Government plans to raise cap on medical out-of-pocket charges to 200 euros

Paris – 23 July 2026: The French government plans to raise the annual cap on medical out-of-pocket charges from the current total of 100 to 200 euros. Health Minister Stéphanie Rist announced on Thursday that preparations were under way for a corresponding decree. The measure would affect insured people with particularly frequent doctor visits, prescriptions for medicines or medical examinations. It is part of efforts to limit the deficit of the statutory health insurance system.

Under the current system, two types of patient contribution are distinguished. The medical deductible is one euro per package of medicine and per paramedical service, as well as four euros per medical transport. In addition, a flat-rate contribution of two euros applies to medical consultations, radiological examinations and laboratory analyses. Both categories are currently capped at 50 euros per person per year, for a combined maximum of 100 euros.

According to the minister, the amounts per service are not to increase again for the time being. Only the cap would change: people who currently reach the annual total of 100 euros due to high treatment needs could in future have to pay up to 200 euros themselves. The proposal therefore would not affect all insured people to the same extent, but primarily those undergoing recurring treatment and receiving numerous prescriptions.

Several groups would remain exempt. Minors, pregnant women from the sixth month of pregnancy until twelve days after giving birth, and recipients of the solidarity supplementary health insurance scheme are exempt from these out-of-pocket charges. Special rules also apply to certain forms of treatment. Standard supplementary insurance policies are generally not permitted to reimburse medical deductibles, meaning that for most people concerned, the amounts remain a direct expense for the insured person.

The government justifies the move by citing financing pressures in the healthcare system. During parliamentary discussions on the 2026 social security budget, the executive pointed to a social security deficit of around 23 billion euros and set a target of reducing it to 17 billion euros. Higher caps are intended to shift part of the costs to insured people without changing the reimbursement rates for the services themselves.

Politically, the plan is sensitive. Medical out-of-pocket charges were introduced in 2004 for doctor visits and in 2008 for medicines, paramedical services and transport. Their individual amounts had already been increased in 2024, while the annual caps initially remained unchanged. Patient associations and sections of the healthcare professions see a doubling of the maximum burden as a risk for people with chronic illnesses and those on low incomes.

The decisive issue now is the specific design of the announced decree. The announcement of 23 July does not yet constitute a rule in force. Only once the regulatory text is published will the timing, exact scope and any transitional provisions be binding. The debate is also likely to extend into preparations for the next social security budget.