This covers the following public hospitals:
Stays can be in the public sector or in private practice.
If you are admitted to Princess Grace Hospital Centre on a public basis, to a French public hospital or to the Monaco Cardiothoracic Centre, you will not have to pay the full cost of your stay upfront, since you can make use of the "third-party payment system".
You must present to the hospital your registration card or a certificate confirming your entitlement.
The hospital sends a request for payment to the SPME Medical Advisor. Once approved by the Medical Advisor, the SPME will pay its share of the costs directly to the hospital.
You will then be responsible for paying the hospital for the following costs as appropriate:
At Princess Grace Hospital Centre you may request to be admitted under the private practice of one or more hospital practitioners.
This option is selected by signing the "patient choice form" on which the names of the various practitioners chosen by the patient must be indicated.
In such cases, the costs of the hospital stay will be covered by the SPME under the same conditions as if the patient had been admitted to hospital on a public basis.
The various practitioners treating the patient on a private basis will, however, invoice their own fees in addition. These will be reimbursed on the same basis as out of hospital care.
You are therefore likely to be required to bear the cost of fees over and above the amount which will be reimbursed by the SPME.
It is up to you whether you choose to be treated by a practitioner working on a private basis.
Where several practitioners are involved in your care, and you wish to be treated by one on a private basis, you are not obliged to opt for private practice in the case of the other practitioners.
Private clinics are:
If you are admitted to a private clinic (excluding at Princess Grace Hospital Centre), you will, in principle, need to pay upfront the costs of your stay and the fees charged by the practitioners treating you.
Each clinic is free to determine whether or not it will operate the third-party payment system.
In the case of full third-party payment: the SPME will pay the costs of the hospital stay (in accordance with current legislation and on the same basis as hospitalisation in the public sector) and practitioners’ fees (on the same basis as for out of hospital care).
If you pay the full cost of your stay and practitioners’ fees: ensure that the clinic provides you with form S3404. This is the only document which is accepted for SPME reimbursement of the costs.
Depending on the fees invoiced by the practitioner(s) and the rules for reimbursement, the costs of a hospital stay and fees in private clinics can be significantly higher than the amount reimbursed.
When being admitted in hospital, make sure you are aware of the full financial consequences of your choice. Ask for a quote for this purpose.
Prior consent of Medical Advisor
Some procedures are subject to prior consent being granted by the SPME Medical Advisor.
In accordance with current legislation, your practitioner must submit a request for prior consent when required.
If you choose a hospital outside Monaco or the Alpes Maritimes department for reasons of personal convenience, the costs of a hospital stay will be paid (public sector) or reimbursed (private sector) up to the limit of the daily rate at Princess Grace Hospital Centre or, failing that, at Nice University Hospital.
Outpatient care provided in the public hospital sector uses the third-party payment system, i.e. patients do not have to pay the full medical costs upfront and are responsible only for the ticket modérateur (patient contribution), where 80% of costs are covered.