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Same consultation, different fees?
If you’ve looked for a specialist in France, you may have noticed that consultation fees aren’t always the same.
One reason is that doctors practise under different fee arrangements called Secteur 1 and Secteur 2.
Understanding the difference
A Secteur 1 doctor has agreed to charge the official consultation fees set by the French health system. If you visit a Secteur 1 GP or specialist, you’ll generally pay the standard tariff, from which Assurance Maladie reimburses its usual share.
A Secteur 2 doctor is allowed to charge higher fees (dépassements d’honoraires). These additional charges are not always fully reimbursed by the state health system, so the amount you pay yourself will depend on your mutuelle.
Higher fees don’t necessarily mean doctors earn more
Some Secteur 2 specialists offer longer consultations, have higher practice costs or provide highly specialised services.
In some specialties, charging above the standard tariff can also make it financially viable to spend more time with each patient.
A real-world example
Availability can also be a factor. Dermatologists, for example, are in short supply in many parts of France, partly because demand for both medical and cosmetic dermatology has increased. Patients may therefore find that both waiting times and consultation fees vary considerably from one practitioner to another.
For example, imagine two dermatologists in the same town:
- Dermatologist A (Secteur 1) charges, say, €35 for the consultation.
- Dermatologist B (Secteur 2) might charge, say, €80.
The difference reflects how they are authorised to charge. Both may be equally competent and qualified, but the second doctor may offer longer appointments, have shorter waiting times or provide more specialised services. Whether the additional cost represents good value is a decision only you can take.
Your mutuelle may cover the difference
If you have a mutuelle, it may reimburse some or all of the additional fee charged by a Secteur 2 doctor, depending on the policy you’ve chosen. That’s why it’s worth understanding what your policy includes before assuming a higher fee will necessarily mean a higher out-of-pocket cost.
Check before you book
Before booking an appointment, particularly with a specialist, it’s worth checking whether the practitioner is Secteur 1 or Secteur 2. This information is usually shown on booking sites such as Doctolib, along with the consultation fee, so there are no surprises.
Related reading: Do I Really Need a Mutuelle in France?
