The government draft decree sets the annual out-of-pocket maximum at 140 euros starting 1 October 2026, representing a 40% increase from the previous 100-euro cap established in 2005.
The ceiling is divided into 70 euros for doctor consultations and diagnostic tests, and 70 euros for prescription drugs, paramedical care, and medical transport.
The Health Ministry estimates an average additional cost of 10 euros per year for insured citizens, rising to 2 euros per month for individuals with long-term conditions.
Existing exemptions remain unchanged for 18 million French residents, including pregnant women and beneficiaries of Complementary Solidarity Health (C2S).
The French government has finalized a draft decree setting the annual ceiling on healthcare deductibles and flat-rate copayments at 140 euros per year, abandoning an initial plan that would have doubled the cap to 200 euros. Under the regulatory text transmitted on 21 August 2026 to the consultative bodies of the National Health Insurance Fund (Caisse nationale de l'Assurance maladie), the maximum out-of-pocket ceiling increases by 40% from the existing 100-euro threshold. Government officials stated that this adjustment reflects accumulated inflation since 2005, when the previous 100-euro ceiling was established. The revised ceiling will take effect on 1 October 2026.
Health Minister Stéphanie Rist stated that the government shifted away from the 200-euro figure after acknowledging that doubling the cap had appeared too abrupt for patients.
“We are now working on a fair reform, based on indexation to inflation since 2005. The increase will therefore be significantly lower than initially planned.”
Data from the article text
The 140-euro annual ceiling is divided evenly into two separate categories of medical expenditure. The ceiling for flat-rate contributions (participations forfaitaires), which apply to consultations with general practitioners and medical specialists as well as laboratory biology analyses and radiological examinations, rises from 50 euros to 70 euros per year. Simultaneously, the cap for medical deductibles (franchises médicales), which are deducted from reimbursements for boxes of prescription drugs, nursing care, physiotherapy appointments, and medical transport trips, rises from 50 euros to 70 euros annually.
According to calculations released by the Ministry of Health on Monday 24 August 2026, the average annual cost increase for insured citizens paying these fees is estimated at 10 euros per year, representing less than one euro per month. For patients suffering from long-term illnesses (affections de longue durée) who utilize a higher volume of consultations and reimbursed prescription drugs, the estimated average financial impact reaches 2 euros per month. At present, the average annual expenditure per insured individual stands at 25 euros for medical consultation contributions and 27 euros for deductibles covering medicines, paramedical procedures, and patient transport.
The draft decree maintains statutory protections for vulnerable populations throughout the healthcare system. The 18 million French residents who are currently exempt from deductibles and flat-rate copayments will remain completely exempt. This group includes pregnant women as well as low-income beneficiaries receiving the Complementary Solidarity Health coverage (Complémentaire santé solidaire).
In addition to resetting the baseline in October 2026, the decree introduces an ongoing adjustment mechanism. Starting on 1 January 2028, both annual contribution ceilings will be re-evaluated each year based on annual inflation. This mechanism will apply an annual coefficient reflecting the average rate of inflation, allowing healthcare copayments to adjust automatically each January rather than through periodic single-step increases.
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A draft decree submitted on 21 August raises out-of-pocket caps by 40% starting 1 October 2026, indexing costs to inflation since 2005 while maintaining exemptions for 18 million people.
AI text based on reports by LesEchos.fr, L'Opinion, Franceinfo and other publishers. Published .