Support for elderly at home or institutions is provided by public health insurance system and through the allowance for autonomy (APA). It is administered by local departments.1
Program and nature of coverage
LTC in France is offered through both home nursing care (through Services de Soins Infirmiers A Domicile (SSIAD) e.g. home health aide/ nurse assistant, for personal hygiene, eating) and institutional care (for disabled and dependent elderly people).
Nature of benefit coverage
Home nursing is completely covered by the public health insurance system. Institutional care is split into three components – health costs, hotel costs and dependence costs. APA does not cover hotel costs. On an average, it covers up to 70% of expense.
Source of funding
LTC is funded by a mix of public health insurance and individual costs through programs – Allocation Personnalisée d’Autonomie (APA) – (personalised allowance for disability) and caisse nationale de solidarité pour l’autonomie (CNSA – the national funding agency for the elderly and handicapped) and complementary income tax deductions. The system is funded by general tax revenues.2
Reforms initiated/ future direction
In Feb 2013, the French PM called for a structural reform of the healthcare system. The reform aims at: ensuring vertical quality and adapting healthcare across demographic changes. Further details pending.
1France Long-term care (PDF 96 KB), 18 May, 2011
Accessed 21 February, 2013
2Long-term care financing reform (PDF 417 KB), Lessons from the U.S. and Abroad, February 2010
Accessed 23 February, 2013