Guide to French Health System

14. Travel and Transport for Health Treatment

14.1. Who is Entitled?

Travel costs for health treatment are, under certain conditions, covered in full or in part by the health system in France.

You will not ordinarily get your transport paid for routine visits to your GP, consultant or hospital, but there are a variety of circumstances when the system provides assistance with health travel costs. Unlike the UK, this assistance is not means-tested.

As might be expected, transport by ambulance for emergency medical treatment, or where medical care is otherwise needed during the journey, is covered by the health system.

In addition, those who suffer from a major or long-term illness (Affection de Longue Durée - ALD), and who present an incapacity or 'deficiency' that requires medical support during the journey, are entitled to financial support, provided the treatment is for the ALD itself.

Similarly, where long-distance travel over 150 kilometres each way is necessary, then financial support is available.

Regular transport, equivalent to at least four journeys of over 50 kilometres for two months for the same treatment, is also eligible.

Finally, financial assistance is also available for accident at work or professional illness cases.

Where a child under 16 or an adult needs to be accompanied, the costs for both are eligible.

14.2. Authorisation

To obtain assistance with travel costs, other than in the case of an emergency, you will need to obtain a medical prescription for transport from your doctor, either your GP or the consultant from whom you are receiving treatment.

Your doctor will specify the type of transport that is best adapted to your circumstances, which may be an ambulance, a taxi, taxi-ambulance (véhicule sanitaire léger - VSL), public transport, or your own vehicle.

If you are prescribed a taxi or taxi-ambulance, you are only entitled to use those accredited with the health authority - a taxi conventionné. Your doctor should be able to provide a list but if not, contact your local health authority. There is a small excess of €2 per journey that applies on these vehicles.

You are obliged to use the transport prescribed, except where you take a less expensive option, when you will then receive reimbursement for your costs. Strictly speaking, in the case of ALD patients, an alternative form of transport (personal or public) is only reimbursable if you are accompanied by a friend or member of your family.

In certain circumstances, the authorisation of the health authority (accord préalable) is also required, although this may sometimes be obtained retrospectively.

Such prior authorisation from the health authority is required for:

• Long distance travel over 150 kilometres;
• Regular transport, equivalent to at least four journeys of over 50 kilometres for two months for the same treatment;
• Transport by air or sea.

Where this applies your doctor will supply you with your request for authorisation, called a Demande d'accord préalable de transport valant prescription médicale (Form S3139), which you will need to send to your health authority. If they do not reply within 15 days the application is deemed to have been accepted.

14.3. Level of Cover

Since May 2023 the level of reimbursement for transport is at the rate of (circa) 50% of the regulated tariffs for taxi or a health vehicle (ambulance), public transport or your own vehicle. If your costs are not being paid directly by the health system (tiers payant), you will need to produce receipts. Prior to May 2023, the reimbursement rate was 65%.

You will also need to pay an excess sum (franchise médicale) on authorised health vehicles and ambulances which is reduced from the reimbursement. The excess is €2 per transport, up to €4 a day and a maximum of €50 per person per year. The excess rises to €4 per transport from 1st March 2024.

However, there are various groups from whom transport is reimbursable at the rate of 100%. They include emergency transport for hospitalisation, ALD patients, accident at work cases, and transfers between medical establishments. Those on a low income (Complémentaire Santé Solidaire -CSS) or an invalidity pension are also eligible.

If you use your own vehicle, you will be entitled to 50% (or 100% as appropriate) reimbursement at the rate of €0.30 per kilometre (2023).

You may be covered for the balance of the costs by your complementary health insurer. It will depend on the policy.

14.4. Making a Claim

You will need to complete the form Cerfa 11162-3 Demande de Remboursement des Frais de Transports (S3140), which you should send to your health authority, together with the transport medical prescription or, where it applies, the request for authorisation from the health authority.

Alternatively, you can make a claim on-line at Mes remboursements simplifiés (MRS).

A video on this website shows how to make the claim.

If you have a complementary health policy then, depending on the terms of the policy, the balance of these costs may be covered by your mutuelle, to whom you should make application.

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