Médecin traitant and mutuelle: the two choices that keep your French healthcare affordable
Whoever doesn't declare a GP in France is reimbursed structurally less — from 19 to 8.40 euros on a 30-euro consultation. And almost everyone (96%) holds a mutuelle on top of the basic insurance. How both work, what is left for you per consultation, and when you arrange them.
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Two choices keep your French healthcare affordable, and as a newcomer you have to arrange both actively:
- a médecin traitant, a regular GP you declare to the health fund;
- a mutuelle, a supplementary health insurance.
French healthcare is good and accessible, but it reimburses on its own terms. Whoever doesn't arrange these two pays too much not once, but at every visit to the doctor.
The médecin traitant: declare one before you need one
France works with the parcours de soins coordonnés, the coordinated care pathway: the route via a fixed GP declared to the health fund.
The difference is no detail. On a standard consultation of € 30 you get € 19 back with a declared médecin traitant. Without, € 8.40 of that remains. Same doctor, same consultation, less than half the reimbursement. And that structurally, at every appointment, for everyone from 16.
For children under 16 one of the parents chooses the GP. They are reimbursed normally even without a declaration. That also applies:
- with a locum;
- in an emergency;
- with a consultation far from home;
- at the gynaecologist, ophthalmologist, psychiatrist and dentist, whom you may see without a referral.
Declaring is simple. The doctor arranges it online during a consultation with your carte Vitale (the French health card). Or you fill in the form together and send it to the CPAM, the health insurance fund of your place of residence. The declaration stays valid as long as you both want it, and switching is always allowed, without a reason.
The real task is finding a doctor who takes new patients. In parts of the countryside that is scarce. Whoever finds none can turn to an organisation coordonnée territoriale (a regional network of healthcare providers) or to the fund. That belongs with your choice of region, not with your arrival. Once landed you start on it in your first weeks, not on the day someone has a fever.
What is left for you per consultation?
| Consultation | Rate | Reimbursed by the fund, after deducting € 2 | For you |
|---|---|---|---|
| GP, sector 1, with médecin traitant | € 30 | € 19 | € 11 |
| GP, sector 1, without médecin traitant | € 30 | € 8.40 | € 21.60 |
| GP, sector 2, free fees | free, base € 23 | € 14.10 | the rest |
| Specialist, sector 1, via your GP | € 26.50 | € 16.55 | € 9.95 |
| Heavy procedure from € 120 | — | everything except a fixed € 32 | € 32 |
What is in those columns:
- The ticket modérateur, the part the fund does not reimburse: € 9 on an ordinary consultation, € 21 outside the parcours de soins.
- The participation forfaitaire, a fixed own contribution of € 2 per consultation for anyone over 18, with a cap of € 50 a year.
No mutuelle reimburses that € 2, nor the surcharge outside the parcours. A "responsible" contract may not cover that.
The chronically ill with a recognised condition, pregnant women and a few other groups pay no ticket modérateur.
The carte Vitale: the closing piece of the long clock
The carte Vitale is the green card that makes everything automatic: claims within a week, no paper forms. You only get it once your definitive social security number is there.
With the provisional number (NIA) from your CPAM application it is not yet possible. Until then you claim on paper. The card itself is free, and arrives two to three weeks after being granted. See it as proof that the longest clock of this journey has run down.
Retired on a Dutch pension? Your route runs through the CAK, which arranges healthcare for people living abroad on a Dutch pension or benefit. You hand in the S1 form (the European form with which your right to healthcare moves with you) at the CPAM of your place of residence. Then too the carte Vitale follows. The treaty contribution, your contribution for that healthcare, is deducted by the CAK from your pension.
Note: that CAK route is expected to remain open from 1 November 2026 only to new registrants with a statutory benefit such as AOW or WIA. With only early retirement your route changes.
The mutuelle: not a luxury but the norm
The basic insurance typically reimburses around 70% of the agreed rates. The rest, the ticket modérateur, is yours. That is why 96% of the French hold supplementary insurance, the mutuelle.
If you are employed, your employer must arrange one for you. If you arrange it yourself, expect a premium that rises with age: on average a few tens of euros a month for a young person, towards € 150 for an 85-year-old.
For your budget this means: the mutuelle belongs in your monthly costs from day one, just like the rent. An emigration budget that only notes "healthcare there is arranged through the state" is missing the item every French person simply pays.
In Vertrekklaar this is phase 5 of 5 of the journey, step 5.2: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to France or go straight to step 5.2 in the open roadmap.
What this rests on
The facts in this article come from these official pages. Rules change. When in doubt, go by the source, not this article.
- Ameli — médecin traitant and the parcours de soins, with the amounts — ameli.fr
- Ameli — applying for the carte Vitale — ameli.fr
- DREES — the complémentaire santé in figures (96% covered, premiums by age) — drees.solidarites-sante.gouv.fr
- CAK — moving to France: handing in the S1 at the CPAM — hetcak.nl
- Service-Public — reimbursement of a consultation: the rates per sector, inside and outside the parcours de soins — service-public.gouv.fr
- Service-Public — ticket modérateur, participation forfaitaire and franchises: what is left for you — service-public.gouv.fr
- Service-Public — declaring the médecin traitant: how, for whom, and the exceptions — service-public.gouv.fr
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