“You must contact the mediator of the Primary Health Insurance Fund”. It almost never fails. On social networks, with each call for help from a person looking for a general practitioner, the answer inevitably ends up arriving: contact the CPAM.
Indeed, since 2005, “the medical agreement provides support from health insurance for patients who encounter difficulties in accessing care”, recognizes the CPAM of Côtes-d’Armor. Support assigned, since 2019, to the Caisse’s Health Support Mission.
If this mission exists, it does not replace “the research that beneficiaries of health insurance must do to find a doctor”, recalls Marin-Luc Auffret, deputy director in charge of the service and customer relations at the CPMA 22.
Clearly, by question of contacting the Health Insurance in the hope that it does the job. “We provide support, after fruitless searches, when there is what is called a difficulty in accessing the law”.
“We are talking more and more about this device. So we are receiving more and more requests,” notes Marin-Luc Auffret. “We rely on our knowledge of the territory to direct them to health professionals”. The proposed solution can also be that of teleconsultation.
The CPAM’s health support advisers also take into account the pathologies and follow-up needs of the people who contact them.
People who have not declared a treating doctor are normally less well reimbursed after a medical consultation. A sort of double jeopardy for those who can’t find any.
This is why, “in order not to financially penalize policyholders who encounter real difficulties in accessing a attending physician, the Health Insurance neutralizes these minorities of reimbursements”.
–
