Health Insurance:Generalization of third-party payment: what impact for patients?
Health Insurance:The result fell on 9 April. The bill of the current Minister of Health, Marisol Touraine, was adopted by the National Assembly. The generalization of third-party payment is therefore underway and will soon become a right for all French people. What are the impacts for patients? When will the device be put in place? Explanations.
Health Insurance:What is a third-party payer?
The third party payment is a device that allows patients not to pay their health costs directly. Today, in most cases, the fees of a general practitioner are paid at the end of the consultation by the patient. The latter is then reimbursed in part, or even in full, by his Medicare and his mutual, provided of course that he has one.
The principle of third-party paying allows the patient to see his expenses directly taken care of by the Social Security and his complementary health. So he will not have to pay anything as is currently the case when purchasing medicines prescribed by pharmacy.
There are two methods in this method of payment. The total paying third party, which, as its name indicates, covers all costs. The latter will be paid by the Social Security.
Then comes the partial pay-as-you-go, which allows the patient to settle only what is called co-payment, ie all fees that are not covered by Medicare.
Who is affected by the third party payment?
To date, the paying third party only covers 30% of consultations in France. Beneficiaries of the State Medical Aid (ACE) can thus resort to this payment process. The same applies to people benefiting from Complementary Health Assistance (ACS) or those with complementary Universal Health Coverage (CMU-C). Children under the age of 15 who go to a health professional for contraception may also use it.
With the adoption of the bill of Marisol Touraine, this device will extend to all French covered 100%. Implementation will be gradual until the end of 2017. On 1 July 2016, doctors will be able to offer their patients, who are 100% covered, to have recourse to third-party payers. As of December 31, 2016, this will be a right for any patient covered 100% by Medicare. Finally, as of November 30, 2017, the third-party payment will be a right for all French people. Thus, physician consultations will be paid directly by the complementary health and Medicare of the patient. The deductibles and packages will be settled to the Health Insurance by the insured via bank direct debit.