Preamble
Unlike the English system, the French regime makes no difference between the public and private treatments (the reimbursement rates are identical).
On the other-hand, the 'Sécurité Sociale' alone does not cover the entirety of your expenses.
A few definitions
Put your mouse over the column
Frais réels : The total amount spent by the insured
Dépassement : Fees charged by specialists over the "Tarif de convention"
Tarif de convention : These are the fixed rates to be used by doctors set by the national convention for all of the health services.
Ticket modérateur : This represents the percentage that is to be paid by the patient, not reimbursed by the "Sécurité Sociale".
This percentage varies following your obligatory regime, set by tariff references allocated to various medical treatments and associated fees encountered.
Remboursements de la Sécurité Sociale :
The reimbursements are determined on five factors:
1) A key letter describing the nature of treatment sometimes followed by a coefficient factor that indicates the value of a medical act.
2) The fixed rate ("tarif de convention") can differ if your practitioner is "conventionné" or "non conventionnée".
3) The level of contribution from your obligatory regime.
4) Your actual expenses.
5) The chosen formula,Top-up, ("Complémentaire frais de Soins").