WE EXPLAIN THE ADVANTAGES OF USING FRANCE’S SO-CALLED ‘COORDINATED HEALTHCARE PATHWAY’ You can consult a health specialist without first seeing a GP in France but it could – depending on the

type of specialist and your insurance coverage – cost you more. The process is usually as follows: You have an illness or an injury, say, for example, you have injured your knee. You should

normally go to see your designated GP (_médecin traitant_). There is a system of designated doctors in France where you choose (in agreement with the doctor) a personal GP in order to

benefit from lower fees and more informed health care. Read about this in our article here: Why having a designated GP in France saves you money. If you do not have a designated GP, you can

soins coordonnés_). Being on a _parcours de soins coordonnés _means better state reimbursement rates for treatment. FEES FOR SEEING A SPECIALIST WHILE ON THE ‘COORDINATED HEALTHCARE

PATHWAY’ Visits to a specialist on the ‘pathway’ can be one of two kinds:_ suivi régulier_ (if you are expected to be seeing the specialist on an ongoing basis) or _avis ponctuel_ (for a

one-off expert opinion). A sector 1 specialist can charge a fee of €30 for a _suivi régulier_ consultation (note that certain specialisms fall outside this and have specific set fees, such

as a psychiatrist, whose basic rate for_ suivi régulier_ is €50.20, or a cardiologist, €51). Sector 1 means a professional who applies the standard rates set out by France’s social security.

A sector 2 specialist can charge above these rates. There are more doctors and specialists in sector 1 in France but sector 2 health professionals are not uncommon. If you go to a sector 1

specialist, 70% of the €30 will be covered by the basic social security healthcare coverage, meaning €21 is covered, with €9 that is not covered, known as the _ticket modérateur._ In actual

fact there is, in most cases, also a €1 levy on any medical consultation, known as the _participation forfaitaire, _which is also not state-reimbursed_._ The €9 _ticket modérateur_ will be

covered for people who have top-up health insurance policies, commonly referred to as _mutuelles_. This means that in the end they will only be out of pocket for the €1 _participation

forfaitaire._ FEES FOR SEEING A SPECIALIST WHILE OUTSIDE THE ‘COORDINATED HEALTHCARE PATHWAY’ For a consultation with a sector 1 specialist outside the ‘pathway’, the doctor may charge more

– up to €35 – however to complicate things further, basic French healthcare will only calculate a reimbursement against €25 of this, and then only at a rate of 30%. This means that out of a

€35 fee the state would cover only €7.50, minus the €1 _participation forfaitaire, _leaving€28.50. Mutuelle policies do not compensate for penalties linked to going outside the health

pathway if they are of a so-called ‘responsable’ kind, which is the vast majority of them. This means if you see a sector 1 specialist without referral you will not obtain more than the €9

reimbursement you would have obtained for seeing one ‘in the pathway’. EXCEPTIONS FOR CERTAIN SPECIALISTS There are some exceptions where you can go directly to a specialist without first

seeing your GP and still be considered as being on the ‘coordinated healthcare pathway’. This includes if you have a long-term illness (_affection de longue durée_) and see a certain

specialist regularly or if you are going to see: * A gynaecologist * an ophthalmologist * a psychiatrist * a dentist, orthodontist, dental specialist (_un stomatologue_) There are also

exceptions linked to emergencies or being away from home. RELATED STORIES EXPLAINER: HOW FRENCH RESIDENTS CAN ACCESS HEALTHCARE IN UK ON TRIPS EIGHT FACTS TO UNDERSTAND FRANCE’S ISSUE OF

‘MEDICAL DESERTS’ WHY YOUR HEALTH REIMBURSEMENTS IN FRANCE MAY NOT BE ARRIVING