Thermal cure: covered by the health insurance
Verified 01 January 2024 - Legal and Administrative Information Directorate (Prime Minister)
When your doctor prescribes a thermal cure, the health insurance can cover, under conditions, the medical, transport and accommodation costs.
To be managed, your course must:
- Be prescribed by a doctor (attending physician or dental surgeon for oral disorders)
- And respect conditions related to the treatments and the spa.
Prescription for a specific medical condition
The Health Insurance is responsible for only cures for which reasons have been given any of the following:
- Oral-lingual mucosal disorder
- Gastrointestinal disorder
- Psychosomatic disorder
- Urinary disorder
- Dermatology
- Gynecology
- Cardioarterial disease
- Neurology
- Phlebology
- Rheumatology
- Developmental Disorders in Children
- Respiratory disorders
Approved or contracted spa
To be taken care of, your cure must take place in an establishment approved and contracted by the Health Insurance.
Your doctor chooses the most suitable facility for your condition. The place of the cure depends on the condition to be treated: not all spa resorts treat the same pathologies.
FYI
If you have complementary health solidarity, treatment facilities must offer you treatment at prices not exceeding conventional tariff.
Duration of the course
To be reimbursed, your cure must include 18 days of actual processing.
However, if your course is incomplete or interrupted for medical reasons, it will be taken care of in proportion to the number of days completed.
Support Request
You must fill out a form cerfa n°11139 consisting of 2 parts:
- Management questionnaire, completed by the doctor who prescribes the course
- Declaration of resources, completed by you (attach the necessary supporting documents)
Spa treatment - Support questionnaire (accompanied by a declaration of resources).
The form is to be sent to your health insurance fund.
Support Agreement
In response to your request, your caisse will send you a form cerfa no. 11140 entitled "Administrative care of thermal cure and billing".
The form consists of 3 parts:
- Component 1 "Medical fees" to be remitted to the thermal physician
- Part 2 "Thermal package" to be handed over to the establishment of your cure
- Component 3 "Transport and accommodation costs". This part is to be sent to your cash register when you return from your cure if you meet the conditions of resources.
Your support is valid for calendar year in progress.
FYI
For the same condition, you are entitled to a only cure per year.
Medical expenses
The following medical expenses shall be covered as follows:
- Medical supervision package (€80 for a single-orientation cure and €120 for a double-orientation cure), reimbursed to 70% of the conventional tariff (dependent €24 or €36 depending on the cure)
- Complementary medical practices if necessary, reimbursed to 70% of the conventional tariff
- Thermal package (variable, depending on the treatments carried out during the cure), reimbursed to 65% of the conventional tariff
Please note
Supplementary care and comfort services are not covered.
Accommodation and transport costs
Your accommodation and transport costs are covered if your resources of the year before the cure have not exceeded €14,664.38.
This ceiling shall be increased by 50%, or 7,332.19 for your spouse, or Civil partnership partner, and for each entitled at your expense.
Transport costs are supported at 55% on the basis of the price of the round-trip SNCF ticket 2e within the limits of the expenditure actually incurred, on presentation of the supporting documents.
The subsistence costs shall be reimbursed to 65% on the basis of a flat-rate fixed at €150.01, or support for €97.50.
Per diem
A work stoppage prescribed in connection with a thermal cure does not give rise to the payment of daily allowances unless your resources are lower than the annual ceiling of Social Security applicable on the date of the prescription.
Thus for a spa treatment prescribed in 2023 your resources must not exceed €43,992.
And, for a prescribed spa cure in 2024, your resources must not exceed€46,368.
This ceiling shall be increased by 50%, or €23,184 for:
- Your husband
- Your Civil partnership partner
- Or dependent child.
Special support rules apply if you are in any of the following situations:
Répondez aux questions successives et les réponses s’afficheront automatiquement
Cure related to a long-term condition (ALD) itself 100% managed
The opinion of the medical service of your cash register is not necessary.
Coverage of medical expenses: 100% on the basis of conventional tariffs
Payment of transport and accommodation costs: subject to conditions of resources, 100% on the basis of the prices indicated above
Cure related to an occupational accident or disease
The opinion of the medical service of your cash register is necessary.
Coverage of medical expenses: 100% on the basis of conventional tariffs
Payment of transport and accommodation costs: no means test, 100% on the basis of the prices indicated above
Cure with hospitalization
The opinion of the medical service of your cash register is necessary.
Coverage of medical expenses: identical to a "normal" cure + 80% hospitalization costs
Payment of transport and accommodation costs:
- No resource conditions for accommodation costs, based on the conventional rate
- Identical to a "normal" cure for transport costs
Conditions of care related to the spa (Article L162-1-7-2)
Conditions of care related to the spa (Article L162-21)
Conditions of care related to the spa establishment
Coverage of treatment costs - daily allowances in the event of prescribed work stoppages during a thermal cure (Article L321-1)
Coverage of medical surveillance and treatment costs (Article R160-24)
Resource condition for payment of daily subsistence allowances (Article D323-1)
Transport and accommodation (Article 3)
National Health Insurance Fund (Cnam)