| Verified against primary record | |
| Reimbursement requests (2023) | 180,001 received, 55,615 granted, 81,588 refused[1] |
|---|---|
| Care in France for persons insured abroad (2022) | EUR 946.08 million met by French institutions[3] |
| Care abroad for French-insured persons (2022) | EUR 522 million reimbursed by French institutions[3] |
| Share of that outbound spending inside Europe | 92 per cent in the EU, EEA, Switzerland and the United Kingdom[3] |
| Independently reported | |
| Outgoing patients (2016) | 146,054, the highest in the European Union[2] |
| Bands apply only to the rows beneath them. The reimbursement counts are claims, not patients, and the European Commission records that the French figures combine cases arising under Directive 2011/24/EU with cases arising under the social security coordination Regulations, with refusals that cannot be separated between the two. The two financial totals rest on the Regulations and on bilateral agreements rather than on the Directive alone, so they are not comparable with the claim counts above them. No typical cost range is given because no official French source publishes prices paid by foreign patients. | |
Medical tourism in France covers both French residents who obtain treatment in other countries and patients insured elsewhere who are treated in France. France is unusual in that it records the largest outgoing patient flow in the European Union while, in financial terms, receiving substantially more for treating people insured abroad than it pays out for treating its own insured abroad.
Official statistics
France reports annually to the European Commission under Directive 2011/24/EU. For reference year 2023 it recorded 180,001 requests for reimbursement of care not subject to prior authorisation, of which 55,615 were granted and 81,588 refused. France reported no prior authorisation figures, because in the French system prior authorisation applies only to care sought under the social security coordination Regulations rather than under the Directive.[1]
The Commission attaches two warnings to the French return. The reimbursement figures mix cases arising under the Directive with cases arising under the Regulations, and the refusals cannot be separated between the two. The report also contains an internal inconsistency in the French row, giving the granted share as 30.9 per cent in its table and 30.3 per cent in its text.[1]
Financial flows are published separately by the Centre des liaisons europeennes et internationales de securite sociale, the French body responsible for international social security. For 2022 it reported that French institutions met 946.08 million euro of costs for care provided in France to people insured under foreign schemes, under the European regulations and international agreements, and that French institutions reimbursed 522 million euro for care received abroad by people insured in France. Of that outbound total, 92 per cent related to care within the European Union, the European Economic Area, Switzerland and the United Kingdom, and 8 per cent to care outside that zone.[3]
Taken together, those two amounts place France as a net receiver of cross-border care by value, which sits awkwardly beside its position as the member state with the largest number of outgoing claims. The two series are not measuring the same thing: one counts claims under a particular legal route, the other sums money moved under a wider set of instruments, and neither is a count of medical travellers.
Eurostat maintains a dedicated collection of hospital discharges of non-residents, with separate tables for in-patients, day cases, bed days and average length of stay. Its reference metadata, last updated on 15 December 2025, states that country of residence is reported for non-resident patients, while noting that some countries cannot supply it. Individual cell values for France were not retrievable for this article.[5]
Legal framework
Under Directive 2011/24/EU, the member state of affiliation must reimburse cross-border care where the treatment is among the benefits it covers domestically, capped at the level of costs that state would have assumed and not exceeding the actual cost of the care received. Prior authorisation may be required only for care subject to planning requirements that involves an overnight hospital stay or highly specialised and cost-intensive infrastructure, for treatments carrying a particular risk, and for care from providers raising serious concerns about quality or safety.[4]
France applies prior authorisation through the older coordination Regulations instead, which is why its Directive return carries no authorisation figures at all.[1]
Where French patients go
The Commission identifies the movement from France to Spain and to Portugal as among the busiest reimbursement flows in the Union, and records Italy to France as one of the busiest prior authorisation flows in the opposite direction. Patient mobility under the Directive is predominantly between neighbouring states.[1]
The European Court of Auditors recorded France as the member state with the most outgoing patients in 2016, at 146,054, out of a Union total of 213,096 patients, of whom 3,562 required prior authorisation. In the same year Spain received the most incoming patients, at 46,138, followed by Portugal at 32,895 and Belgium at 27,457.[2]
A long-standing pattern of cross-border care also operates on France’s northern frontier. Belgium’s patient mobility observatory recorded roughly 15,670 patients crossing within the organised border care zones in 2012, of whom 14,451 travelled from France to Belgium and 1,219 in the opposite direction.[1]
Limits of the evidence
No official French series counts medical travellers. The Directive return counts claims and mixes two legal routes; the financial statistics sum money rather than people and cover a wider set of instruments; and privately funded treatment, which is what commercial usage most often means by medical tourism, appears in none of them. The refusal rate implied by the 2023 French return, with 81,588 of 180,001 requests refused, is also not interpretable on its own, because the Commission notes that requests may be decided in a later year than the one in which they were received.
See also
- Cross-border healthcare, the framework producing the French claim figures
- Cross-border healthcare for border communities, the arrangements behind the France to Belgium border flow
- Medical tourism in Belgium, the destination that counts incoming French patients directly
- Outbound medical tourism, the direction of travel France leads in the European Union
- Medical tourism and balance of payments statistics, how monetary flows of this kind are compiled
References
- European Commission, Directorate-General for Health and Food Safety. Data on cross-border patient healthcare following Directive 2011/24/EU, reference year 2023. 15 May 2025. Verified against primary record: the report was opened and the French rows, the note that France reports prior authorisation only under the Regulations, the warning that French refusals cannot be separated by legal route, the stated table and text discrepancy, the named patient flows and the border zone figures were read directly. Retrieved 23 October 2026.
- European Court of Auditors. Special Report 07/2019: EU actions for cross-border healthcare. 2019. Verified against primary record: the report was opened and the 2016 outgoing and incoming patient figures, the Union totals and the prior authorisation count were read. Retrieved 23 October 2026.
- Centre des liaisons europeennes et internationales de securite sociale. La crise sanitaire continue a se repercuter en 2022 sur les depenses relatives aux soins de sante internationaux. Decryptage number 30. Verified against primary record: the page was opened and the 2022 amounts met by French institutions for care in France, the amounts reimbursed for care abroad, and the split between care inside and outside the European zone were read. Retrieved 23 October 2026.
- European Parliament and Council. Directive 2011/24/EU, Chapter III, Articles 7 and 8. 9 March 2011. Verified against primary record: the chapter text was opened and the reimbursement rule in Article 7 and the three permitted grounds for prior authorisation in Article 8(2) were read. Retrieved 23 October 2026.
- Eurostat. Hospital discharges and length of stay for inpatient and curative care (hlth_hosd), reference metadata. Last updated 15 December 2025. Verified against primary record: the metadata page was opened and the non-resident definition, the statement that country of residence is reported, and the list of non-resident tables were read. Retrieved 23 October 2026.
Sourcing note: this entry uses only official sources. The two French financial totals and the Directive claim counts are drawn from different instruments and are deliberately not combined, compared as a balance, or converted into patient numbers. No figure for privately funded treatment of foreign patients in France was located in any official publication, and none has been estimated here. The Eurostat non-resident collection is cited for its definitions and structure only; its individual cell values could not be retrieved.