Home Insurance What reimbursement for doctor’s visits to your home?

What reimbursement for doctor’s visits to your home?

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What reimbursement for doctor’s visits to your home?

Some family doctors practice home visits, but these are increasingly rare. An association like SOS Médecins and its 63 branches in France are able to offer many options for home visits. This non-profit association, recognized as being of public benefit, is truly a liberal home emergency medical service, which brings together 1,300 doctors who perform home visits 24 hours a day, 7 days a week within the perimeter of their establishment .

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How much does a GP visit cost?

For patients over 80, pregnant women over 6 months, people suffering from a debilitating illness covered at 100% or in connection with hospitalization at home, a home visit by a doctor is common and reimbursement of increases from Social Security will be in full .

But other patient profiles may need to call their doctor for a home visit. And if so, how much does it cost? What reimbursement from health insurance and mutual insurance?

Does a situation warrant home care? The doctor can then use the displacement increment (MD):

  • Monday to Friday from 8:00 a.m. to 8:00 p.m. and Saturday from 8:00 a.m. to 12:00 p.m. the travel supplement (MD) is set at 10 euros;
  • in the middle of the night (between 8:00 p.m. and midnight or between 6:00 a.m. and 8:00 a.m.) the night travel supplement (MDN) is set at 38.50 euros;
  • in the middle of the night (between midnight and 06:00) the midnight journey increase (MDI) is set at 43.50 euros;
  • weekend (from Saturday noon) or public holiday, the travel increase for Sunday or public holiday (MDD) is fixed at 22.60 euros.

The doctor will assess your ability to move around based on your medical and/or social situation. Cover for return journeys is reserved for people who cannot travel. If the trip is not eligible, he may charge a surcharge which remains your responsibility.

Do several people in your family need a home consultation? Only the first act counts as a visit, the following are considered consultations.

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What Social Security reimbursement for doctor visits at your home?

Reimbursement from health insurance depends on the doctor’s sector. It constitutes 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 from the health insurance is 70% of the basic rate of 25 euros, i.e. a reimbursement of 16.50 euros.

For non-member sector 2 doctors, who therefore practice free of charge, the reimbursement of the health insurance is 70% of the basic rate of 23 euros, or 15.10 euros reimbursed.

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

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What reimbursement from the mutual insurance company for doctor’s visits to your home?

Your health insurance can cover the remaining 30% at your expense, the famous deductible. If the doctor gave you a care sheet, send it to your insurance company.

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