Starting December 22, medical consultation fees will increase, marking the first adjustment in five years. A general practitioner’s fee will rise from €26.50 to €30, while pediatric consultations for children under 2 will see incremental increases. Health insurance typically covers around 70% of these fees, but this may drop to 65%. Approximately 3 million low-income individuals without complementary health insurance will be most affected, with potential premium hikes anticipated in 2025.
Upcoming Increases in Medical Consultation Fees
Starting December 22, you can expect to see a rise in the costs associated with medical consultations, whether you’re visiting a general practitioner or a specialist. The National Health Insurance Fund (Cnam) announced this adjustment back in May after extensive negotiations with medical unions. These new rates will take effect on December 22 and will remain in place for the next five years.
The most significant change will be the fee for a consultation with a general practitioner, which will increase from €26.50 to €30. Additionally, other consultations will see slight increases as well. Consultation fees for pediatricians for children under 2 years old will jump from €38.50 to €39, with a further increase to €40 scheduled for July 2025.
In cases where you have a coordinated consultation (where you see a specialist after your primary care doctor), the fee for a medical gynecologist will rise from €33.50 to €37, while appointments with psychiatrists, neuropsychiatrists, or neurologists will be charged at €55, down from the current €61.70.
Your Out-of-Pocket Costs Explained
Curious about what you will be paying out of pocket? The overall impact on your expenses will depend on your specific situation. Health insurance typically covers about 70% of consultation fees, although a reduction to 65% was announced by the Minister of Health on November 18.
For instance, if you visit a contracted general practitioner in sector 1 (who does not charge extra fees), the consultation currently costs €26.50. “If this is your declared primary care doctor, Health Insurance reimburses 70% of the fee minus a €2 flat-rate participation charge, resulting in a reimbursement of €16.55,” as per the details from the Social Security website. If it’s not your primary care doctor, the reimbursement drops to just €5.95.
If you have complementary health insurance, it may cover the remaining charge of €9.95 up to €7.95 (not including the €2 flat-rate participation) for a consultation with your primary care doctor. This remaining charge increases to €16.55 if you have not declared a primary care doctor or if you consult another without prior approval.
With the new fee of €30, this remaining charge will also rise. If Health Insurance continues to reimburse at 70%, the out-of-pocket expense for a consultation with your primary care doctor will reach €11, of which up to €9 can be reimbursed by your mutual insurance provider. However, some individuals may be exempt from the remaining charge, known as co-payment, including the €2 participation fee.
Initially, this increase will impact only about 5% of the French population (approximately 3 million people), primarily low-income individuals without complementary health insurance. Most of these insurances usually cover the remaining charge (excluding the €2 participation fee) for insured patients or directly to doctors practicing third-party payments, meaning patients do not have upfront costs.
Over time, those who currently have this protection might also see higher costs. It is anticipated that complementary health insurances will likely reflect these increases in their premium rates. Notably, increases in premiums ranging from 4.5% to 9.5% are already planned for 2025.
Are you eligible for any free mutual insurance benefits under your health plan?