Background
The medical allowance is an amount that remains at the patient's expense after reimbursement of the sickness insurance; it applies to medicines, medical aids and health transport. The lump sum contribution is deducted from reimbursements for certain consultations, radiological examinations and biology analyses. 2026-858 of 11 September 2026 notes the annual maximums that the insured can pay under these two mechanisms.
Why it's important
For the majority of insured persons, this means higher deductions from reimbursements, especially for those who often buy medicines or use health transport. It is essential to know the exempt categories to check whether the change concerns you. As of January 1, 2028, the ceilings will be adjusted annually according to inflation, and this increases over time.
What Changes
As of October 1, 2026, the annual ceiling for medical deductibles is increased from €50 to €70, that for flat-rate participations from €50 to €70, and the total maximum of deductions from €100 to €140 per year.
Useful details
- Medical franchising: 1 € per medicine box, 1 € per paramedical procedure (infirmary, physiotherapist, etc.), 4 € per sanitary transport.
- Daily limits of the franchise: 4 € per day maximum for paramedical acts and 8 € per day maximum for sanitary transport.
- Annual franchise ceiling: 50 € per person per calendar year (from the 1st January to the 31 December); it increases to 70 € from the 1st October 2026.
- Lump sum contribution: 2 € per biology act, per doctor or per consultation, within the limit of 8 € per day for the same health professional; the current annual ceiling of 50 € goes to 70 € the 1st October 2026.
- Maximum total remaining charge for franchises and lump-sum participations: 140 € per year, compared to 100 € previously.
- Exemptions: children and young people under the age of 18; beneficiaries of complementary health support; pregnant women of 1st day of 6th month of pregnancy at 12th day after delivery; minors for contraception and emergency contraception without parental consent; victims of an act of terrorism for the health costs associated with the event. From the 1st January 2028, the ceilings will be adjusted annually according to inflation.
Terms to know
- Franchise médicale
- Amount that remains at the patient's expense after reimbursement of the Sickness Insurance, e.g. 1 € per medicine box.
- Participation forfaitaire
- Amount deducted from refunds for certain consultations, analyses or examinations, e.g. €2 per act.
- Complémentaire santé solidaire (CSS)
- Supplementary public health protection for people with low incomes; its beneficiaries are exempt from deductibles and participations.
- Plafond annuel
- The maximum amount an insured person can pay in respect of these deductions in a calendar year.
