Will your spa treatment soon be much less supported? As the government seeks to save money, reimbursement could fall sharply, but the change is not yet an accomplished fact.
A reduction project that would shift part of the cost to patients
Today, Health Insurance specifies on ameli.fr the conditions for covering a thermal treatment: the thermal package is reimbursed at 65% of the conventional rateprovided that the treatment is prescribed and corresponds to one of the 12 recognized therapeutic orientations. This concerns the thermal package, and not automatically all associated costs, such as accommodation, transport or certain price supplements.
The project mentioned is part of the Social Security budget for 2027. According to Stéphanie Rist’s speech to the CNAM board of directors on October 8, 2026, the expected saving would be around 250 million euros according to the Court of Auditors. The rate envisaged by the government would drop from 65% to 15%: concretely, the rate would drop to 15% for the obligatory part.
One of the very practical contributions of the column concerns mutual societies. Indeed, the government presents complementary health insurance as a possible relay, but this support should not be understood as automatic. Relay by a complementary service is not guaranteed : it depends on the contract and the guarantees taken out.
Several hundred thousand patients would be affected each year, an order of magnitude close to half a million. The indications cited include rheumatism, certain respiratory diseases and certain dermatological diseases. To review the general framework, True Medical also details the indications and rules for reimbursement of a spa treatment.
Before making a decision, the points to check are very concrete:
- Ask the doctor if the treatment falls within a recognized indication for your situation.
- Ask your health insurance fund about the applicable coverage conditions.
- Review your supplementary health insurance contract or request a written reimbursement quote.
Medical effectiveness which remains to be examined indication by indication
The debate is not only about the budget. The proof of effectiveness of these treatments raises questions: there is work, but the overall evaluation remains insufficient to draw a general conclusion. This caution is consistent with the 2019 annual public report of the Court of Auditors on hydrotherapy, in which the need for an evaluation by indication is clearly stated. In other words, medical effectiveness cannot be asserted globally.
We could distinguish two situations.
- For stable or long-standing non-progressive rheumatoid arthritis, the available opinions suggest a probable analgesic and functional benefit, but low level of evidence. For fibromyalgia, cures can be considered in certain moderate and stable cases; True Medical reviews data on hydrotherapy and fibromyalgia. For chronic low back pain, the favorable opinion is old, which limits its current scope.
- Conversely, other indications remain more uncertain pending a complete examination, notably asthma and certain skin diseases such as eczema. They may appear in the course of certain spa guests, but their benefits must be verified by an independent analysis. On this point, the articles devoted to thermal cures for asthma should be read as clarification, not as definitive proof.
The High Authority for Health was asked to evaluate the medical benefit of thermal cures, with a review of the literature and a more complete opinion expected. For patients, this means that more complete conclusions are expected by the end of 2027. In the meantime, it is neither a question of starting nor abandoning a treatment on the sole basis of this debate: people followed for a chronic illness, persistent pain, a respiratory or dermatological pathology must rely on personalized medical advice and on the responses of their fund and their complementary insurance.