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Caisse Primaire d’Assurance Maladie, Health Support Mission goes out to meet people who have given up on healthcare

the essential
With the Health Support Mission, Health Insurance offers personal support so that you can access your rights and your care and guide you through the health journey.

D since the implementation in Tarn of the Health Support Mission in 2017, 5,302 waivers of treatment have been declared by the insured. Currently 304 people are supported in relation to difficulties in accessing rights, waivers, difficulties in accessing care or frailty in relation to digital technology. Emilio Quesada, acting director of the Caisse Primaire d’Assurance Maladie (CPAM) in Tarn, specifies the profile of these people who have given up care: “25% are people who do not have supplementary health insurance, exCMU, i.e. do not enjoy benefit from any mutual insurance or additional help. They therefore have financial difficulties in accessing health services. 47% are people who live alone. Among them many pensioners, but also 24% of people who have children and 3% of these children are not treated, while the care of the child is total until the age of 16. Various reasons explain this renunciation of care. Some do not know what steps to take and do not know who to contact, others do not dare to turn to a public institution, still others find it difficult to get an appointment with a professional. To this must be added those who have difficulty with transport or access to online procedures. “Most often this waiver relates to dental care, but also orthopedics, and to hands lings from specialists” states Emilio Quesada.

Find the solutions:

As part of the CPAM du Tarn Health Support Mission, advisers speak directly to policyholders so that they become actors in their health journey. They call them directly and then, once contacted, find the solutions so that they can get the right treatment. “We have a process to address these people, with dedicated staff who also rely on the territorial network of reception in the department as well as Espaces France Services. But we also have agreements with relay partners that allow us to detect these people and set up a health course, in consultation with the insured and as quickly as possible”. The Health Support Mission has signed agreements with UDAF, Emmaüs, Association of the Paralyzed of France (APF), Restos du Cœur, who meet people in difficult social and personal situations .

Prevention and health checks:

It also directs policyholders towards preventive actions, health checks (at the centers in Albi and Castres) and offers a complete check of the policyholder’s state of health (especially regarding teeth and eyes). The health support mission offers a 100% dematerialized offer, but also a “100% aware” offer. The “Nærtilbud” advisers travel to the insured’s home to sort out, for example, files that are causing problems. “This is the illustration of our approach: “going towards”, concludes Emilio Quesada. The advisors from the Health Support Mission find the solution by establishing a relationship of trust with the insured”.

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