{"id":4094,"date":"2014-11-19T10:20:45","date_gmt":"2014-11-19T09:20:45","guid":{"rendered":"https:\/\/www.toutsurmesfinances.com\/assurance\/contrats-responsables-et-solidaires-le-decret-au-jo.html"},"modified":"2021-07-28T15:55:02","modified_gmt":"2021-07-28T13:55:02","slug":"contrats-responsables-et-solidaires-le-decret-au-jo","status":"publish","type":"post","link":"https:\/\/www.toutsurmesfinances.com\/assurance\/contrats-responsables-et-solidaires-le-decret-au-jo.html","title":{"rendered":"Contrats responsables et solidaires : le d\u00e9cret au JO"},"content":{"rendered":"

Les contrats responsables et solidaires enfin sur les rails. Le d\u00e9cret d\u00e9finissant le nouveau cahier des charges de ces contrats est paru mercredi 19 novembre 2014 au Journal Officiel<\/a>. Il pr\u00e9cise les planchers et plafonds<\/strong> des garanties d’optiques que devront respecter ces contrats de compl\u00e9mentaires sant\u00e9 qui b\u00e9n\u00e9ficient d’aides fiscales. Il fixe \u00e9galement les plafonds de remboursement des d\u00e9passements d’honoraires<\/strong>. Ces contrats sont entr\u00e9s en vigueur au 1er avril 2015.<\/p>\n

 <\/p>\n

<\/span>6 paliers de remboursements<\/span><\/h2>\n

Pour lutter contre la surench\u00e8re des prix de l’optique, le gouvernement a souhait\u00e9 r\u00e9former les contrats dits responsables en modifiant les paliers de prises en charges des compl\u00e9mentaires sant\u00e9. Ainsi, 6 niveaux de remboursements sont fix\u00e9s pour les soins d’optiques. Les mutuelles devront prendre en charge au minimum de 50 \u00e0 200 euros, selon le type de verres et de 470 \u00e0 850 euros au maximum. La prise en charge des montures sera elle limit\u00e9e \u00e0 150 euros<\/strong>.<\/p>\n

Parall\u00e8lement, le d\u00e9cret confirme la cr\u00e9ation d’un observatoire<\/strong> des prix et de la prise en charge en optique m\u00e9dicale. Il sera charg\u00e9 d’analyser les prix de vente, les caract\u00e9ristiques et la qualit\u00e9 des \u00e9quipements d’optique et leur niveau de couverture par les contrats de compl\u00e9mentaire sant\u00e9. Les r\u00e9sultats de l’observatoire seront remis \u00e0 la ministre de la Sant\u00e9 chaque ann\u00e9e avant le 30 juin. Le premier rapport devrait \u00eatre rendu avant la fin du mois de juin 2016.<\/p>\n

>> Compl\u00e9mentaire sant\u00e9 : collectif ou individuel, quel est le meilleur type de contrat ?
\n<\/a>
\n<\/strong><\/p>\n

<\/span>Jusqu’\u00e0 125% de d\u00e9passement rembours\u00e9<\/span><\/h2>\n

Les mutuelles devront d\u00e9sormais prendre en charge syst\u00e9matiquement les tickets mod\u00e9rateurs<\/strong> (ce qui reste \u00e0 la charge de l’assur\u00e9 apr\u00e8s le remboursement de la S\u00e9curit\u00e9 sociale) \u00e0 l’exception de certains soins de types hom\u00e9opathiques ou les frais de cure thermale par exemple. Le d\u00e9cret fixe \u00e9galement le plafond de remboursement op\u00e9r\u00e9 par les compl\u00e9mentaires sant\u00e9s concernant les d\u00e9passements d’honoraires des m\u00e9decins non adh\u00e9rents au dispositif du contrat d’acc\u00e8s aux soins*. Celui-ci est limit\u00e9 \u00e0 125% du tarif de la S\u00e9curit\u00e9 Sociale pour 2015 et 2016 et sera ramen\u00e9 \u00e0 100% \u00e0 partir de janvier 2017<\/strong>. Dans tous les cas, le remboursement devra \u00eatre inf\u00e9rieur \u00e0 celui des d\u00e9passements d’honoraires de m\u00e9decins adh\u00e9rents au contrat d’acc\u00e8s aux soins.<\/p>\n

*Le dispositif de contrat d’acc\u00e8s aux soins est entr\u00e9 en vigueur depuis le 1er d\u00e9cembre 2013. Il invite les m\u00e9decins \u00e0 signer un accord qui permettra \u00e0 leurs patients d’\u00eatre mieux rembours\u00e9s. Par exemple, pour une consultation \u00e0 40 euros le remboursement se fait sur la base de 28 euros contre 23 euros pour les m\u00e9decins non signataires.<\/em><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/section>\n","protected":false},"excerpt":{"rendered":"

Le d\u00e9cret encadrant les contrats d’assurance maladie compl\u00e9mentaire dits responsables et solidaires est paru au Journal officiel (JO) mercredi 19 novembre 2014. Il fixe les plafonds de remboursement des frais d’optiques et des d\u00e9passements d’honoraires. \u00a0<\/p>\n","protected":false},"author":13718,"featured_media":4093,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-4094","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sante"],"acf":[],"yoast_head":"\nContrats responsables et solidaires : le d\u00e9cret au JO<\/title>\n<meta name=\"description\" content=\"Le d\u00e9cret encadrant les contrats d\u2019assurance maladie compl\u00e9mentaire dits responsables et solidaires est parue au Journal officiel (JO) mercredi 19 novembre 2014. 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