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Patients may see a doctor other than the primary care physician under certain circumstances: in the event of a medical emergency, the absence of the primary care physician or his locum, or if the patient is far from home.Gynecologists, ophthalmologists and psychiatrists may also be consulted directly without a referral from a primary care physician.Universal Healthcare Coverage (“Couverture maladie universelle”/ CMU) was rolled out in 1999 to cover health care expenses for individuals not belonging to a compulsory health insurance scheme.Eligibility was conditional either upon the payment of a given amount of contributions or upon completing a given number of hours of work during each reference period.To continue receiving cash benefits after 6 months of leave, the claimant must have worked at least 600 hours in the previous 12-month period or have paid contributions on at least 2,030 times the hourly SMIC prior to going on leave.The claimant must also have been registered with the health insurance scheme for at least one year.

Healthcare expenses cover medical and paramedical expenses as well as medications, orthopedic appliances, and hospital costs.

The patient's out-of-pocket payment will be higher if the coordinated healthcare pathway system is not followed.

Reimbursement rates are listed online on On top of the co-payment (“ticket modérateur”), the patient is responsible for a number of other charges: a flat-rate charge for extensive procedures, a €1 charge for visiting a doctor and for examinations and tests and a flat charge for medications, paramedical procedures and travel for medical purposes.

Under this system there are different "secteurs" within which practitioners may choose to work, and which apply different rates of reimbursement: Practitioners may also charge higher rates for patients who are not referred by or registered with a primary care physician or who have not followed the "healthcare pathway" system. The social security system covers a portion of the cost of medications included in the positive list of reimbursable pharmaceutical products.

Certain medications are reimbursed on the basis of a reference price determined according to the price of the lowest-priced generic equivalent.

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Scope of coverage: From the age of 16, all patients must choose a primary care physician ("") who will provide referrals as part of the “coordinated care pathway” system.

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