The explanations of "Your Surgeon" are transparent

The explanations of "Your Complementary Health" must ALSO be transparent

​

Your surgery is already 100% covered by your Social Security fund.

Alone, this additional fee is the responsibility of your mutual insurance company.

​

A health insurance that claims to be 100%, this means that it does NOT reimburse excess fees

One should understand  100% = 0%

A mutual that claims to be 200%: it  reimburses EVERYTHING if this overrun does not exceed the opposable tariff

A mutual that claims to be at 300% means that it  reimburses up to twice the enforceable social security tariff

ETC...

​

OPTAM? Yes or no?

Generally, practitioners registered with OPTAM charge an overall price of 200% of the enforceable social security tariff.

Practitioners not registered with OPTAM give an image of "unsupervised pricing practices"

​

THIS IS FALSE:  Dr. Elisé's fees are often lower than the enforceable price of social security

The doctor. Elisé is not an OPTAM member, his fees are not subject to your complementary health contract.

On the other hand, Dr. Elisé NEVER penalizes a quality mutual (which reimburses 200%, 300%, etc.), his fees are FIXED.

​

If your health insurance does not reimburse your care...

Your Mutual must give you a certificate which clearly mentions:

the lack of coverage, or the amount  a partial refund.

The doctor  Elisha  never refused his care