The healthcare pathway consists of choosing and designating a referral doctor with your Caisse Primaire d'Assurance Maladie (CPAM). The chosen doctor is then your first point of contact for any health problems you may have: he or she refers you to specialists if necessary, and establishes your care pathway.

By giving priority to consulting your preferred doctor, you benefit from better reimbursement of your healthcare expenses**. If you don't, you'll receive less reimbursement from the French health insurance system and your supplementary health insurance.

An example to help you understand:

- You consult a general practitioner in sector 1.

- The consultation costs €25.

- If you follow the health care pathway (**health insurance reimburses** 70% of this amount - €1 fixed contribution (amount to be paid by you) i.e. **€16.50.**).

Your mutuelle santé reimburses the remaining 30%, i.e. €7.50. The remaining €1 is payable by you.

In the event of a consultation outside the healthcare pathway, the Assurance Maladie reimburses 30% of the consultation plus a €1 fixed contribution (amount payable by you), i.e. €6.50. Your mutual insurance company will still reimburse €7.50. This leaves €11 to be paid by you.


In certain cases, you may be referred to a doctor other than your own.

If you have a major health emergency, are traveling or on vacation, or if your preferred doctor is absent, you may use a doctor other than your own.

If you have a major health emergency, are travelling or on vacation, or if your GP is absent, you can consult another doctor without any impact on your reimbursements.

Certain specialists can also be consulted, without having to go through a GP, such as: dentists; ophthalmologists; gynecologists; pediatricians; psychiatrists (for 16-25 year-olds).