After hospitalization, the sums paid by patients vary. An Observatory underlines the strong disparities, according to the establishments and the complementary ones.
The French are making the big difference in the dependents after hospitalization. The Interassociative Committee on Health (Ciss), in partnership with 60 million consumers and Santéclair, on May 22, delivers its Citizen Observatory for Health Dependents. This year again, he highlights the disparities faced by patients.
Attznrtion on the phone and TV
In 2012, the remaining charge amounted to € 500 on average per patient before the intervention of the complementary health insurance. But “some patients can end up with sums of several thousand euros at the end of their stay”, deplores the Observatory. Moreover, 10% of patients assume an out-of-pocket charge exceeding € 1,300, and some pay up to € 5,190! The establishment itself may be responsible for these fluctuations, depending on whether it is public or private, depending on the service. And the additional costs are not forgiving: single rooms, when requested by patients, inflate the bill. The same goes for the rental of television or telephone calls.
The nature and length of the hospital stay may be involved … but complementary health contracts are not always advantageous. Thus, after reimbursement from one of these organizations, 5% of patients must spend € 119… while the average is € 26. Significant proof of these variable contracts: the payment of the daily hospital fee. Recipients of CMU-C (complementary to CMU) are reimbursed, as well as health insurance covers that related to the hospitalization of pregnant women. Patients with occupational diseases are exempt … which is not the case for those with long-term illness (ALD). In certain cases, the complementary ones define in their contract a limited number of days covered. Side fee overruns, the problem is repeated: the amount assumed by the complementary fluctuates according to the contract.
Take a closer look at your contract
How to limit the remainder of charge linked to hospitalization? “In all cases, the Observatory recommends finding out about the conditions under which its complementary health care system covers doctors’ fees as well as their overruns in relation to the Social Security tariff,” advises the Observatory.
The advice also applies to other out-of-pocket items, to which you must be particularly careful. The complementary contract makes it possible to know with precision the conditions of reimbursement and the level of the support. The Observatory insists on invoicing the private room. If it is allocated without express request, it should in no case be invoiced; otherwise, the patient can contest.
To avoid any unpleasant surprises, the Observatory is calling for clearer access to the daily service rates charged by hospitals. Until then 60 million consumers put to use a map detailing them by establishment.
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