Healthcare Reimbursement in Lebanon: Who Reimburses What Depending on Your Situation

The French consulate general in Beirut points it out: in case of hospitalisation, care or medical repatriation, the French State does not cover healthcare costs. CLEISS, which lists the states linked to France by a bilateral social security agreement, does not include Lebanon. There is therefore no coordination between schemes, no totalising of periods and no cross-reimbursement on the basis of a form.

Four payers may be involved depending on status: the Lebanese NSSF, the French scheme kept in place (secondment), the CFE and international health insurance. The notions of reimbursement basis and out-of-pocket cost help you compare offers. One point dominates practice: healthcare facilities systematically check the patient’s ability to pay before undertaking treatment (France Diplomatie, the French foreign ministry). How care is organised is described in the guide to the Lebanese healthcare system.

The employee on a local contract is declared by their employer to the NSSF, whose sickness-maternity branch covers the care of insured members under the conditions set by the fund. It publishes lists of covered medicines, surgical procedures and medical devices. CLEISS specifies that an expat falls under the local scheme and leaves the French scheme: they inform their health insurance fund and return their carte Vitale. The conditions of access for a foreign employee are confirmed with the NSSF (+961 1 700 801). See the glossary entry on the local contract.

The seconded employee sent by their French employer stays affiliated to the compulsory French scheme, with contributions paid in France, for 3 years renewable once. They are covered within the limit of the benefits they would have received for the same care in France: they send their affiliation fund the paid invoices with form S 3125c “care received abroad”. Dependants who accompany them follow the same procedure. CLEISS indicates that, in a country where care is expensive, supplementary insurance allows for greater cover. See seconded or expat and the glossary entry on the seconded employee.

The self-employed person can contribute to the CFE for sickness-maternity risks (CLEISS), or take out international insurance; the Lebanese scheme applies under the NSSF’s conditions. See digital nomad insurance.

The student has no agreement-based cover, as Lebanon is not among the states linked to France by a social security agreement (CLEISS). Under age 30, the CFE offers its youth plan, from €57 a month, and international student insurance remains possible. See student insurance abroad.

The spouse and children follow the status of the main holder: dependants at the NSSF under its rules, dependants of a seconded employee for care reimbursed on invoices, or a family contract at the CFE or in international insurance. See expat family insurance.

For a retiree who lives permanently outside the European Union, Assurance Maladie specifies that healthcare costs are no longer covered by the French scheme; form S1, reserved for Europe, does not apply. The retiree can join the CFE or take out private insurance. The CFE retirees’ plan starts at €147 a month at the advertised price, with no health questionnaire, and is aimed at people drawing a pension from the French basic scheme; it covers care outside France.

To be reimbursed during temporary stays in France from a country with no agreement, a retiree must have contributed at least 15 years to one or more compulsory French schemes and register with the National Centre for Retirees of France Abroad (Cnarefe). A CFE member who is a retiree of the general scheme sends their claims to the CPAM (local health insurance fund) of Seine-et-Marne. See the guide to retirees’ health insurance abroad and the page on retiring in Lebanon.

The CFE is a voluntary social protection body. Abroad, it reimburses according to the country in which you are treated, through rates or flat amounts applied to actual expenses: when the Lebanese price exceeds the basis used, the difference stays with the member. The guide to CFE reimbursements details this mechanism.

• Plans: main plan (age 30 and over) from €87 a month, youth plan (under 30) from €57 a month, retirees’ plan from €147 a month; prices vary by country and age. Care in France is covered for stays of less than three consecutive months.
• Waiting period: immediate cover if enrolment takes place within three months of moving abroad; beyond that, three months’ wait before age 45 and six months from age 45 (see waiting period).
• Maternity: conception must follow enrolment at the CFE.
• Assistance: the assisted category pays part of the contribution subject to means testing; the application is filed at the consulate.

On returning to France, an employee who resumes work is immediately affiliated, with no waiting period for care; a retiree contacts their pension fund. Without work or a pension, they apply for universal health coverage on a residence basis, with in principle a 3-month waiting period. A CFE member without employment receives, under conditions, the benefits of the expatriate scheme for 3 months (CLEISS). See reducing the waiting period and the page on returning to France.

First-euro international health insurance reimburses actual costs within its ceilings, after any excess, waiting periods and exclusions in the contract. With direct billing, the insurer guarantees the costs to the establishment, which answers the ability-to-pay check carried out at admission. The contract is compared on the annual ceiling, the coverage zone, evacuation and the handling of medical history.

The tourist pays for care on the spot. Assurance Maladie indicates that, outside Europe, only urgent and unforeseen care may possibly be reimbursed on return to France, on the basis of French flat-rate tariffs and not actual expenses, with no daily allowances; the medical adviser decides on reimbursement, with no appeal in case of refusal. The consulate general points out that the French State does not fund medical repatriation, and that the bank card often covers hospitalisation and repatriation for stays of less than 90 days, depending on the contract. See long-stay travel insurance.

• Consultation: the NSSF reimburses its insured members according to its rules and tariffs; the seconded employee is reimbursed within the limit of French tariffs; the CFE applies its country scale; a first-euro contract reimburses actual costs within its ceilings.
• Hospital stay: hospitals check ability to pay before treatment; the NSSF covers the hospitalisation of its insured members according to its rules, the establishments concerned being confirmed with the fund; the seconded employee pays then is reimbursed on invoices; direct billing under an international contract avoids the advance.
• Medicines: the NSSF publishes lists of covered medicines; public prices follow the Ministry of Health list; the CFE and international contracts reimburse according to their scales and ceilings.
• Dental: the extent of NSSF dental care is confirmed with the fund; CFE and international plans cover it according to their conditions and annual ceilings.
• Optical: glasses and lenses are mostly covered by international contracts, with ceilings per period to read in the benefits table.
• Maternity: covered by the NSSF sickness-maternity branch for insured women; the CFE requires conception after enrolment; international contracts generally apply a waiting period specific to the contract.

The reimbursement guide and the expat health insurance page give benchmarks; Expavy helps you weigh these options against your situation. The Lebanon: expat health insurance page brings together the insurance obligations by type of stay.