Which mode of payment is not used by health insurance policies ?

What-do-you-know.comUseful tipsWhich mode of payment is not used by health insurance policies ?

To ensure individuals against the financial risks associated with healthcare in the event of illness, several mechanisms have been put in place. These are in particular social security and mutual insurance. These two entities operate in a complementary fashion. Indeed, the mutual is responsible for completing the reimbursements made by Health Insurance. In all cases, these refunds are made by excluding a certain method of payment. To find out which mode it is, we will reveal how these refunds are made.

Refunds made by Social Security

Social Security is responsible for reimbursing costs related to care and consultations up to 70% of the conventional rate. However, this reimbursement is subject to certain conditions. In fact, to benefit from this reimbursement rate, the patient is required to respect the coordinated care pathway. Likewise, the duration of hospitalization should not exceed 24 hours.

Added to this is the fact that certain costs, such as those due to dental treatment (dental implants), are not covered by Social Security. The same is true for the reimbursement rate for drugs, which varies according to the type of product. A distinction is thus made between drugs with white labels which are reimbursed at 65%, those with blue labels which are reimbursed at 30%, or even drugs with orange labels which are reimbursed at 15%.

In all cases, the reimbursement of Social Security will be made automatically. To do this, all you need to do is present your up-to-date Carte Vitale at the time of the consultation. Sometimes, it may be necessary to send Health Insurance a paper care sheet to benefit from automatic reimbursement.

Refunds made by the mutual

After the reimbursement of Social Security, a part remains the responsibility of the insured. We then speak of co-payment. It is the latter that is supported (fully or in part) by the mutual.

Depending on the guarantees subscribed, the mutual company may reimburse the hospital package, excess fees, and certain medical prescriptions, among others. To do this, you will need to take a few steps. Essentially, it is the remote transmission of treatment sheets to Social Security that will send them to the mutual and the transmission of invoices to the mutual by post.

As soon as these steps are taken, the mutual insurance company will reimburse the costs of care. This reimbursement can be made in the form of a check or a bank transfer. However, it will be necessary to define the desired payment method when signing the contract.

What to note about the payment method for health insurance policies

In short, the fact is that: whether it is Social Security or mutual insurance, the different payment methods used are automatic payment (Carte Vitale), bank check and bank transfer. So you can notice that cash payment is not used here. In conclusion, you must therefore remember that payment in cash is the method of payment that is not used by health insurance policies.