{"id":25,"date":"2016-10-18T19:24:45","date_gmt":"2016-10-18T17:24:45","guid":{"rendered":"http:\/\/www.arthus-consulting.fr\/?p=25"},"modified":"2017-09-19T21:00:02","modified_gmt":"2017-09-19T19:00:02","slug":"mieux-comprendre-le-remboursement-des-mutuelles-de-sante","status":"publish","type":"post","link":"https:\/\/www.arthus-consulting.fr\/2016\/10\/18\/mieux-comprendre-le-remboursement-des-mutuelles-de-sante\/","title":{"rendered":"Mieux comprendre le remboursement des mutuelles de sant\u00e9"},"content":{"rendered":"<p>Les mutuelles de sant\u00e9 remboursent le ticket mod\u00e9rateur en partie ou en totalit\u00e9. Elles peuvent, en plus, prendre en charge les diff\u00e9rentes majorations, les franchises m\u00e9dicales et les participations forfaitaires par acte m\u00e9dical. Les formules sont diff\u00e9rentes d&rsquo;une mutuelle \u00e0 une autre<br \/>\n<!--more--><\/p>\n<h2>Remboursement \u00e0 100 %<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-66\" src=\"http:\/\/www.arthus-consulting.fr\/wp-content\/uploads\/2016\/10\/remboursement-mutuelle-de-sante-100.jpg\" alt=\"\" width=\"285\" height=\"177\" \/>Lorsqu&rsquo;on d\u00e9duit le remboursement de la s\u00e9curit\u00e9 sociale du frais m\u00e9dical, il reste un pourcentage \u00e0 payer par l&rsquo;assur\u00e9. Par exemple, si la s\u00e9curit\u00e9 sociale rembourse 70 % de votre consultation, vous devez payer les 30 %. Les mutuelles de sant\u00e9 peuvent payer en totalit\u00e9 ces 30 % ou seulement une partie. Le taux de remboursement des mutuelles s&rsquo;exprime en 100 %, 200 %, 300 % ou m\u00eame plus. Comment les comprendre ? Prenons un exemple concret. Vous avez consult\u00e9 un g\u00e9n\u00e9raliste, mais avec des honoraires libres. Toutefois, la s\u00e9curit\u00e9 sociale paye uniquement 70 % du forfait des g\u00e9n\u00e9ralistes conventionn\u00e9s. Elle rembourse alors 70 % du 23 \u20ac (tarif forfaitaire des g\u00e9n\u00e9ralistes), soit 16,10 \u20ac. Comme vous devez payer 1 \u20ac de participation forfaitaire \u00e0 chaque acte m\u00e9dical, on d\u00e9duit cette somme aux 16,10 \u20ac, soit 15,10 \u20ac. La s\u00e9curit\u00e9 sociale paye finalement 15,10 \u20ac. Si vous souscrivez une mutuelle au taux de remboursement \u00e0 100 %, il paye \u00e0 100 % la diff\u00e9rence entre le tarif de base de 23 \u20ac et le remboursement de 15,10 \u20ac de la s\u00e9curit\u00e9 sociale, soit 7,9 \u20ac. Si l&rsquo;honoraire de votre m\u00e9decin libre est de 60 \u20ac par exemple, vous devez payer 60 \u20ac-15,10 \u20ac-7,9 \u20ac=37 \u20ac.<\/p>\n<h2>Remboursement \u00e0 200 %<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-68\" src=\"http:\/\/www.arthus-consulting.fr\/wp-content\/uploads\/2016\/10\/remboursement-mutuelle-de-sante-200-300x143.png\" alt=\"\" width=\"300\" height=\"143\" srcset=\"https:\/\/www.arthus-consulting.fr\/wp-content\/uploads\/2016\/10\/remboursement-mutuelle-de-sante-200-300x143.png 300w, https:\/\/www.arthus-consulting.fr\/wp-content\/uploads\/2016\/10\/remboursement-mutuelle-de-sante-200.png 420w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>Votre mutuelle paye alors jusqu&rsquo;\u00e0 2 fois le tarif de consultation pris en charge par la s\u00e9curit\u00e9 sociale, soit 23 \u20ac*2=46 \u20ac. Dans ce cas, votre mutuelle rembourse une grande partie de votre consultation : 46 \u20ac-15,10 (d\u00e9j\u00e0 pay\u00e9 par la s\u00e9curit\u00e9 sociale)=30,90 \u20ac. Ce qui vous reste \u00e0 payer est alors : 60 \u20ac-15,10 \u20ac-30,90 \u20ac=14 \u20ac. Donc, plus le pourcentage du remboursement par la mutuelle est important, moins vous aurez \u00e0 d\u00e9bourser lors de vos actes m\u00e9dicaux.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les mutuelles de sant\u00e9 remboursent le ticket mod\u00e9rateur en partie ou en totalit\u00e9. Elles peuvent, en plus, prendre en charge les diff\u00e9rentes majorations, les franchises m\u00e9dicales et les participations forfaitaires par acte m\u00e9dical. Les formules sont diff\u00e9rentes d&rsquo;une mutuelle \u00e0 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":67,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,2],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Mieux comprendre le remboursement des mutuelles de sant\u00e9 - Arthus-consulting<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.arthus-consulting.fr\/2016\/10\/18\/mieux-comprendre-le-remboursement-des-mutuelles-de-sante\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Mieux comprendre le remboursement des mutuelles de sant\u00e9 - Arthus-consulting\" \/>\n<meta property=\"og:description\" content=\"Les mutuelles de sant\u00e9 remboursent le ticket mod\u00e9rateur en partie ou en totalit\u00e9. Elles peuvent, en plus, prendre en charge les diff\u00e9rentes majorations, les franchises m\u00e9dicales et les participations forfaitaires par acte m\u00e9dical. 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