Glossary
Out-of-pocket cost (reste à charge)
The share of healthcare costs that remains payable by the policyholder once reimbursements from all schemes and policies involved (Social Security, CFE, supplementary cover) are deducted.
The out-of-pocket cost adds up several elements: the co-payment (the share not reimbursed by the base scheme), any deductible or flat-rate contribution, and, for an expat covered by CFE, the gap between the French reference rate and the actual cost of care abroad — often the largest component outside France.
Supplementary insurance or a CFE top-up reduces this out-of-pocket cost without necessarily bringing it down to zero: it all depends on the coverage limits of the policy taken out, which can themselves leave an uncovered share on the most expensive categories of care.
Example
For a consultation billed abroad well above the French reference rate, the out-of-pocket cost can remain high even after CFE and a top-up step in, if the latter caps its own reimbursement.
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