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In brief
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Duration: Consultation — usually without payment (or otherwise)
Cost: Free (paying third parties) or only remains dependent
On-site only

Who this guide is for

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  • You if you want to understand why you sometimes do not pay to the doctor
  • You if you have CSS/mutual and want to use the paid third party
  • You if you are in LDA or maternity (automatically paid third parties)

To be prepared in advance

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  • Vital card (up to date in CPAM)
  • Mutual Card/CSS (if applicable)
  • Knowledge of your status (ALD, maternity, CSS)

Step-by-step procedure

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  1. 1Third party paying full fee: you do NOT pay NOTHING to the doctor/pharmaceutical. Valid in ALD (on list), maternity, CSS, for patients of certain mutuals.
  2. 2Part-paying third parties: the CPAM pays its share (70 %), you only pay the rest (moderator tick + exceedances). The mutual fund can cover the rest.
  3. 3ALD (long-term condition): exemption from the moderator ticket — 100 % reimbursement for long-term diseases (diabetes, cancer, etc.). The CPAM pays directly.
  4. 4Maternity: pregnancy-related examinations and care — full-paying third party after reporting CPAM.
  5. 5CSS: free supplement — third party paying anywhere (physician, pharmacy, hospital).
  6. 6Mutual: check the contract — many cover the rest directly via mutual paying third party. Present the mutual card.
  7. 7Doctors sector 1 are required to pay a third party in ALD/maternity/CSS (for others — optional). Sector 2 can refuse.
  8. 8Hospital: for hospitalisation, usually paying third party (you only pay the daily plan 20 €/day, and again, often covered by the mutual).

Common mistakes

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  • Pay in full when the paying third party is entitled — difficult to be reimbursed afterwards.
  • Do not update the Vital Card when changing — the system does not "see" rights.
  • Do not present the mutual card — one loses the mutual paying third party.
  • Believe the third party paying everywhere. Sector 2 and some care may require an advance.
  • Ignore that ALD/maternity automatically give exemption.

Official sources

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Show sources in this section

Useful links

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ALD (chronic disease)CSS (free)Maternity

Important remark

The application of the paying third party depends on the status and the doctor. This information is indicative — for your case, check on Ameli.

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