Are you going to the osteopath, the dentist with an excess fee, or another practitioner?
Do not wait to send your care sheet or invoice to your health insurance to be reimbursed as soon as possible.
In other cases, everything is done automatically.
How do I get a refund from my health insurance fund?
When the health insurance is directly linked to your mutual, everything is done automatically.
If, for example, you consult your general practitioner for a wet cough that you cannot get rid of and which prevents you from sleeping at night, you will be asked to put your vital card in a box before taking your leave.
Social Security will then process your file, reimburse its share to the bank account associated with the account of the socially insured person and send the necessary information directly to your mutual health insurance.
The latter will then be able to reimburse the amount to which you are entitled, according to your contract.
If the remote transmission did not work or it is not offered, you will need to send the care sheets to your primary health insurance fund (CPAM), which will then send the file to your mutual insurance company.
This solution requires more time to obtain reimbursement from the share incumbent on the mutual health insurance.
A third case exists: sending the request for reimbursement directly to the health insurance fund for treatment that is not covered by Social Security anyway.
Before preparing your letter, check that your contract provides for partial or full reimbursement of the treatment in question.
It can be a treatment with an osteopath or adult orthodontics, for example.
You can do this via the mutual insurance application to save time.
And if you need these health professionals, do not hesitate to compare health insurance in order to find a contract adapted to your needs.
I find a health insurance that suits my needs
How long does it take to get a refund from your health insurance fund?
It all depends on the means used, among the three mentioned above.
The fastest is, as you can imagine, teletransmission, which allows you to be reimbursed in just a few days by Social Security and little more by your mutual health insurance after receipt of the information.
When the postal route is necessary, count one month on average before being reimbursed by the Health Insurance, then by the mutual.
Finally, the responsiveness of your mutual depends on the organization chosen and the nature of your request.
It is sometimes necessary to send an additional document, which lengthens the delay.
Another element to be taken into account for mutual insurance is the waiting period.
What is the waiting period?
Period of time following the subscription of the contract during which you do not receive reimbursement for your health costs, the waiting period has a variable duration depending on the contract.
It generally applies to the most expensive treatments, which may require a wait of 3 to 6 months or even longer.
The objective for the mutual health insurance is to avoid abuse on the part of the insured.
You can compare insurance contracts to choose insurance with a low deadline.
And if you are not satisfied with your current mutual insurance, know that you can change it.
For more specific information on your file, study the general conditions of your insurance contract.
The waiting period set by Health Insurance has been set at 3 days, during which you will not receive any daily allowance.
Some companies, depending on the collective agreement and under conditions, in the event of sick leave, can cover it.
>> I click here to compare the best mutual health insurance
What if no refund occurs?
First thing to check in the “My information” section of your Ameli account: whether your complementary organization is indicated and known to your health insurance fund for you and your loved ones.
Click on "Your complementary organization" and check that the mention "Yes" appears in the line "Teletransmission" in order to benefit from the automatic sending of payment information from your fund to your mutual insurance company.
If all the information on the Ameli account is correctly entered but you notice a payment problem, contact your mutual health insurance company to resolve the malfunction with an advisor.
If you notice that no complementary organization is known to your fund, inform your mutual insurance company so that it takes the necessary steps to activate the automatic sending of payment information.
Be careful and don't miss anything!
In some cases, it may happen that you forget to write down your social security number on your treatment card!
An error that extends the payment period... Don't forget any information when you have to send a care sheet to obtain a refund.