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how does social security work abroad?

While the European Health Insurance Card covers certain medical costs within the EU, travel insurance is strongly recommended elsewhere in the world.

Feeling unwell, spraining your ankle, suffering from food poisoning… When traveling as in everyday life, no one is immune to an accident or falling ill. If the Social Security covers these risks during stays in France, the question of medical expenses arises during a trip abroad. And depending on whether you are traveling in Europe or elsewhere in the world, the rules for taking charge are not the same.

In Europe

The European Health Insurance Card (EHIC) allows you to assert your rights to French social security in a European Union (EU) state as well as in Norway, Liechtenstein, Iceland, Switzerland and the United Kingdom. Free, valid for two years, it can be ordered from the Ameli.fr website. Allow 15 days for delivery. Each member of a family must have their own, even children under 16.

Only the urgent care, following an illness or an unexpected accident, can be covered in this way. “These are treatments that prevent you from having to return to France for treatment and allow you to end your stay in safe medical conditions.“, underlines the site Service-public.fr. Chronic or pre-existing illnesses as well as pregnancy and childbirth are also affected.

In most cases, there is no advance for medical expenses. The simple presentation of the EHIC to a health professional is enough to benefit from care in the same way as a citizen of the country visited. Nevertheless, free is not systematic. “Since healthcare systems differ from one country to another, some services provided free of charge in your country may not be provided elsewhere.“, warns the site of the European Commission. Depending on the destinations or healthcare establishments (particularly private hospitals), it is sometimes necessary to advance the costs and then have them reimbursed by making a request on the Ameli.fr website (section “My procedures” and “Reimbursements of care at the abroad”) on presentation of paid invoices.

Elsewhere in the world

Advantage of travel insurance: they cover both treatment, hospital stay and repatriation costs. Adobe Stock

As the name suggests, the EHIC only works within the EU and EEA. Apart from these thirty countries, unannounced or urgent care can still be reimbursed in those who have concluded a bilateral agreement with the French health insurance. This is the case of Morocco, the province of Quebec in Canada or Turkey (see complete list of countries).

In this case, it is necessary to advance the costs and to present, on return to France, the supporting documents for health expenses accompanied by the Cerfa form n°12267 to your health insurance fund. Attention, reimbursement is not automatic. “Given the supporting documents, the Health Insurance will assess whether or not you were in an emergency situation and, depending on the case, will or will not reimburse your care. In the event of agreement, the treatments are reimbursed on the basis and within the limit of the French flat rates in force (and not on the basis of your actual expenses)», Details the Ameli website. And to specify thatin case of refusal, no dispute is possible“.

For trips outside of Europe,it is prudent to take out travel insurance specific or to ensure that you already have such insurance, for example with your car insurance or your bank card“, recommends the Center for European and International Social Security Liaison (Cleiss). “The contract must be adapted to the actual costs of health care costs practiced in the country of stay.In other words, we will not choose the same coverage depending on whether we are staying in Africa or in a country with a high cost of living such as the United States or Canada.

Advantage of travel insurance: they cover both treatment, hospital stay and repatriation costs while covering non-health risks (car rental, civil liability, lost luggage, etc.). In the event of hospitalization, they can sometimes cover the travel and accommodation costs of a close relative who must come to the patient’s bedside. Because some received ideas can cost you dearly. While most bank cards do include insurance, the ceiling is often insufficient for treatment abroad, unless you have a premium card. Similarly, in the event of an accident, consulates and embassies do not provide any financial assistance to their nationals.

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