France to Reduce State Health Reimbursements in 2027
From 1 January 2027, Assurance Maladie will pay a smaller share of some healthcare costs in France.
The changes concern:
- Dental treatment
- Medical transport
- Certain medicines
- Some medical equipment and devices
In most cases, the unpaid portion will be covered by the patient’s mutuelle. However, people without complementary health insurance may have more to pay themselves.
What will change?
For many dental treatments, Assurance Maladie could reimburse only 40% to 50% of the official reimbursement rate. The remaining 50% to 60% may be covered by a mutuelle.
State reimbursement will also fall for certain medical devices and non-emergency medical transport.
Some medicines judged to provide only a moderate or limited medical benefit will be reimbursed at very low rates. Medicines considered medically important are not affected in the same way.
These percentages apply to the official Social Security reimbursement tariff, which may be lower than the amount actually charged.
Who will remain protected?
Important exceptions will continue, including:
- Treatments covered by the 100% Santé scheme
- Certain essential prostheses, orthopaedic equipment and wheelchairs
- People receiving Complémentaire santé solidaire
- Many treatments directly related to a recognised long-term condition, known as an ALD (affection de longue durée)
However, “100% cover” for an ALD means 100% of the official reimbursement tariff. It does not necessarily cover extra charges or treatments unrelated to the recognised condition.
Could mutuelle premiums rise?
People with good complementary health insurance may notice little difference when receiving treatment because their mutuelle should cover much of the extra amount.
The cost has not disappeared, though. It has simply moved from Assurance Maladie to the complementary insurers. La Mutualité Française estimates that mutuelles will have to take on an additional €1.5 billion to €1.7 billion.
This could eventually lead to higher premiums, particularly when policies are renewed.
What about the medical charges patients pay themselves?
The government has dropped its original proposal to double the combined annual limits for medical deductions from €100 to €200.
Instead, it plans to increase the two separate limits from €50 to €70 each. This would create a possible combined maximum of €140 a year:
- Up to €70 for the €2 deductions applied to consultations, certain scans and laboratory tests
- Up to €70 for deductions on medicines, paramedical treatment and medical transport
This proposal still requires a decree before it becomes final.
What should you do?
There is no need for immediate action, as the main reimbursement changes begin on 1 January 2027.
However, anyone without a mutuelle may wish to review their cover. Those who already have complementary insurance should check their renewal notice carefully, as premiums or levels of cover could change.
Sources:
French Social Security Code – reimbursement rates from 2027
Assurance Maladie – understanding the ticket modérateur
Mutualité Française – estimated cost transferred to complementary insurers
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