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What reimbursement in case of a doctor's home visit?

2023-06-04T07:13:11.641Z

Highlights: When a consultation with the doctor is necessary but travel to his office is impossible, the option visit to home. Some family doctors are doing home visits, but they are becoming increasingly rare. SOS Médecins and its 63 branches in France is able to offer many possibilities for home visits. For patients over 80 years of age, pregnant women over 6 months, people suffering from a 100% covered disabling disease or as part of a home hospitalization, a home visit by a doctor is common and the reimbursement of increases by the Social Security will be full.


When a consultation with the doctor is necessary but travel to his office is impossible, the option visit to home


Some family doctors are doing home visits, but they are becoming increasingly rare. An association like SOS Médecins and its 63 branches in France is able to offer many possibilities for home visits. This non-profit federation recognized as being of public utility is indeed a liberal emergency medical service at home that brings together 1,300 doctors carrying out home visits 24/24 within the perimeter of their establishment.


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How much does a doctor's visit cost at home?

For patients over 80 years of age, pregnant women over 6 months, people suffering from a 100% covered disabling disease or as part of a home hospitalization, a home visit by a doctor is common and the reimbursement of increases by the Social Security will be full.

But other patient profiles may need to call their doctor for a home visit. And if so, what cost? What reimbursement from the Health Insurance and the mutual?

A situation justifies home care? The physician will then be able to use the travel surcharge (MD):

  • Monday to Friday from 8 a.m. to 20 p.m. and Saturday between 8 a.m. and 12 p.m., the travel surcharge (MD) is set at 10 euros;
  • in the middle of the night (between 20 p.m. and midnight or between 6 a.m. and 8 a.m.), the night travel surcharge (MDN) is set at €38.50;
  • at night (between 0:6 and 43:50), the mid-night travel surcharge (MDI) is set at €<>.<>;
  • on weekends (from Saturday noon) or public holidays, the travel surcharge for Sunday or public holidays (MDD) is set at 22.60 euros.

The doctor will estimate your ability to move according to your medical and/or social situation. Home travel coverage is reserved for people unable to travel. If the trip is not justified, he may charge you a supplement that will remain your responsibility.

Do several members of your family need a home consultation? Only the first act is counted for a visit, the following ones are considered as consultations.


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What reimbursement of the Sécu in case of visit of the doctor at home?

The reimbursement of the Health Insurance depends on the sector of the doctor. It amounts to 70% of the basic rate of 25 euros for general practitioners in sector 1. You will then be reimbursed 16.50 euros.

For a general practitioner in sector 2 who is a member of OPTAM, the reimbursement of the Health Insurance amounts to 70% of the basic rate of 25 euros, i.e. a reimbursement of 16.50 euros.

For non-member sector 2 doctors, therefore practicing free fees, the reimbursement of the Health Insurance amounts to 70% of the basic rate of 23 euros, or 15.10 euros reimbursed.

However, if you consult a doctor outside the course of care, you will only be reimbursed up to 30% by the Health Insurance on the basis of 25 euros, i.e. 6.50 euros; or 30% by the Health Insurance on the basis of 23 euros, i.e. 5.90 euros. Your complementary health insurance will be able to cover the complementary part.

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What reimbursement of the mutual in case of visit of the doctor at home?

Your health insurance can cover the remaining 30% at your expense, the famous co-payment. If the doctor has given you a care sheet, send it to your insurer.

At every stage of your life, you will find that it is essential to take out good health insurance. The best for you, ie the mutual that is perfectly adapted to your needs. Comparing health insurance contracts can help you get better insurance for a more affordable rate. In 2 min top time, you will receive a health insurance quote using this online comparator of mutuals.

Source: leparis

All life articles on 2023-06-04

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