Social Security reimburses the dermatologist up to 70% of the basic rate.
A mutual fund covers the remaining 30% if you have one.
Be careful though, many dermatologists charge excess fees.
In this case, the only solution to avoid too much out-of-pocket costs is to opt for a mutual fund with a high reimbursement rate: between 150% and 300%!
Find mutual insurance with the best conditions
What dermatologist reimbursement by mutual insurance?
Mutual reimbursement for a dermatologist consultation depends on your contract and the guarantees taken out.
If you would like to know your level of coverage, refer to the guarantee table in your contract in the “specialist doctor” section.
A basic mutual contract displays a 100% BRSS coverage rate.
What does it correspond to ?
This involves covering the portion not reimbursed by social security of the convention rate and not a 100% reimbursement of your health costs.
Explanations: Social Security reimburses the dermatologist at 70% of a convention rate set at €31.50.
With 100% mutual insurance, you then obtain coverage for the remaining 30% (70% social security + 30% mutual insurance).
Clearly, if your dermatologist charges excess fees, these remain your responsibility.
Are you consulting a dermatologist with overcharges?
In this case, it is imperative to have a good mutual with a rate greater than 100%.
Our advice: opt for a minimum 150% contract.
Let's take an example: your consultation with the dermatologist costs €50.
Social Security reimburses €21.05 (70% of €31.50).
A medical excess of 1€ is always retained and non-refundable
With 100% mutual insurance: you obtain a reimbursement of €9.45, i.e. a remainder payable for you of €19.49
With a 150% mutual insurance the reimbursement is €25.20, i.e. a remaining charge of €3.75
With mutual insurance at 200% or more: you have no remaining costs
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How much does a consultation with the dermatologist cost?
The price of a dermatologist consultation is set at €31.50 by Health Insurance: this is the agreed rate.
However, dermatologists approved in sector 2 have the right to charge excess fees with an average consultation rate between €31.50 and €90.
What is the convention sector?
Specialist doctors have the choice of practicing in 3 sectors: sector 1, 2 or 3 (non-approved).
In sector 1, prices are fixed with no excess fees.
Conversely, sector 2 doctors are authorized to charge price increases.
Please note: in sector 2, there is a small nuance between doctors who adhere to OPTAM or not.
This is the practical, controlled pricing option involving the professional billing limited overruns.
Also pay attention to non-contracted doctors (sector 3): their prices are completely free and do not allow for Social Security coverage.
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