If you live in France, it is important to understand the parcours de soins coordonnés.
This is the standard care pathway in the French public healthcare system. It means choosing a main doctor, called your médecin traitant, and usually seeing them first for most medical issues. If needed, they can then refer you to a specialist.
Following the parcours de soins helps you get the standard reimbursement from Public Health System (Sécurité Sociale). If you do not follow it, you will usually be reimbursed less.
Why does it matter?
The parcours de soins helps coordinate your care and avoid unnecessary extra costs.
If you see certain specialists without first going through your médecin traitant, and no exception applies, French Health Insurance will usually reimburse less of the consultation cost. This means you may have to pay more out of pocket.
Which specialists can I see directly?
In some cases, you can see a specialist without first going through your médecin traitant.
This usually includes:
gynecologists,
ophthalmologists,
stomatologists,
psychiatrists or neuropsychiatrists for people aged 16 to 25.
You can also usually book a dentist directly.
Are there exceptions?
Yes. You may also be able to go outside the usual care pathway in situations such as:
an emergency,
being away from home,
or when your regular doctor is unavailable.
What happens if I do not follow the parcours de soins?
If you do not follow the parcours de soins, French Health Insurance will usually reimburse less for your consultation.
This can happen if:
you have not declared a médecin traitant,
you book certain specialists directly without a referral,
or no exception applies to your situation.
For example, for a €30 consultation with a sector 1 GP, reimbursement can be much lower outside the parcours de soins than within it. In practice, this usually means higher out-of-pocket costs.
Who should declare a médecin traitant?
If you are over 16 and insured under the French public healthcare system, it is strongly recommended to declare a médecin traitant.
This helps you stay within the parcours de soins and avoid lower reimbursement.
How do I declare my médecin traitant?
In most cases, your doctor can declare it for you during an appointment using your carte Vitale.
You can also change your declared doctor in your Ameli account.
What should I do?
You should:
find a doctor who accepts new patients,
declare them as your médecin traitant,
and go through them first for most medical care.
This will make the healthcare system easier to navigate and help you avoid reimbursement surprises.