The price of private doctors will be discussed during negotiations between health insurance and doctors this Thursday, February 8, the opportunity to raise interest in the prices of consultations.
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General practitioners want the price of the consultation to increase to 30 or even 50 euros. Currently, the price varies depending on the doctor. A consultation with a general practitioner costs a little more since this fall: 26.50 euros compared to 25 euros a few months ago.
Sector 1 or Sector 2?
If you pay 26.50 euros to your general practitioner, it is because he applies the “safety rate”, that is to say without excess fees. This is what we call Sector 1. This rate is applied by the majority of general practitioners, more than 9 out of 10. It allows the patient to be reimbursed at 70% by Health Insurance, if he This is done by his attending physician, and the rest is covered by mutual insurance.
General practitioners in Sector 1 may charge more depending on the procedure. If they examine a child under 6 years old, the price increases by 5 euros, there is also an increase for a consultation in the evening, after 8 p.m. For “long and complex” home visits you will have to pay 60 euros.
In Sector 2, doctors can charge overcharges and therefore consultations are more expensive and the price will not always be the same from one practice to another. This concerns very little general practitioners, but rather specialists, notably anesthesiologists, surgeons, ophthalmologists and even ENT specialists.
The price of the consultation can be known before making an appointment by consulting the health directory on the Ameli website.
How are prices defined?
It all depends on whether or not the doctor adheres to Optam, the practical controlled pricing option. If this is the case, this means that the doctor has made a commitment to Social Security to limit his excess fees and even to maintain part of his consultations at the base rate. In exchange, he receives a bonus and his patients are reimbursed a little better by Health Insurance.
Those who do not belong to Optam can freely set their prices and therefore practice excess fees of their choice. Patients will be less reimbursed by Health Insurance. This pricing freedom must nevertheless be exercised with “discernment” recalls the Council of the Order of Physicians.