Most of the members of a complementary health simply present their insurance card when a health professional requires it. Rare are those who are really interested in the decryption and reading of their insurance card. The document, however, contain important information about the quality of my care and on the level of reimbursement of my healthcare costs. How to read my insurance card : Cocoon helps me to understand it all !
The information that contains my insurance card
All the cards of the mutual does not look like the same. But all are substantially on the same operation. Among the information on my insurance card to appear the contact information to contact my mutual, my membership number, the period of validity of my insurance card, the type of convention as well as information on the beneficiaries of supplemental health (first name, last name, status, social Security number and date of birth). My insurance card also informs on the level of reimbursement of my costs of health care through the use of acronyms, the items of expenditure and percentages.
Understand the acronyms of my mutual
My mutual can express my benefits in several ways. Each of them corresponds to an acronym : SSRB for a percentage of the basis of reimbursement of the social Security, TC for a refund based on a percentage of the tariff convention, HSMP for a percentage of the monthly ceiling of the social Security, etc., The acronyms RO, for compulsory, e for the actual costs, and TM for co-payments, have often also their place on a map of mutual.
Understand the positions of my mutual
Mutual societies have the habit to group care in different items of expenditure. One can read on their mutual positions, such as : hospitalization, optical, routine care, pharmacy, dental, etc I have to then refer me to my contract of mutual to know what treatments are actually taken into account in these different positions.
Understand the payback percentages of my mutual
Each item of care is then associated with a percentage (in the case of a refund SSRB). These percentages represent the share of health costs taken care of by my extended health. A percentage of 100 % means that my mutual will provide support to 100 % of my health expenses in the expense item. These figures refer however to a tariff reference (or base form) defined by the social Security. It may then be a difference between the actual amount of my health costs and the basis of reimbursement provided by the social Security (this is notably the case of the exceedances of fees). It must have a payback percentage higher (200 %, 300 %) to increase the amount of repayments. Understand the returns of my mutual is therefore indispensable when I want to get a refund in optimal conditions. The seniors have any interest in choosing a mutual, which perfectly covers the cost of their regular health
Other items on my insurance card
The detail of the information and the ease with which it is possible to read his insurance card can be of the selection criteria for subscribing to a mutual. Be sure to regularly renew the insurance card in the event of a change of situation, as it is necessary to regularly update the rights of the carte vitale.
The remaining burden of the insured, for expenses of health depends on the support of the health Insurance but also of the repayments made by its mutual. Understand his insurance card is essential to keep up with his repayments and so ensure that they are compliant with the contract they have signed.