The course of care
Posted on August 6, 2008
Filed Under Information |
To receive the maximum rate of repayment of social security, as part of the trail care, it is possible to consult
The doctor who signed the document of the declaration of choice of doctor
His replacement, if it is absent
Another doctor: the place of residence, on vacation, workplace
Any doctor in case of emergency.Patients not respecting the course of care will receive a refund of 50% instead of 70%.
The repayments of complementary health will be generally in this case, based on the reimbursement of health insurance.
check with its complementary health.
It is possible to consult directly without going through the treating physician
An ophthalmologist, in the context of specific situations:
and renewal prescription eyeglasses, contact lenses
Screening and monitoring of glaucoma
A Gynaecologist
Regular reviews, monitoring, screening, contraception, abortion drug
Children under 16 years
Adolescents aged 16 to 25 years: neuropsychiatrist or psychiatrist
For doctors did not downloading and using another piece of care, sure that the doctor noted dessue the name of the treating physician.
Situations involving no financial penalties when does not consult his doctor traitantSoins sick care to 100%
Patients followed for a chronic disease specialist consultant on a regular basis: they must not in this case consult their doctor before consulting their physician specialist
Emergencies
Care Abroad
Screening for breast cancer
IVG
Hospice.
Children and adolescents aged 18 months of age
Pregnant women from the first day of the 6 th month of pregnancy
Those benefiting from the CMU and the MEA
Patients off the trail care: the basis for reimbursement of social security is 50% of the base rate of social security
If the patient fails the course of care.
If the doctor is not declared
If you see without the advice of your doctor
The package hospital
This package is not reimbursed by health insurance and can be repaid by certain complementary
It is 16E for hospital to hospital or clinic
It is 12E for hospitalization in a psychiatric situations that can be exempted from this forfaitFemmes pregnant
Hospitalisées during the last 4 months of pregnancy
period of confinement
Hospital 12 days after delivery
The babies hospitalized from birth to 30 days
Accidents at work
Occupational diseases
Hospitalization home
Disabled children under age 20 hospitalized in a specialized institution or professionne
People with a military pension
The ticket moderator
The co-payment is the sum that remains to be borne by the insured after repayment of social security. This sum may be taken in whole or in part by a complementary health.
Patients receiving the CMU complementary are exempt from user fees.
A patient who is not in the course of care will be penalized: his co-payment increase for example during a consultation with a general practitioner from 30% to 50%.
The package 18E
This package applies to all acts whose cost is greater than or equal to 91E or acts whose coefficient is greater than or equal to 50.
The complementary healthy can handle this package
Those exempt: those supported by 100%, those affiliated to the CMU, those dependent on the regime of Alsace Moselle.
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