Hospital fees set to increase in France: how will patients be affected?

Certain hospital fees are set to increase in France and costs passed onto mutuelle insurance providers, under plans to save €400 million a year in state social security spending. 

Increases to various ‘flat fees’ were included in plans sent out by government authorities to various health advisory bodies. 

The changes, if approved, will be set out in ministerial orders and decrees, and will not be debated in parliament. They could see fees rise from March 1 at the earliest.

Although most of the increases would be met by complementary mutuelle insurance, this carries the risk of higher premiums next year – and those without supplementary cover having to meet the costs themselves.

Flat fees targeted

A series of hospital fees are charged to patients in France, including the forfait hospitalier (daily rate for all patients) and frais d’hospitalisation (these depend on the hospital, reason for admittance, etc, but can reach into the thousands of euros).

Covered at 80% for those signed up to France’s state healthcare (Assurance Maladie), the remaining 20% is often covered by top-up mutuelle insurance obtained privately or through an employer.

Alongside these can be various comfort fees (such as for having a TV, private room, etc) that are not covered by state reimbursement but may be covered by your mutuelle.

Our article here gives an in-depth explanation of how fees work.

The new plans would see the forfait hospitalier increased from €20 to €23 per day (for admittance to a psychiatric ward, it would increase from €15 to €17), without seeing a commensurate increase in state reimbursement. 

Another charge due to increase is the forfait patient urgences, an emergency flat fee applied to patients who attend an emergency department but are not admitted for an extended stay following treatment or assessment there afterwards.

The standard fee for this will increase from €19.61 to €23, as will the reduced fee (for certain patients such as long-term illness sufferers), from €8.49 to €9.96.

Certain procedures, usually those with a tariffs of at least €120 are considered to be actes lourds, and as such are fully reimbursed by the state minus a fixed rate (known as the participation forfaitaire), currently €24.

From April 1 this will increase to €32. 

It should be noted, however, that those currently exempt – including women in the final stages of pregnancy, newborn children, and recipients of the state-funded complémentaire santé solidaire top-up insurance – will continue to be exempt from these charges.

Non-mutuelle holders at risk

In theory, the plans should not see out-of-pocket costs increase for those insured in France.

“This increase in patient co-payments for hospital care will be fully covered by patients' supplemental health insurance plans under solidarity and responsible contracts,” said Unocam, France’s union of top-up healthcare providers. 

However, recent attempts to place the burden of social security healthcare spending onto private insurers has seen mutuelle groups admit these additional costs may be passed on to patients in the form of higher premiums.

This could lead to further across-the-board increases in insurance costs in 2027, after insurers were prevented from increasing premiums in 2026.

Those without complementary insurance, who receive only the 80% reimbursed by the state, will be directly affected by the increases.

Up to 2.5 million people in France – around 4% of the population – do not have top-up mutuelle insurance, and must pay these excess fees out-of-pocket. 

Among the poorest 10% of the population, this proportion rises to 12%, increasing the risk of further difficulty in meeting healthcare costs.