Emergency units (services d'urgence) are available in most hospitals and in some private clinics.
For treatment, patients can choose between state hospitals and private clinics. Hospital fees are paid by the CPAM, whether at a hospital or a private clinic. However, after the first 24 hours of hospitalisation, a patient must pay a daily fee (forfait hospitalier) which is not reimbursed. Anaesthetists and surgeons in private clinics may charge additional fees (dépassements d'honoraires). These fees are not reimbursed by social security. Some mutuelles reimburse part or all of these fees, however, prior approval is generally required.
Prescription medicines are distributed in pharmacies on presentation of the Carte Vitale and the prescription. The patient pays a percentage of the cost. A mutuelle generally covers the remaining percentage, depending on the level of reimbursement of the product. Not all medicines are reimbursed. Medicines for certain chronic medical conditions and fertility treatments are reimbursed at 100 percent.
In an effort to reduce health costs, generic medicines are becoming more readily available. If a pharmacy has a generic medicine in stock and the patients refuses this, the CPAM will only reimburse the percentage of the cost of the medicine.
Pharmacies are generally open from Monday to Saturday from 08:30 to 19:30. Many pharmacies close between 12:00 and 14:00, although in shopping centres and large towns, pharmacies will stay open all day.
At least one local pharmacy is open on Sundays and public holidays - the "duty pharmacy". Night pharmacies can also be found in some large towns. Details of, and schedule for the "duty pharmacy" are posted in pharmacy windows, in local newspapers and at the local police station.
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