Cross-border health and social care cooperation agreements

fr en

Thes agreements are designed to benefit patients in a concrete and direct manner by allowing them to take advantage of high-quality care as close as possible to where they live, as the nearest hospital may be located across a country border.

I. Background

In addition to the mechanisms provided by European regulations (EC) 883/2004 and (EC) 987/2009 and by Directive 2011/24 (EU) on cross-border healthcare, French domestic law as from 2005 on the coverage of care received outside of France has fully incorporated EU legal precedent on the free provision of services and the free movement of goods with regard to healthcare (decree 2005-386 of April, 19, 2015)

As a result, the French Social Security code (article R 160-3) allows for cross-border agreements to be concluded between France’s social security institutions and certain health or socialcare facilities located in another European Union member State or party to the agreement on the European Economic Area or Switzerland, upon authorization from the competent authorities or the regional health agency (“agence régionale de santé”/ ARS).

These agreements set forth the terms of admission to these facilities for patients entitled to coverage of their healthcare expenses, or their beneficiaries pursuant to European regulations, assuming they cannot receive appropriate care for their condition in France, as well as the rules for reimbursement of the care provided.

When these regulations apply, individuals entitled to coverage of their healthcare expenses, as well as their beneficiaries pursuant to European regulations, are not required to get prior authorization for hospital-based care.

II. Framework agreements

In order to organize and standardize this type of agreement, France’s competent authorities have decided to conclude framework agreements with their European equivalents.

Indeed, so long as medical care remains a domestic competence for each individual member State, bilateral agreements in this area will remain essential in order to eliminate obstacles to the free movement of patients and health care professionals.

The main provisions of these framework agreements are designed to:

The framework agreements signed by France

* Two framework agreements have been signed with Switzerland (September 27, 2016) and Luxembourg (November 21, 2016). A bill authorizing the approval of these two framework agreements on cross-border healthcare cooperation was submitted to the French National Assembly on November 22, 2017.

III. Health or health and social care agreements

Pursuant to French legislation and to the health or health and social care cooperation framework agreements that have been signed by France, various cross-border agreements have been concluded between France’s social security organizations and certain health or health and social care facilities located in another European Union member state or party to the European economic area agreement, upon authorization from the competent authorities or the regional health agency (« Agence régionale de santé »/ARS ).

It should be noted that these agreements generally apply to border-area residents and health care professionals.

To determine whether a person is covered by these cross-border agreements, it is essential to check the agreements’ material, personal, and geographical scope of application.

Agreements signed by France :