The State System
Employers and employees are required to contribute to the CSM for each employee. Employers pay 23.66 percent of gross payroll for healthcare and employees pay in the region of 15 percent for all social security benefits, which include healthcare. Employers register their employees with the CSM when a new employee starts work. Dependant family members are covered by the contributions paid by employed family members. The unemployed, old age pensioners and people on long-term sickness benefit or maternity leave do not have to pay healthcare contributions. Foreigners immigrating to Monaco without jobs must produce proof of private health insurance in order to obtain their residence permit.
Self-employed citizens need to get additional insurance to cover members of their family. On registering with the state system, you will be given a medical card, which you must present each time you visit a medical professional or hospital. The state fund covers most medical services including treatment by specialists, hospitalisation, prescriptions, pregnancy and childbirth and rehabilitation.
Employees and their dependants are reimbursed for medical costs, which include treatment by doctors and consultants, hospitalisation, laboratory services, prescription medicine, dental care, surgical appliances, and ambulance transportation. There are three categories of payments, which are determined by medical practitioners and auxiliary medical services. Each person is placed into one of the groups according to their income and family size. Each group receives a different percentage of subsidies.
Most citizens take out additional private insurance to cover the services and fees not paid for by the state system. This complementary medical insurance is called a mutuelle. The amount you pay into the mutuelle depends on the coverage you require, and is sometimes provided by your employer as a work related benefit.
Doctors are known as médecin traitant and are the first point of contact with the state health system. Citizens can register with the doctor of their choice; however, people seeking state medical care must make sure that their doctor is contracted by the CSM. If you are treated by anyone other than a state funded doctor, you will have to pay the fees yourself.
GPs prescribe drugs and referrals to specialists and hospitals, treat acute and chronic illnesses, and provide preventive care and health education.
Consultants are senior doctors who have completed a higher level of specialised training. GP's refer patients to a Consultant if he believes that a patient may need specialist help and diagnosis. There are numerous specialist fields of medicine in Monaco like gynaecology, oncology, paediatrics and dermatology.
The government of Monaco places great importance on the quality of its healthcare facilities. There are three hospitals in the country, all of which are based in the capital Monte Carlo: The Princess Grace Hospital is equipped with the latest technology, operates as a general hospital, and has a 24-hour emergency department. The Cardio-Thoracic Centre treats thoracic and cardiac illness. The Haemodialysis Centre treats illness related to kidney failure.
Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors. The conditions in each of the hospitals are excellent.
Emergency care is available free for everyone including those without state health insurance. However, once your condition is stabilised they will want proof of your insurance status. Emergency treatment is provided at the emergency room of the Princess Grace Hospital.
There are many private practices in Monaco provided by independent office-based doctors and specialists. The premises, equipment and personnel are funded by the doctors themselves and through private insurance contributions. Private healthcare is often as a top up to the basic state healthcare.
Dental care in Monaco is excellent but expensive. Some dental treatment is available through the state healthcare system, but it only covers routine visits and check-ups. Citizens must pay themselves for more detailed dental treatment like crowns and bridges.
Dispensing chemists sell medicines in Monaco. Only doctors and consultants can prescribe medicine. Non-prescription drugs are sometimes priced higher than prescription drugs. Under this system, you may pay less for a packet of aspirin if it has been prescribed by your doctor. Costs for some prescription drugs are reimbursed through the CSM.
More information is available at www.gouv.mc