The “médecin traitant” is essentially your primary care doctor in France, equivalent to a family doctor or general practitioner (GP) in the UK or a primary care physician in the USA. Having one is not just a matter of convenience – it can significantly reduce your healthcare costs in France.
Understanding the “Parcours de Soins Coordonnés“
France’s healthcare system operates under a framework called the “parcours de soins coordonnés“. This system is designed to improve the quality and efficiency of care while managing healthcare costs. To benefit from this system, every individual is required to choose a primary care physician, or “médecin traitant.” This doctor becomes your main point of contact for health issues, coordinating your medical care and referring you to specialists or tests when necessary.
Why declaring your “Médecin Traitant” matters
Once you find a doctor you trust, it’s important to formally declare them as your “médecin traitant.” Failing to do so – or bypassing your médecin traitant to see a specialist directly – can have financial consequences.
Without following this coordinated care pathway, the Sécu (the French healthcare system) and your private health insurance (mutuelle) will reimburse only 30% of your medical costs, compared to the usual 70% when you follow the proper steps.
When you can skip a referral and still get full reimbursement
There are some exceptions when you don’t need to have been referred directly by your médecin traitant to see particular specialist doctors. If you see the following specialists without referral, Sécu will still reimburse you 70% of the conventional rate:
- Gynecologist: for periodic clinical examinations, including screening procedures, prescription and monitoring of contraception, monitoring of pregnancy, voluntary termination of pregnancy (abortion) by medication;
- Stomatologist: except for major surgical procedures
- Psychiatrist: if you’re between 16 and 25 years old;
- Ophthalmologist: for prescribing and renewing glasses, screening and monitoring glaucoma
Additionally, children under 16 years old are exempt from the parcours de soins coordonnés framework, meaning their healthcare costs are reimbursed at 70% regardless of whether they have a médecin traitant.
How to choose a Médecin Traitant
Choosing a médecin traitant is a personal decision, and you have complete freedom in your choice. However, the doctor you select must agree to take on this role. Here are some key points to keep in mind:
- Type of Doctor: Your médecin traitant can be a general practitioner or a specialist working in sector 1 or sector 2 (as per France’s healthcare pricing). They may work independently, in a group practice, or at a health center or hospital.
- Location: There are no geographical restrictions – you can choose any doctor, regardless of their location.
- Family Considerations: Each family member can have the same or a different médecin traitant, but everyone must declare their doctor individually – there’s no collective declaration.
- Special Cases: Some general practitioners may decline to act as the médecin traitant for very young children and may recommend a pediatrician instead.
Take the time to choose a doctor who knows you well and makes you feel comfortable.
How to Declare Your Médecin Traitant
Declaring your médecin traitant is a straightforward process. Here’s how it works:
- Immediate Recording: There’s no paperwork or mailing involved – the declaration is recorded instantly.
- Ask Your Doctor: Request your chosen doctor to declare themselves as your médecin traitant. They must agree to take on this role.
- Provide Your Details: Make sure to have your Social Security Number and Carte Vitale with you.
- Submission: Your doctor will send the declaration electronically to your primary health insurance fund (CPAM).
Do you live in France? What has your experience been like with French healthcare? Share in the comments below.
