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#HEALTH DOSSIER
29 Jan 2021 /
By netconcepteurs /
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Reimbursement of drugs and third-party payment
When you buy medicines, the Assurance Maladie covers part or all of their cost.
Your Vitale card allows you not to advance the part covered.
But beware, this device is not applicable if you refuse generic drugs.
WHAT ARE THE RULES FOR REFUNDING YOUR MEDICINES?
Medicines are covered by Health Insurance on prescription issued by a doctor, a midwife, a dental surgeon, a nurse, a director or deputy director of an analysis laboratory, within the limits of their professional practice.
Some topicals for external use can also be taken care of when prescribed by a chiropodist.
To allow reimbursement of the drug, the prescription must be made within the framework of the therapeutic indications giving rise to the right to reimbursement, and the drugs must appear on the “List of drugs reimbursable by social insurance”, fixed by ministerial order.
Note that, for each drug prescribed, the prescription must indicate the dosage and duration of treatment or the number of packaging units (box or vial).
DRUG REIMBURSEMENT RATES
There are four reimbursement rates for drugs:
100% for drugs recognized as irreplaceable and expensive
65% for drugs with major or substantial actual benefit
30% for medicinal products with moderate actual benefit and certain magistral preparations
15% for drugs with low medical benefit
The reimbursement rates apply either on the basis of the sale price (limit sale price set by law), or on the basis of a fixed liability rate (TFR).
The limit sale price and the TFR appear on the back of the order used to issue the products.
PLEASE NOTE: since January 1, 2021, homeopathic medicines and homeopathic magistral preparations (PMH) are no longer reimbursed by Health Insurance.
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