Treatment abroad - France will pay

THE FRENCH healthcare system is so good that at first glance it is hard to see why anyone living in France would even think about going abroad for treatment.

However, once you realise that in France a good-quality porcelain crown could cost up to €800, of which only e75 would be reimbursed by la sécu (properly but more rarely called la caisse d’assurance maladie) and that the same crown would cost only €300 in Budapest, then the attraction of going abroad for treatment suddenly becomes more obvious (particularly for those who have always wanted to visit Hungary). As for dental implants, these are notoriously expensive – anywhere in the region of €2,000 to €3,000 for one tooth – and they are not reimbursed at all by la sécu.

There is another factor at play. Treatment in France tends to be dragged out over a long period. The wait between preparing a tooth to receive a crown and actually having the crown fitted is often as long as 10 days, for example.
However, if you have the treatment abroad, you can arrange to have lots of work done over a short period.

Some people needing major amounts of reconstructive surgery even opt for two trips, each lasting a fortnight, in order to get their treatment completed fast rather than spend the afternoon in a French dentist’s waiting room every fortnight for a year or more.

Another area where foreign prices are attractive to people in the French system is eyecare because treatments, even simple eye tests, are badly reimbursed by la sécu (see our article on costs on the healthcare section of our website).
Some people even get their prescriptions in France but buy their glasses abroad.

These minor bits of medical care – getting dental check-ups and X-rays, getting an eye check, buying a new pair of glasses – hardly even require their own trip abroad. People increasingly do these tasks on the first day of a holiday before they start relaxing.

When it comes to cosmetic treatments like breast enlargement, it is a world market because state health insurance systems generally do not cover treatments which are perceived as being for vanity only.

Eastern European countries, especially Hungary but also Bulgaria and the Czech Republic, have overtaken Spain as favourites for dental work because standards are high and prices are attractive. Tunisia is also a booming destination for medical tourism – but in case you want to make follow-up visits, most people involved in the industry strongly recommend going somewhere easily accessible.

It is not all one-way traffic, however. Medical costs are even higher in Switzerland than in the EU, resulting in a brisk traffic of Swiss patients driving down the motorway from Geneva to Grenoble for laser surgery to improve their eyesight and then moving smartly on to Prague to get their teeth fixed.

Getting reimbursed by la sécu for medical treatment received abroad but within Switzerland and the EU is reasonably straightforward in that you have the law on your side. However, if you are intending to claim, you should get an accord préalable (prior agreement) which you do by simply filling in a form. If they do not reply in 15 days, it is presumed that there is no objection. Check the normal reimbursement level on www.ameli.fr

Once you have had the treatment and returned to France, you claim reimbursement by filling in a déclaration de soins reçus à l’étranger (declaration of treatment received abroad) which is available from your local office or from www.ameli.fr as a PDF file. You then send it off with all your bills, travel tickets, a pay slip from the month before you travelled abroad for treatment, plus prescriptions and whatever other paperwork justifies your trip. You must keep photocopies of everything – one copy for you and one for your mutuelle (top up insurance company).

Getting reimbursed by your mutuelle involves the same procedure as for la sécu – the law is on your side within the limits of the insurance you have bought but you should consult them before you go to avoid any unpleasant surprises. You then send off all your paperwork when you return.

Every mutuelle has a different policy and reimbursement tariff for elective medical treatment abroad, so it is not possible to generalise – but in theory living in the free market means there are no barriers to buying medical care wherever you like. It is however always a good idea to check your policy before undertaking elective treatment abroad. Naturally, costs such as travel, accommodation and living expenses during your stay abroad are not reimbursed.