Understanding The French System:

Unlike the English system, the French regime makes no difference between the public and private treatments (the reimbursement rates are identical). On the other-hand, the 'Sécurité Sociale' alone does not cover the entirety of your expenses.

Frais médicaux

The TOTAL amount charged for your treatment.
This can be a Fixed rate or an amount announced by a specialist.

Dépassement d'honoraires

Amount charged by a Doctor for time spent treating a patient.

A Doctor in "Secteur 1" will NOT charge over the"Tarif de Convention" and you will be totally reimbursed even on the lowest levels of Top-UP.

A Doctor in "Secteur 2" can charge over the "Tarif de Convention" and you will only be reimbursed if you have a higher level of "Top-Up".

You could be faced with "Dépassement d'honoraires" for a simple 15 minute Specialist visit or for 4 hours of Major Surgery.

Rates charged must be communicated in advance, get in contact with the administration if not. .

Tarif de Convention

Base rate given to medical treatment recognizable by a code that indicates its nature and tariff called “Nomenclature” fixed by the “CCAM”(Classification Commune des Actes Médicaux).

The “Tarif de Convention” fixes the 100% base rate that all medical professionals use but it does NOT limit their fees charged.

Top-Ups relate to the base rate and NOT to actual expenses. .

Hors Nomenclature

These are treatments that are NOT included on the “CCAM” list thus they do not have a base rate.

These treatments are often in addition to ongoing treatment.

The “CCAM” tend to exclude preventative medicines, "Médecines douces“ that have not been accepted by the “Académie des Sciences”.

Some Top-Ups reimburse thing like osteopathy and homeopathy using Fixed rates set by the companies called “Forfait Annuel”.

Part Régime Complémentaire

"Part Mutuelle". This is the amount paid on your behalf by a Top-Up.

"Dépassement d'honoraires" can be reimbursed by a Top-Up.

Top-Ups starts at 100% and can go up to 600% or more depending on your needs and especially what area you live in.

SOFICA’s sugests middle cover, around 200% for hospitalization permitting you to use Doctors charging twice the "Tarif de Convention“ but lower for the rest as some base rates are very low.

Ticket modérateur

This represents the difference between your “Régime Obligatoire” reimbursements and the "Tarif de Convention".

This amount, normally reimbursed by a Top-Up will be reimbursed by your “Régime Obligatoire” in case of long-term illness, handicap or maternity.

The “100%” or the "TM" referred to on "Tiers Payant“ slips from Top-Ups will guarantee payment of the "Ticket Moderateur" to any professional accepting to use this facility without having to advance any money. .

Part Régime Obligaroire

The Percentage of the "Tarif de Convention" that is covered by your “Régime Obligatoire”.

Usually these reimbursements come from "CPAM" or “RSI” if you are self employed.

Reimbursements range from 35% to 100% but are commonly referred to as 70% of the "Tarif de Convention".

Once fully into the French system you will receive a “Carte Vitale”.

This card replaces payment to medical professionals equipped with the “System Noemi”.

Hospitalization / Hospitalisation

The question of payment will come after your wellbeing
If you are in an emergency situation, you will be taken care of regardless of your nationality, professional or financial situation.
However, after this point or if you have a planned hospital stay you could be asked for a “PEC”.
This "PEC" enables the hospital or Clinique to claim amounts due for your treatments directly from your "Régime Obligatoire" and eventually your "TOP-UP".

If you are in France on holiday you may present your “EHIC”.
You will be asked for your blood group card - "carte de groupe sanguin'".
They will ask about allergies - "avez-vous des allergies?" or "êtes-vous allergique?".
You will be asked for your medical history - "antécédents médicaux ou chirurgicaux".
You will be asked about any medication you are taking – "Quel est votre traitement actuel / courant/ en cours?"
They will ask about your diet – "Avez-vous un régime spécial?" Without salt – "Sans sel" Without sugar – "Sans sucre" Gluten free – "Sans gluten"

Examples of reimbursement:

SOFICAS clients benifit fully from the French system as we use French companies that know thier subject

"Télétransmition"
Automatic reimbursements using only your "Carte Vitale".
"Tiers Payant"
No money to be advanced at the chemist / lab / x-ray and more.
"Prise en charge"
Possible on demand even for Optical and Dentistry.
Hospitals stay expenses can be paid directly by your "Top-Up".
"Frais de séjours and chambre particulière"

Hospitalization / Hospitalisation:

The question of payment will come after your wellbeing
If you are in an emergency situation, you will be taken care of regardless of your nationality, professional or financial situation.
However, after this point or if you have a planned hospital stay you could be asked for a “PEC”.
This "PEC" enables the hospital or Clinique to claim amounts due for your treatments directly from your "Régime Obligatoire" and eventually your "TOP-UP".

If you are in France on holiday you may present your “EHIC”.
You will be asked for your blood group card - "carte de groupe sanguin'".
They will ask about allergies - "avez-vous des allergies?" or "êtes-vous allergique?".
You will be asked for your medical history - "antécédents médicaux ou chirurgicaux".
You will be asked about any medication you are taking – "Quel est votre traitement actuel / courant/ en cours?"
They will ask about your diet – "Avez-vous un régime spécial?" Without salt – "Sans sel" Without sugar – "Sans sucre" Gluten free – "Sans gluten"

Key Words:

ENGLISHFRENCH
AchingDouloureux
AmbulanceAmbulance
AnaestheticAnesthésique
AnaestheticAnesthésie
AnkleLa cheville
AppendixL'appendice
ArmLe bras
Assistant nurseAide soignante
BackLe dos
Back of the neckLa nuque
BedpanUn bassin
Bell / buzzerSonnette
BladderLa vessie
BloodLe sang
Blood testPrise de sang
Blood test (results)Résultat sanguin, Bilan sanguin
Blood test to be taken fastingPrise de sang à jeun
BodyLe corps
BoneL'os
BottleUne bouteille
BowelsLes intestins
BrainLe cerveau
BreastLe sein
BruiseUn bleu /une contusion / un hématome
Burnune brûlure
Burning sensationSensation de chaleur / douleur cuisante
Buttocks / bottomLes fesses
CalfLe mollet
CapsuleGélule
Car accidentAccident de la route
Casualty / A&EUrgences
Change your dressingFaire votre pansement
CheeksLes joues
ChestLa poitrine
ChinLe menton
CollarboneLa clavicule
Contraceptive pillLa pilule
Cough / a coughTousser / une toux
Covered in bruisedEtre couvert de bleus
CrushedEcrasé / broyé
CrutchesLes béquilles
Cutcoupe
Dizzinessle vertige
DoctorMédecin
DrawsheetL’alèse
Dressing gownRobe de chambre
Drink (A)Une boisson
Drink (To)Boire
EarL'oreille
EatManger
ECGElectrocardiogramme (électro)
ElbowLe coude
Exhaustedépuisé
Eye (eyes)L’œil (Les yeux)
FaceLe visage
Face flannelUn gant de toilette
Feel sickJ'ai des nausées / J'ai mal au cœur
Feel unwell / faintJ'ai un malaise / j'ai la tête qui tourne
FingerLe doigt
FingernailL'ongle
FootLe pied
ForeheadLe front
Gall bladderLa vésicule biliaire
Get undressedDéshabillez-vous
Grazedécorché
GumGencive
HandLa main
Have a washFaire sa toilette
HeadLa tête
HeartLe cœur
HeelLe talon
High temperaturela fièvre
HipLa hanche
Hospital gown (open at the back)Casaque / blouse opératoire
InfectionInfection
InjectionPiqûre
Intensive careSoins intensive
JawLa mâchoire
KidneyLe rein
KneeLe genou
LiverLe foie
Lower backLes lombaires / les reins
LungsLes poumons
Make the bedFaire le lit
MealUn repas
Medicine (treatment)Médicament / traitement
MouthLa bouche
MuscleLe muscle
Nauseala nausée
NeckLe cou
NightdressChemise de nuit
NoseLe nez
NurseInfirmière
Operating theatreBloc opératoire
OperationIntervention chirurgicale
OperationIntervention
Out of breathessoufflé
Pain killerCalmant
ParamedicsSAMU
Permission to operateAutorisation d’opérer
Physio after an accidentRe-éducation
PhysiotherapistKinésithérapeute
PhysiotherapyKinésithérapie
PillCachet / Comprime
PyjamasPyjama
RibLa côte
Scratchune égratignure
SensitiveSensible
Set up a dripFaire une perfusion
ShoulderL’épaule
Sleeping pillSomnifère
SlippersPantoufles
SoapLe savon
Soreendolori
SpleenLa rate
Sticking plasterSparadrap / pansement adhésif
StitchesPoints de suture
Stomach (external)Le ventre
Stomach (internal)L'estomac
StretcherBrancard
SurgeonChirurgien
Surgical dressingPansement
Swellingune bosse
Swollenenfle
Take your blood pressureContrôler votre tension
TeethLes dents
Tendersensible
TendonLe tendon
ThighLa cuisse
ThroatLa gorge
ThumbLe pouce
Tiredfatigue
ToenailL'ongle du pied
ToesLes orteils
TongueLe langue
TowelUne serviette
Ulcerulcère
WaterL'eau
WheelchairFauteuil roulant
Woundedblessé
WristLe poignet
X-rayRadio

Useful Phrases:

ENGLISHFRENCH
Call an ambulanceAppeler une ambulance
Call the emergency servicesAppeler le urgences
Call the policeAppeler la police
Do not get upNe pas se lever
Do you know an English speeking doctor?Connaissez-vous un médecin qui parle anglais?
Do you want an injection?Voulez-vous une piqûre?
I am allergic to…Je suis allergique a / a la / aux…
I am constipatedJe suis constipé(e)
I am diabeticJ'ai le diabète
I am going to faintJe vais m’evanouir
I am in painJ'ai mal
I am taking medicationJe prends des médicament
I don't feel very wellJe ne me sens pas tres bien
I feel betterJe me sens mieux
I feel sickJ'ai envie de vomir / J'ai mal au cœur
I feel badJe me sens mal
I feel weakJe me sent faible
I feel worseJe me sens moins bien
I fell overJe suis tomber
I have a broken boneJ’ai une fracture
I have a broken toothJ'ai une dent cassée
I have a chest coldJ’ai une bronchite
I have a coldJe suis enrhumé
I have a coldJ’ai une rhume
I have a got feverJ’ai de la fievre
I have a headacheJ'ai mal à la tête
I have a sore throat / tonsilitisJ'ai mal a la gorge / j'ai une angine
I have a woundJ’ai une blessure
I have an abscessJ'ai un abcès
I have an abscessJ’ai un abcès
I have back acheJ'ai mal au dos
I have been sickJ'ai vomi
I have burnt myselfJe me suis brûlé
I have chest painsJ’ai des douleur à la poitrine
I have cut myselfJe me suis coupé
I have fluJ'ai la grippe
I have gor a head acheJ’ai mal à la tête
I have got a headacheJ’ai mal à la tête
I have got a sore throatJ’ai mal à la gorge
I have got a stomach acheJ’ai mal à l’estomac
I have got crampsJ’ai des cramps
I have got diarrheaJ’ai la diarrhea
I have had a heart attackJ’ai eu une crise cardiaque
I have lost a fillingJ'ai perdu un plombage
I have painJ'ai de la douleur
I have pains in the chestJ'ai mal à la poitrine
I have shiversJ’ai des frissons
I have stomach acheJ'ai mal au ventre
I have the fluJ’ai la grippe
I have to see a doctorJ'ai dois de voir un médecin
I have toothacheJ'ai mal aux dents
I have windJ'ai des gaz
I need a bedpanJ’ai besoin d'un bassin
I think it's brokenJe pense que c'est cassé
I want a peeJe veux faire pipi
I'm bleedingJe saigne
I'm dizzyJ’ai la vertige
I'm hungryJ'ai faim
I'm sickJe suis malade
I'm sweatingJe transpire
I'm thirstyJ'ai soif
Is it serious?C’est grave?
It hurts everywhereJ’ai mal partôut
It hurts hereJ’ai mal ici
It is painful since…C'est douloureux depuis…
Its swellingCa enfle
I've been sickJ'ai vomi
I've got the shiversJ'ai des frissons
Permanent fillingObturation définitive
Stay lying downRestez allongé
Temporary fillingObturation provisoire
That hurtsça me fait Mal
That hurts!Ca me fait mal !
That is very painfulC'est très douloureux
That itchesCa me démange
That itchesCa me gratte
That ticklesCa me chatouille
That's too looseCe n'est pas assez serré
That's too tightC'est trop serré
There has been an accidentIl y a eu un accident
To have a bowel movement (phoo)Aller à la selle (faire caca)
To ring (for a nurse)Sonner l'infermiere
To urinateUriner (faire pipi)
Where is the Chemist?Ou se trouve la pharmacie?
Where is the Doctors?Ou se trouve un medecin?
Where is the Hospital?Ou se trouve l'hôpital?