CFE reimbursements: on what basis, and with what out-of-pocket cost

For each medical procedure, there is a reference rate set at the national level — the Social Security reimbursement base — and French health insurance reimburses a percentage of this rate, regardless of the price actually charged by the practitioner. CFE applies exactly the same French reference rate to its members abroad, whether they receive care in Paris, Bangkok or New York.

In practice, CFE never adjusts to the local price level. An identical procedure can cost, depending on the country, a fraction of the French rate or several times that rate: either way, the CFE reimbursement base stays the same, the one in force in France.

In France, since 22 December 2024, the negotiated rate for a visit to a sector-1 general practitioner is €30 (it was €26.50 before). French health insurance reimburses 70% of this base, i.e. €21, from which the mandatory flat-rate contribution of €2 left to the insured is deducted: the net reimbursement therefore comes to €19.

CFE applies this same reference rate to its members abroad: a visit to a general practitioner is reimbursed there on the basis of this same €30. Yet the real cost of a GP visit in many destination countries far exceeds this amount — this is notably the case across much of North America, developed Asia, the Gulf or Oceania.

Each country page on the site details the real costs observed (consultation, hospitalisation, imaging) for direct comparison against this €30 reference rate — see for example the United States or Switzerland pages.

The mechanism applies to all procedures covered by CFE: hospitalisation, surgical procedures, dental care, optical, tests, imaging. The gap between CFE reimbursement and the real cost tends to be proportionally larger for categories where prices vary the most from one healthcare system to another — hospitalisation first, followed by dental and optical, categories for which the French reimbursement base has always, by design, been modest.

• The co-payment — the portion of the reference rate left to the insured.
• Flat-rate contributions, such as the €2 applied to every consultation.
• Fee excesses, near-systematic outside France.
• Assistance and medical repatriation, which are separate guarantees.

For hospitalisation abroad, two situations exist. Without direct billing, the insured pays all the costs upfront and is then reimbursed at the applicable rate or flat amount, on presentation of the hospitalisation form completed by the care provider.

With direct billing, at a facility in the partner network (VYV) of a covered country, CFE directly covers 70%, 80% or 100% of the bill depending on the geographic zone — the remainder (private room, companion, extra meals, or the remaining 20 to 30% depending on the zone) is left to the insured or their top-up cover. This direct billing requires individual membership (outside a corporate contract), a MondExpat, JeunExpat or RetraitExpat Santé product, open rights, and no equivalent top-up cover already in place.

Among the 168 countries covered by this site, CFE’s hospital direct-billing network notably includes Senegal, Ivory Coast, Morocco, Tunisia, Thailand, Vietnam, Indonesia and Mauritius (list by zone: Africa, ASEAN, Indian Ocean, Middle East and part of the Americas — to be re-checked country by country, as the list changes).

A top-up guarantee designed to work alongside CFE covers, depending on the level subscribed, the portion not reimbursed of the French rate and, a specificity of living abroad, the gap between the French reference rate and the real local cost. Conversely, a “first-euro” international health insurance policy reimburses directly on the basis of its own caps and the real costs incurred, without going through the French reference rate — see the guide CFE or private insurance.

See also the country-by-country comparison of consultation costs to measure this gap concretely for your destination.