Thermal cure funding confirmed in France for 2026

Concerns that France might scale back state reimbursement for thermal spa cures in the 2026 social security budget have eased after confirmation that funding will be maintained.

France has more than 100 approved stations thermales (spa resorts) and around half a million people a year attend cures, typically to manage chronic conditions and reduce symptoms such as pain, inflammation or respiratory issues. 

These are medically-supervised treatment programmes using natural thermal spring water and they can be part-reimbursed by the state health system if strict conditions are met.

A cure thermale is a prescribed medical treatment using fresh thermal spring water in an approved centre. By contrast, thalassothérapie (thalasso) uses seawater and is generally positioned as being for wellness/relaxation; it is not reimbursed by Assurance Maladie.

Who can prescribe a cure?

A cure can only be prescribed by a doctor (GP or specialist) who believes it is appropriate for your condition. In some mouth-related conditions, a dentist may be able to prescribe.

If you want reimbursement, it is important to check eligibility before booking, because reimbursement is only possible if the cure is prescribed and formally approved by your health insurance caisse.

Your doctor needs to sign you up to a treatment plan via an official form mentioning up to two main conditions that it is for.

To qualify for reimbursement, the cure must include 18 days of effective treatments (typically spread over three weeks, with centres often closed on Sundays). 

You normally need to complete the full programme; if the cure is interrupted, reimbursement may only apply in limited situations such as medical reasons or force majeure.

Eligible conditions: 12 official categories

State reimbursement is limited to cures for conditions within 12 recognised therapeutic orientations. These include (with examples):

• Rheumatology (eg. osteoarthritis, back pain, inflammatory rheumatism)

• Respiratory tract disorders (eg. asthma, chronic bronchitis, sinusitis, allergic rhinitis)

• Dermatology (eg. eczema, psoriasis, scarring)

• Neurology (eg. Parkinson’s, multiple sclerosis, post-stroke effects)

• Lymphatic vessels and veins (eg. venous insufficiency, heavy legs, oedema)

• Digestive and metabolic disorders (eg. mild/moderate Crohn’s disease, ulcerative colitis)

• Urinary and metabolic disorders (eg. cystitis, urinary infections)

• Gynaecology (eg. pelvic pain, menopausal issues, recurrent infections)

• Cardio-arterial disease (eg. peripheral artery disease, arterial hypertension)

• Oral mucosal disorders (eg. dry mouth, oral lichen planus)

• Psychosomatic conditions (eg. depression, insomnia)

• Developmental disorders (eg. ADHD, involuntary urination)

Not all resorts treat all conditions, which is why the prescribing doctor usually indicates the most suitable establishment.

The spa must be approved

Only cures in an establishment that is approved (conventionné) by Assurance Maladie can be reimbursed. You will usually see wording such as cure thermale conventionnée on the spa’s website.

How to apply: prescription plus Cpam approval

Once your doctor agrees a cure is appropriate, they complete the official form (questionnaire de prise en charge), which you sign, and you complete a financial resources declaration. The paperwork is sent to your Cpam (or MSA for agricultural workers).

If approved, your fund sends a three-part authorisation document (prise en charge administrative de cure thermale et facturation), including sections for medical fees, the spa’s package cost, and (where relevant) travel/accommodation support. The approval is valid for the current calendar year.

How much is reimbursed?

• Reimbursement is based on fixed official tariffs, not necessarily on what you pay in total.

• The thermal treatment package (forfait thermal) is generally reimbursed at 65%

• Medical supervision fees during the cure are generally reimbursed at 70%

• Certain other specific therapeutic acts will be reimbursed at 70%

• Your remaining share is the ticket modérateur, which may be partly covered by your mutuelle depending on your contract

Some people qualify for 100% reimbursement (for example if the treatment is related to a recognised affection de longue durée long-term condition, or if you are covered by the CSS low-income health scheme.

Many approved spas also operate tiers payant, meaning you do not pay upfront for the reimbursed portion.

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 (€48,060 a year in 2026 plus 50% again for each dependent who lives with you). 

Can you get help with travel and accommodation?

Assurance Maladie may also contribute to transport and accommodation for lower-income patients, based on an annual income ceiling.

For 2026 applications, the resources cap referenced in official guidance is €14,664.38 (with a 50% increase for a spouse/partner and each dependant).

Where applicable, transport support is calculated using a standard reference cost (often a second-class SNCF return fare) and accommodation support is calculated using a fixed allowance.

One cure a year – with limited exceptions

As a rule, state reimbursement is limited to one cure per calendar year, although there are exceptions in specific cases (for example, where a patient has two orientations treated during the same cure, if the centre can provide both).

Note also that spas sometimes offer ‘comfort’ options or upgraded packages that go beyond the reimbursed treatment plan. 

These extra elements may not be covered by the state, but some top-up insurance mutuelles offer partial cover within an annual limit.

Following the stay, patients are typically asked to complete a satisfaction and follow-up survey. This is one of the tools used by the authorities to monitor service quality in approved spas.

These articles are edited extracts from our Healthcare help guide.

The guide is available in digital format at shop.connexionfrance.com