If you’re living in France and managing a long-term health condition, you may have heard of something called ALD – Affection de Longue Durée. It’s one of the most important parts of the French healthcare system — yet many people don’t fully understand what it means or how to access it.
In this guide, we’ll walk you through what ALD is, who qualifies, how to apply, and what’s actually covered (including the hidden costs you might still face).
What Is ALD (Affection de Longue Durée)?
An Affection de Longue Durée (ALD) is a long-term or serious illness that requires ongoing treatment and regular medical supervision over an extended period.
If your condition qualifies as an ALD, the French healthcare system (Assurance Maladie) will cover 100% of the official base rate for all care related to that illness — including consultations, tests, hospital stays, and prescribed treatments.
However, “100% cover” doesn’t mean you’ll never pay anything (we’ll get to that below).
👉 If you’re not sure whether your condition qualifies, Hello Santé can help you check your eligibility . Contact us here to get started.
Which Conditions Qualify as ALD?
There are two main categories of ALD:
1. ALD Exonérante (Full Coverage)
These are the most serious or long-term conditions that require heavy or continuous treatment. The French government has a fixed list of 30 recognised illnesses, including:
- Diabetes (Type 1 and Type 2)
- Cancer
- Multiple sclerosis
- Parkinson’s disease
- Severe hypertension
- Chronic kidney disease
- Certain psychiatric disorders
If your condition appears on this list, you’re likely eligible for 100% reimbursement on related care.
2. ALD Hors-List (Non-listed ALD)
If your illness isn’t one of the 30 but still requires treatment lasting more than six months and costing more than a set threshold, your doctor can still request ALD coverage for you.
How to Apply for ALD
Your GP (médecin traitant) must initiate the ALD application. Here’s how it works step-by-step:
- Consult your GP — they’ll complete a protocole de soins (treatment plan) outlining your condition and necessary treatments.
- Submission to CPAM — your doctor sends this electronically to your local Caisse Primaire d’Assurance Maladie (CPAM).
- Approval — CPAM reviews and either approves or requests additional information.
- Notification — you’ll receive an attestation de droits ALD, confirming your entitlement.
Once approved, your ALD status appears on your Carte Vitale, and all care related to your illness is billed under this category.
👉Need a helping hand with any ALD related admin?
Hello Santé can help, Book support here.
Even with ALD, Some Charges May Still Apply
While ALD exonérante covers 100% of the base rate for care directly linked to your recognised condition, it doesn’t necessarily mean you’ll never pay anything.
Here’s what may still cost you:
- Extra fees (dépassements d’honoraires)
- Specialists in secteur 2 often charge above the state-set rate.
- ALD covers 100% of the official tariff only — not the excess.
- A good mutuelle can help bridge this gap.
- Hospital comfort charges
- Private rooms, TV access, and other frais de confort are not covered by ALD.
- Unrelated treatments
- Only care directly related to your recognised illness qualifies for ALD coverage.
- Routine check-ups or unrelated conditions follow the normal reimbursement rate.
- Certain medications or therapies
- Some prescribed items or alternative treatments may not be fully reimbursed.
- Administrative or non-medical fees
- Forms, certificates, or non-prescribed visits aren’t included in ALD cover.
💡 Tip: Check your feuille de soins or Ameli account — if you see “Exonération ALD,” that part of your care has been reimbursed at 100%.
How Long Does ALD Last?
Most ALDs are granted for five years, after which your doctor must renew the request. Some conditions, such as diabetes or lifelong disabilities, are approved indefinitely.
👉 If your ALD has expired or your reimbursements have stopped unexpectedly, Hello Santé can help reinstate your coverage quickly and ensure your Carte Vitale is correctly updated. Reach out today.
💬 Final Thoughts
Navigating ALD can be confusing, especially when it’s all in French. But getting approved can save you hundreds (or even thousands) of euros each year on essential treatments.
At Hello Santé, we help English speakers in France make sense of the French healthcare system — from assistance with medical paperwork to reconnecting your mutuelle and contacting CPAM on your behalf.