to psychologists as part of wider efforts to improve mental health in France.

Osteopaths, hypnosis and alternative medicines 

Homeopathic treatments are fairly often prescribed by doctors and were at one stage reimbursed at 30%. However, it was decided that there is insufficient proof of their efficacy, and this is no longer the case.

Reimbursement for ‘alternative’ medicine is generally patchy. For example, chiropractic only became legal in 2002 and is not reimbursed. Osteopathy and acupuncture can be reimbursed if carried out by a doctor, but only on the basis of the €30 cost of a GP appointment – and dépassements d’honoraires are the norm.

A report by the Académie Nationale de Médecine said acupuncture, chiropractic, osteopathy, hypnosis and tai-chi could all give some relief to patients. They said situations where they could be beneficial included pain relief where drugs are no longer helping. They could also be useful with secondary effects of chemotherapy – nausea and vomiting – avoiding the need for more drugs, the experts said. Another report, by Inserm, confirmed the efficacy of hypnosis as a complement to anaesthetics in surgery. It said it allowed for reduced use of sedatives and painkillers and found it was used in procedures from extracting wisdom teeth to breast biopsies. Many people also use it to deal with addictions, such as smoking.

Some GPs and psychiatrists use it, in which case you are reimbursed 70% on the basis of a consultation and a mutuelle tops up the rest. Otherwise certain mutuelles reimburse a set number of sessions under the heading of alternative medicine, or reimburse up to a certain percentage of the cost.

In 2018, a patient aged 88 had a heart operation to replace a valve by catheterisation, using hypnosis instead of general anaesthetic, at Lille CHU Hospital.

With regard to osteopathy, the Académie Nationale de Médecine said it was ‘moderately effective’ for a range of back and neck conditions and in some cases for headaches and dizziness. It warned however that there could be complications from manipulations (notably of the neck) of a serious nature but this was rare. It said therapies like this had their place if they remained complementary and people consulted a doctor first.

Osteopaths in France follow a five-year course or a fast-track one if they are already doctors or physios. Typically, osteopathy is a one-off, or a couple of sessions at most and costs around €70 for a session of on average 45 minutes.

Another comparable technique is chiropractic, which is much less common in France. It is very direct in its approach. 

One osteopath told The Connexion: “They go directly to where it’s hurting and crack you to put you back in place; an osteopath may look also at the tissues and muscles and seek underlying causes – because the origin of the problem is not always in the place where you have the most pain.”

Sport on prescription (for certain conditions) 

Doctors can prescribe sport to patients suffering from a recognised long-term illness (ALD) such as diabetes or cardiovascular disease but reimbursement depends on where you live. A decree extended this to other people suffering chronic illnesses or with risk factors such as obesity or high blood pressure. Those who hold the carte mobilité inclusion disabled person’s card or who have home help assistance, either through the allocation personnalisée d’autonomie or aide à domicile, or people assessed as having a déclin fonctionnel lié à l’âge, can also be prescribed sport.

The prescription, which lasts six months and is renewable, must be written by a doctor but people in charge of the programme can be other professionals such as physiotherapists, sports teachers and trainers. The idea followed trials in several towns, notably Strasbourg. 

Starting in 2012 doctors there gave patients a prescription for free activities such as cycling, Nordic walking or tai-chi to reduce their need for drugs and improve their health. They found that Assurance Maladie made savings as people changed their lifestyles and could reduce medication. Strasbourg still offers a subsidised sport programme.

With the passing of a law in 2017 officialising the idea of prescribing sport, ministers said doctors would be offered extra training in this area. However, so far reimbursement is not systematic. The government said doctors would be offered model prescriptions and the regional health agencies would draw up lists of sports specialists able to provide sessions suitably tailored to people’s health conditions – activité physique adaptée. In some areas subsidised or free sessions are offered by councils or associations. Paris, Biarritz, Blagnac and Caen are among communes with such schemes.

Some mutuelles and other insurers will also reimburse part of the cost. People who have insurance (of any kind) from Maif, for example, can have up to €500 reimbursed over two years if they have an ALD. If sport sessions are carried out in your home, they can be eligible for a 50% tax credit for ‘personal services’ if you pay via the Cesu system or pay an accredited firm.

Note that for sport in general, some activities require people to obtain a doctor’s certificate to say they are fit to take part although this is lessening. Parents should not have to supply such certificates for their children to sign up for a sports club but will be asked to fill in a questionnaire attesting to the child’s suitability.