Glossary
Co-payment (ticket modérateur)
The share of a reference rate (reimbursement basis) that remains payable by the policyholder after reimbursement by the base health insurance scheme, before any top-up cover steps in.
In France, Assurance Maladie generally does not reimburse 100% of the negotiated rate for a procedure: the unreimbursed share is the co-payment. CFE, which replicates this mechanism for expats, applies the same principle on the same French reference rates, regardless of the country of residence.
The co-payment is distinct from the gap between the French reference rate and the actual cost of a procedure abroad, which can be far larger than the co-payment alone in countries with high medical rates.
Example
For a GP consultation reimbursed at 70% of its reference rate, the remaining 30% (before the flat-rate contribution) makes up the co-payment.
Also searched as: unreimbursed share · base out-of-pocket cost
Related terms
To go further: CFE guide: how reimbursements are calculated (French)