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How do CFE refunds work?

Mondassur explains how the reimbursement of the CFE works according to the type of acts, how to join the CFE and how a complementary to the CFE works. Read also our article on CFE tariffs to add to the price of a Complementary Mondassur to the CFE essential worldwide.

geographical area cfe world
What are the geographical areas of the CFE to calculate your reimbursement of health expenses?

The CFE has divided the world into 5 geographical areas from the cheapest with zone 1 to the most expensive with the United States, the United Kingdom or Norway in zone 5. This classification is based on the medical cost encountered in the different countries of the world. Thus, in the USA, the medical cost is the highest in the world. It is also noted that some countries such as Italy have a very high medical cost. Africa and Asia are divided between the countries of Zone 1 and those of Zone 2 mainly. Some exceptions from countries in zone 3 because of the obligation to leave the territories to be able to be properly treated. Brazil, Australia, Canada or Mexico will also be in zone 3.

How does the CFE reimburse in case of hospitalization?

The reimbursements of the CFE for hospitalization as for routine medical care will depend on the geographical area where you are with coverage ranging between 19% and 80%. The more you are in a high geographical area, therefore at a high medical cost, the lower the percentage of coverage by the CFE will be. Thus, in the USA, the CFE will take your hospitalization up to 19% or cancer care by chemotherapy up to 20% of your actual costs. In Mexico, your hospitalization will be covered up to 42%. Given these reimbursement percentages, it becomes essential to supplement your CFE coverage with a CFE supplementary insurance such as GoldExpat CFE. Otherwise you may have a very high load leftover.

hospitalization cfe

What reimbursement of the CFE in case of maternity?

For maternity care, the CFE will take a maternity with caesarean section differently from a maternity without surgery. The maximum ceiling for all areas combined for maternity is about 2,449 euros. Here again, a cfe supplementary insurance is especially necessary for countries with high medical costs. Mondassur also offers with the Maternity Plus option a reinforcement of the maternity coverage in order to avoid that your remaining dependent is too important.

Here are the maximum ceilings in maternity for the reimbursement of the CFE only:

  • Vaginal delivery: 2448,69€
  • Caesarean delivery: 2763,69€
  • Abortion: 792,33€

How does the CFE reimburse medical expenses abroad?

Regarding current medicine, the CFE is always based on the convention rates of the French social security which allow in particular for consultations of doctors to supervise the care.
For consultations in general medicine or with a medical specialist, the CFE will take 70% of the amount spent capped at the convention rate, i.e. 25 euros for example for a general practitioner or specialist, or a maximum reimbursement for the insured of 17.50 euros. It is easy to understand that your remaining expenses will always be important even in countries with low medical costs. Again, it is strongly recommended to take out additional CFE insurance.
Regarding other routine medical care such as X-rays, MRIs, scanners, laboratory examinations, pharmacy, dental, cfe coverage will be in % of the actual costs and depends on the type of care and will vary between 10% and 60%. For example, for all imaging that can reach high levels of cost, the support will be between 15% and 55% depending on the geographical area; dental between 10% and 30%. You will find in the table below the details of the supports according to the acts.

The level of reimbursements from the CFE have been published in the Official Journal. They apply universally to all persons contributing to the CFE for the health coverage part. Note that there may be waiting periods of 3 to 6 months during which the CFE will not take care of you at all, you have the possibility to take out insurance at the 1st euro in a 1st time.

what reimbursement with the cfe

How to join the CFE and what waiting periods for the CFE?

If you join the CFE before your departure or within three months of your move abroad, the coverage of your care begins immediately. Otherwise, your care will be covered after a period of 3 months if you are 30 years or older and under 45 years and 6 months for those over 45 years old. This period of 6 months is currently exceptionally reduced to three months for any new membership until 31 March 2022. You can join the CFE regardless of your age and without an online health questionnaire. For the complementary CFE Mondassur,membership is done in parallel. If the CFE does not take care of you, your complementary CFE will not be able to come in full. When you join the complementary CFE Mondassur, we will be able to see together the possible options for your coverage during this period.

If you are under 30, you will not have a waiting period.

Be careful, during the waiting or waiting period of the CFE, you will not be covered even for emergency care.

What reimbursement with a CFE supplementary insurance?

Supplementary insurance to the CFE completes the reimbursements of the CFE. A refund can never be paid beyond what you have actually spent.

Examples:

  • If you have a €250 scanner in Italy, the CFE will take care of 20% of this €250. If your complementary mutual CFE like Goldexpat reimburses you at 90% of your actual costs, you will then be reimbursed 225 euros in total divided between 50 euros from the CFE and 175 euros from the mutual.
  • You have purchased medicines in the USA, you will be reimbursed in the USA 45% of the amount of the medicines and the complementary mutual CFE will reimburse you the rest up to the ceiling covered if applicable.
  • You have for 500 euros of medicines, the CFE reimburses 225 euros and the complementary 90% of 225 euros, for a total reimbursement of 450 euros.

With a Mondassur insurance complementary to the CFE, you will be able to request your health care reimbursements on your CFE space. The CFE will then send us your request so that you receive a single CFE + Mondassur refund. A one-stop shop for your care reimbursements.

How does the CFE supplement work with CFE refunds?

A complementary health insurance to the CFE will offer the big advantage of not paying money if you have to be hospitalized as is the case if you only benefit from the CFE.
You will also have the possibility to send your claims to the supplementary insurance if it operates as a one-stop shop. Otherwise, you will have to wait until you receive the statements from the CFE to obtain the additional refund.

Do I have to take a cfe supplement?

It is essential to take out supplementary insurance with the CFE. Even if you take out supplementary insurance with weak guarantees, this allows you to benefit from direct care in case of hospitalization. You can also benefit from repatriation assistance guarantees valid worldwide. Taking out supplementary insurance with the CFE is therefore essential whether you are in a country with a high medical cost or in a country with a low medical cost. The CFE will never take 100% of your health care and can be less than 20% depending on the country you live in.
You can request a free quote to know the rates of a complementary CFE and also compare them with an expatriate insurance at the 1st euro that is to say reimbursing you without intervention of the CFE.

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