Fee overruns, psychological support, prostheses… Cancer care is not fully covered. Patients pay more than 450 euros on average.
456 euros. This is the average amount that women have to pay out of pocket after a mastectomy. The League against Cancer publishes this April 23 its Societal Cancer Observatory. The section devoted to reconstruction after breast cancer is unequivocal: for one in two women, medical and paramedical care entail an out-of-pocket charge.
More than 1,000 euros for some
On paper, cancer-related care is 100% covered by Social Security. But this only applies to “reimbursable acts, products and services, within the limits of the ceilings set by Health Insurance”, specifies the League in its report. Out of the 992 women questioned by the BVA Institute, one in three evokes an out-of-pocket charge on transport costs, excess fees for surgical procedures and the cost of “comfort” drugs. “
The sums that patients have to pay can be considerable. For a third of them, they fluctuate between 100 and 499 €. But for 27%, the amount can reach 999 euros. It is when the mastectomy is followed by reconstruction that the remaining costs are highest (€ 1,391 on average).
Key care poorly reimbursed
The fees represent the main item of out-of-pocket expenses. But “ancillary” costs, such as adapted removable prostheses or pharmacy costs, are regularly cited by the women questioned. Expenses however necessary for these patients. The sacrifices made to obtain psychological support illustrate this well: the remainder of the charge represents 33% of the price of the consultation.
Recommended at all stages, this support is only supported under certain conditions. Going to the psychiatrist is reimbursed on the basis set by Health Insurance. A package of two sessions with the psychologist is also accepted … The others will be the responsibility of the patient.
“Many women talk about the deleterious effect of mastectomy on their body image, the loss of their femininity … When they express this need for support, they agree to pay an out-of-pocket charge for these consultations,” explains To Why actor Emmanuel Jammes, Delegate to the “Society and health policy” mission at the Ligue contre le cancer. One in three said they had recourse to treatment, mainly psychological, for an average amount of 456 euros. It is a real financial sacrifice. “
Married, patient who has had a mastectomy: ” There is an additional cost in terms of household help, sophrology … It is a pity that these parallel supports are not fully or partially supported. “
The remainder of charge poses real problems for patients who have undergone a mastectomy. Half of them mention financial difficulties. So much so that some (15%) have to call for external help, even if the majority (75%) dig into their savings.
Prostheses: unequal reimbursement
Prostheses are only reimbursed by Health Insurance once a year. The amount taken in charge does not correspond to the reality of the market, as the Observatory of the Cancer Society reminds us.
– Non-adhesive external prosthesis: reimbursed on the basis of € 69.75. Actual prices may exceed € 150.
– Amoena silicone prosthesis: fully covered (160 €).
– Silicone prosthesis from other brands: reimbursed on the basis of € 69.75. Actual prices may exceed 210 €.
– Adapted bras (50 € minimum) and prosthesis maintenance products are not covered.
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