Stays at a thermal spa

France has spa treatments in more than 100 resorts known as stations thermales which treat half a million people a year – with 65% of the treatment cost potentially covered by the social security if you have a condition considered likely to benefit from this.

Depending on your financial situation, some travel and accommodation costs are also paid. Ask your doctor about applying to be covered for a cure thermale.

Spa treatment is said to be curative and preventative – for example, waters at Gréoux-les-Bains in Alpes-de-Haute-Provence are said to be suitable for rheumatism and respiratory infections as they are rich in sulphur, calcium, sodium and magnesium.

The treatments, les soins, aim to relieve people’s pain and reduce medication. Some top-up insurance include coverage towards non-reimbursed elements of a prescribed thermal cure, but sometimes within a set limit per year.

Taking a spa treatment: formalities and coverage

French doctors can prescribe spa treatments for a variety of ailments and, in some cases, these can be state reimbursed.

If you plan a spa treatment for which you will be seeking reimbursement, you should confirm your entitlement to reimbursement beforehand. Your doctor will be able to advise you if a spa treatment is recommended for your specific problem.

If this is the case, your doctor can write you a prescription.

In most cases, your doctor will also be able to determine which spa facility is best suited for your medical needs.

There are more than 100 government-approved health spas across France.

Note that a cure thermale uses fresh water, not salt water. Thalassothérapie seawater treatments, which are said to have relaxing and preventative effects, are not state reimbursed.

If your issue concerns a disease of the mouth, such as an oral mucous membrane disorder, your dentist may be qualified to write a spa prescription.

It is your responsibility to ensure that your medical coverage will be sufficient to pay for all the various costs.

Your GP or specialist is the only one who can prescribe a thermal spa treatment plan, if they believe it would be effective for your condition.

The plan must be medically prescribed and last 18 days (effectively three weeks as the centres are closed on Sundays), with treatments offered six days a week to be eligible for reimbursement.

Your doctor or specialist must sign you up to the plan via an official form - a sample copy of which can be seen here.

Up to two different conditions can be included on the form.

Reimbursement for the plan should be processed within a month.

Your treatment will only qualify for state reimbursement if the problem for which you have received a prescription comes under one of a specific list of 12 types of recognised conditions, which we list, with examples, here.

The medical term sequelae refers to additional health problems that are a consequence of another underlying condition.

Rheumatology 

Osteoarthritis – degenerative and inflammatory rheumatism – musculoskeletal disorders – osteoporosis – lumbago – sciatica – tendonitis – Rheumatoid arthritis – ankylosing spondylitis – after-effects of trauma or surgery – chronic inflammation of the tendons – fibromyalgia syndrome – joint stiffness – after-effects of fractures

Lymphology and blood 

Lymphatic insufficiency – haemorrhoids – heavy legs – chronic oedemas of the lower limbs – sequelae of phlebitis – Raynaud’s syndrome – venous thrombosis and its consequences – vascular disorders of the extremities – varicose veins and varicose ulcers

Neurology 

Muscular disorders of neurological origin – fibromyalgia – Charcot Marie Tooth disease – Parkinson’s disease – paralysis after a cerebrovascular accident – post-polio – multiple sclerosis – sequelae of hemiplegia or paraplegia

Respiratory tract 

Respiratory allergies – asthma – bronchitis – otitis – sinusitis – allergic rhinitis – angina – rhinosinusitis – recurrent rhinopharyngitis – hay fever – spasmodic cough – COPD

Digestive system, metabolism 

Hepatobiliary disease – mild or moderate Crohn’s disease – mild or moderate ulcerative colitis – consequences of intestinal parasitic diseases – intestinal transit disorders

Cardio-arterial diseases 

Angina pectoris – peripheral artery disease – arterial hypertension – Raynaud’s disease – sequelae of infarction – after-effects of surgical treatment: bypass surgery, arterial dilatation

Oral mucosal disorders 

Aphthosis – dry mouth – post-radiation burns – glossitis – intolerance to fixed or mobile prostheses – leukokeratosis – oral lichen planus – periodontal diseases – trauma or surgery after-effects – stomatodynia

Urinary system, metabolism 

Urinary calculi – colibacillosis – cystitis – cystalgia – urinary infection – recurrent prostatitis

Dermatology 

Acne – scars – eczema – chronic pruritus – psoriasis – facial redness – after-effects of burns

Gynaecology 

Pre and post-natal mini-cures – pelvic and vaginal pain – dysmenorrhoea – recurrent infections – menopausal problems – painful periods – episiotomy after-effects – dryness of the pelvic mucosa

Psychosomatic conditions 

Depression – insomnia – asthenia (ie. weakness/fatigue) – chronic hyperventilation syndrome

Developmental disorders 

Attention deficit/hyperactivity disorder – anorexia – nocturnal enuresis

Reimbursement of thermal treatment

Thermal cures are reimbursed by the state health insurance as they are considered to be therapeutic and may be prescribed by a doctor to treat a chronic disease.

The typical course of treatment lasts for a total of 18 days of treatment and you are required to follow the entire course in order to receive reimbursement. Unless this is due to something out of your control or an adverse clinical response, the cost of an interrupted cure is not reimbursed.

Reimbursement of thermal treatments is subject to other restrictions as well.

Firstly, you should check that a spa you are looking at is government-approved (conventionné): its website will probably mention wording such as établissement thermal conventionné or cure thermale conventionnée.

Note that spas often specialise in helping with certain conditions and a single establishment will not cover all of the kinds listed on the previous page. If you are eligible for help with transport costs then you may only obtain reimbursement up to the cost of transport to the nearest approved spa that deals with your ailment.

Often, it will be your doctor who says which spa you should attend.

You should also note that some spas offer a basic treatment regime that is covered by state insurance as well as alternative options that may be more expensive and not benefit from coverage.

Generally, reimbursement is granted for no more than one spa treatment per calendar year.

An exception to this limit concerns the situation where your doctor gives you two prescriptions for two different ailments and your spa can provide parallel courses of treatment for both pathologies at the same time. In this case, you may be reimbursed for both treatments.

When going to a thermal spa for a pre-approved medical treatment, the state insurance regime and your mutuelle will cover all or part of your medical expenses, as well as, for those on low incomes, a share of transportation costs, room and board. Workers, unless on fairly high salaries, also benefit from a daily sick leave allowance.

Accredited spas also operate le tiers payant, ie. there is no upfront charge for reimbursed amounts.

The first step in all cases, is obtaining a prescription from a doctor (or a dentist for mouth-related issues). He or she also has to fill out a form called Cure thermale – questionnaire de prise en charge and will ask you to sign it.

You must also fill out a declaration of your financial means. These forms have to be forwarded to your Cpam (or the MSA for those working in agriculture).

It will, in turn, send you a form in three parts, one (honoraires médicaux) to give to the doctor overseeing your care at the spa, one (forfait thermal) to the spa admissions staff and one (frais de transport et d’hébergement) to send to Cpam on your return if you qualify for help towards transport and accommodation.

Most costs corresponding to the care are covered at 65% of a fixed sum called the forfait thermal. This depends on the therapeutic goals and what illness/es it relates to.

Then, there is a fee for the doctor responsible for overseeing your care during the stay (often involving one consultation at the start, during and at the end of the stay), which is reimbursed at 70%.

Certain other medical acts are reimbursed at 70% on the basis of tarif de convention rates for those procedures.

At the end of your treatment, you will be required to pay the ticket modérateur non-state reimbursed amount.

It may be possible for you to recover some or all of this through your mutuelle.

Note that treatment for an affection de longue durée, or for people on the CSS scheme for those on low incomes, the reimbursement rates are 100%.

If you will be on sick leave while staying at the spa you will qualify for daily compensation amounts as long as your income is not over a certain level (€47,100 a year in 2025, plus 50% again for each dependent who lives with you).

With regard to transport, board and lodging expenses, typically, if your income is higher than €14,664.38 a year (+50% for each dependent) these are not covered by the state. Your mutuelle may allow you to recover some of the extra transport/accommodation costs.

Transport expenses are typically state-reimbursed at 65% of the cost of a second-class round-trip SNCF train ticket.

Room and board are state-reimbursed at 65% of a fixed cost of €150.01. The net reimbursement is therefore €97.50.

After the stay you will be asked to complete a treatment satisfaction survey, which is one of the tools that the government uses to evaluate the quality of services given by thermal spas.

All spas operating under agreement with health authorities are required to offer this to their patients.

The survey is a cure and post-cure evaluation but other points are included such as aspects relating to hygiene and staff professionalism.