The third-party payment is a device that allows patients not to advance their health costs. By means of their Vitale card and sometimes the mutual insurance card, the payment is organized automatically. The third party payment only concerns part of the population but should very soon be extended.

Normally, when we see a doctor or specialist, we pay for our consultation. The reimbursement is done mechanically a few days later. It is possible by registering the Vitale card at the time of the consultation or by sending the care sheet. First, we receive reimbursement from the Health Insurance. Then, the complementary health supplements the assumption of the expenses advanced according to the contract subscribed and the guarantees which are specific to it.

The third-party payment is a process that allows patients not to advance all of their health costs. The health professionals consulted are reimbursed directly from the Health Insurance and mutual funds. Only the user fee can be requested if it is not exempt. The system is made possible thanks to the Vitale card which contains all the information essential to the process.

The third party payment can be, depending on the case, partial or total. In the context of a partial third-party payment, the patient only pays the user fee, that is to say the costs which are not covered by the Health Insurance. It is possible that the health professional, the medical establishment or the pharmacy applies the third-party payment on the expenses reimbursed by the complementary health insurance.

In this case, the user fee is reduced but it still applies since each insured must pay the flat-rate contribution of € 1 and any deductibles. In the case of full third-party payment, you don’t have to pay any fees. This is associated with the mandatory third party payment and exemption from user fees.

In certain situations, the third party payment is a right. It is therefore mandatory for health professionals. The third-party payment is automatically applied for people who benefit from complementary universal health coverage (CMUC), State medical aid (AME) and assistance with the payment of complementary health insurance (ACS).

The third-party payment is also compulsory for patients who are victims of a work accident or an occupational disease, for people who benefit from an organized screening (breast cancer, cancer colorectal ou prostate cancer for example) and for minors under 15 who want a contraceptive.

Finally, third-party payment is compulsory in all hospitals under agreement with the Health Insurance. It should be noted that pharmacies apply third-party payment. However, the device is no longer mandatory if patients refuse generic drugs.

Third-party payment is often optional today. It can be performed by medical analysis laboratories, radiology centers, dental offices, etc. Patients who are cared for in the context of a long-term illness (ALD), pregnant women and people who have financial difficulties can also apply for third-party payment for their so-called city care.

As part of the law to modernize our health system, a generalization of third-party payment will be gradually implemented. Changes are therefore expected throughout 2017.

To find out more about third-party payment, you can request information from the Health Insurance by telephone, online or directly at the various reception points. Most often, general practitioners inform their patients of the rights they have.