CPAM reimbursement rate reducing

7 Replies
CSM-73573

1251032795

Message

Hi, does anyone know why my level of reimbursement (for general doctors visits) from CPAM has been steadily reducing, it started at 70% of the tarif conventionnel then fell to 50% and is now 30%. I know I don't get a 100% reimbursement as I have not selected a medicine traitant but 30% seems a little bit low. Thanks

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janet-72456 1251139465

You should definitely register your treating physician - but 30% does seem low; I am not aware that my cover has dropped to that extent - I would call my "caisse" if I were you to check out what is going on



mike-72234 1251189617





If you don't select (and use...) a médecin traitant, then you get very little reimbursed. The Government-supplied numbers are here:



The amount has, indeed, been reduced since 31 January 2009.


To find out how to select a médecin traitant, see here:



The system essentially requires you to select a médecin traitant.

CSM-73573 1251190328

thanks very much for the info.



janet-72456 1251190921

mike - thank you very much - very useful information indeed - I see from the ameli.fr link that you posted that if you DO nominate and use your Doctor that 70% of the consultation fee is re-imbursed, if the doctor operates within the tarif guidelines that is; same aplies to refferrals by your GP to a specialist. The rate drops to 30% if you consult a specialist without a referral from your GP...


As mike says nominate and use a treating physician - it will save you a lot of money




JB1963 1253014376

It's useful to know as well that you DON'T need a referral for children if they are under 16. You can take them to any specialist without one and get reimbursed the normal rate of around 70 percent.


Also, you don't need referrals for eye doctors, gynaecologists or paediatricians




julia-72705 1253021792

JB - useful reminder, the same applies when your usual Dr is not available and/or when you are away from home, is that not true?



JB1963 1253105856

Apparently so. Although not needed to see anyone else so far fortunately!




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