When choosing a doctor in France, you may come across the term Sector 2 practitioner. Understanding what this means is essential for managing your healthcare costs and insurance coverage, especially with the latest regulatory updates in 2025.
When booking an appointment with a doctor, you may wonder about the difference between non-contracted doctors and those contracted under Sector 1 or Sector 2. Let’s take a closer look at the concept of a Sector 2 contracted doctor to better understand how it works in France.
The medical field, with its complex and constantly evolving regulations, can sometimes seem confusing. One topic that regularly comes up in healthcare—and has a direct impact on consultation costs for patients is the choice of the practitioner’s contractual sector. These sectors are divided into three categories, ranging from Sector 1 to Sector 3.
This article will help you understand the concept of “Sector 2 contracted” and the implications it carries.
What is sector 2 ?
French doctors operate under agreements with the national health insurance system. These agreements define two main sectors:
- Sector 1: Doctors follow the official Social Security fee schedule. Patients pay standard rates and receive maximum reimbursement.
- Sector 2: Doctors can charge higher fees (dépassements d’honoraires) within “reasonable limits.” Social Security still reimburses based on Sector 1 rates, leaving patients responsible for the difference.
Sector 2 is often chosen by specialists and experienced practitioners, offering flexibility but also higher costs for patients.
What are the actual prices of sector 2?
To better understand the concept of “contracted sector 2,” let’s consider a numerical example. For instance, if we take a general practitioner from sector 2 who sets a consultation fee of 80€, while the standard sector 1 price, set by Social Security, is 25€ for such a service, the practitioner’s extra fee is 55 euros. The patient will receive a reimbursement based on the Social Security’s share based on the standard sector 1 price of 25€, which is 70% of 25€, minus a 1 euro deductible, therefore 20€. The remaining difference (60 euros) is the patient’s out of pocket, unless they have appropriate supplementary medical coverage also called “mutuelle”. This is why it is strongly advised, and even mandatory for employees, to take out additional medical insurance.
How can I tell if my doctor is of sector 2?
Sector 2 is not accessible to all doctors. It requires obtaining a right to opt by the CNAM and meeting specific criteria established by Social Security, which are as follows:
- Declaration to the Medical Association: physicians must inform the Medical Association of their choice to practice in sector 2.
- Respect for standard rates: although sector 2 allows physicians to set higher fees than those of sector 1, they must adhere to a certain ceiling, called the authority rate, negotiated between the physicians’ representatives and Social Security.
- Information on fees: sector 2 physicians must be transparent; on their website, on the “Doctolib” appointment booking website, within the clinic, etc; about the rates they charge and any potential extra fees
What’s new in 2025?
Recent changes aim to improve transparency and control costs:
- Stricter fee limits: Updated ceilings on extra charges to prevent excessive billing.
- Mandatory price transparency: Doctors must display fees online (e.g., Doctolib) and in their offices.
- Teleconsultation coverage: Virtual consultations are now reimbursed at the same rate as in-person visits for both sectors.
- Digital health integration: Practitioners must ensure interoperability with the Dossier Médical Partagé (DMP) for secure data sharing.
- Better insurance coverage: Responsible health insurance contracts must offer enhanced reimbursement for Sector 2 fees.
How does this affect patients?
Social Security reimburses consultations based on Sector 1 rates, even if you visit a Sector 2 doctor. This means:
- You pay the difference out of pocket.
- A mutuelle health insurance plan is essential to cover extra fees.
Employers offering group health plans should review their policies to ensure compliance with new 2025 standards.
How to check your doctor’s sector
You can verify your doctor’s sector:
- On official health directories.
- Through platforms like Doctolib, which now require clear fee disclosure.
FAQ
Is teleconsultation covered for Sector 2 doctors?
Yes, teleconsultations are reimbursed at the same rate as physical consultations.
What are the new transparency rules in 2025?
Doctors must display their fees online and in their offices, including any extra charges.
Do mutuelles cover sector 2 fees?
Most responsible contracts now offer enhanced coverage for extra fees.
To avoid any surprises, we recommend consulting the Social Security directory where you can search for your healthcare professional and check their profile: http://annuairesante.ameli.fr/. This website allows you to know the doctor’s status (contracted or not) and their fees.
If you are an employer and wish to offer your employees the best medical coverage, thus avoiding a significant out-of-pocket expense, or if you are self-employed and want to benefit from adequate insurance, contact us! Our team will be happy to answer your questions, and all quote requests are free and non-binding.