Medical imaging sessions are very often used by doctors to help them diagnose a pathology. Do you want to know how these medical imaging sessions are reimbursed by your health insurance? Here is what it is in detail:
– there are 3 types of medical imaging: radiography, ultrasound, and MRI ;
– Health Insurance reimburses 70% of the agreed price of a medical imaging session if you are part of a coordinated care course;
– excluding the coordinated treatment course, the Health Insurance reimburses 30% of the agreed rate;
– the health insurance covers the moderating ticket, that is to say, the agreed price not reimbursed by Social Security;
– some mutuals cover all or part of the excess fees.
It is important to compare the offers of mutual insurance companies and to subscribe to the guarantees that best suit your needs.
Reimbursement of medical imaging by mutual health insurance
X-ray
Radiography is the simplest and least expensive medical imaging technique. This method uses X-rays and makes it possible to obtain two-dimensional images of the bone structure or organic tissues. Radiography is sufficient in most situations but must be supplemented by other techniques for the most specific cases.
What are the prices for an x-ray?
The Health Insurance sets agreed on rates for X-ray examinations for each part of the body.
For each X-ray, there is a fixed contribution of €1 which remains payable by the patient.
What reimbursements for an X-ray by Social Security?
Social Security reimburses 70% of the cost of an X-ray consultation. To be reimbursed for the full 70%, you must have followed the coordinated care pathway. This means that your general practitioner must have provided you with a prescription for carrying out the x-ray.
If you have had the x-ray without a prior prescription from your general practitioner, the health insurance will only reimburse you 30% of the cost of the x-ray.
Fee overruns are, of course, not covered by Social Security.
What reimbursements by the mutual health insurance?
The role of the health insurance fund is to cover the difference in price between the Social Security reimbursement and the agreed rate.
For example, if, as part of a coordinated care course, you perform a dental X-ray. The actual amount of the consultation is €29.16. Health Insurance reimburses you for 70% of this price, i.e. €23.33. Your health insurance will then reimburse you for the remaining 30%, i.e. €5.83.
Reimbursement by your health insurance depends on the coverage you have taken out. Some complementary health offers reimburse up to 200% of the agreed rate.
Few mutuals cover the fixed financial contribution of €1.
Ultrasound
Ultrasound makes it possible to visualize the organs, vessels, and ligaments. It is an ultrasonic wave imaging technique. Its purpose is to detect a tumor, infection or malformation. Ultrasound is used in particular to carry out quarterly examinations during pregnancy.
What are the prices for an ultrasound?
The prices for obstetric ultrasounds are as follows:
- €61.47 for the 1st-trimester ultrasound;
- € 81.92 for the 2nd-trimester ultrasound;
- €73.99 for the 3rd-trimester ultrasound;
- €35.65 for the dating ultrasound.
The cost of a non-obstetric ultrasound depends on the organ observed.
What reimbursements for an ultrasound by Social Security?
The 3rd ultrasound performed as part of the quarterly examination of pregnant women is 100% covered by Health Insurance. The first two ultrasounds are 70% covered by Social Security.
Ultrasounds performed as part of a coordinated care course are reimbursed at 70% by Health Insurance. If you do not go through your general practitioner, you are only reimbursed 30% of the price of the ultrasound by Social Security.
What reimbursement by complementary health insurance?
The mutual supplements the reimbursement of the ultrasound by the Health Insurance. The amount reimbursed depends on the cover taken out.
In principle, your health insurance reimburses 30% of the cost of the ultrasound which was not covered by Social Security. You can check how high your healthcare costs are covered by the mutual insurance company by looking at the table of guarantees in your mutual insurance contract.
Some mutuals can take care of excess fees. If the mutual covers more than 100% of the agreed rate, this means that it covers the excess fees.
MRI (Magnetic Resonance Imaging)
MRI (or Magnetic Resonance Imaging) is a technique that makes it possible to obtain images of the interior of the body in two dimensions or in three dimensions. The images are obtained using electromagnetic waves. MRI is the most precise method of medical imaging. It is also the most expensive. The device used to carry out the MRI examination is very expensive and requires great technical skill to be able to use it.
MRI is mainly used in neurology, ophthalmology, and cardiology.
What are the prices for an MRI?
The cost of the MRI is divided into two amounts:
- the price of using the device: we speak of a technical package;
- medical fees related to the use of the device.
The full rate technical package is €244.68. When several MRIs are performed for the same pathology during the same session, each MRI benefits from a reduced rate of €85.68.
The medical fees are €69.
The total cost of an MRI is between €320 and €500.
What reimbursements for an MRI by Social Security?
The MRI technical fixed price is paid for variably by the Health Insurance.
Medical fees are covered at 70% of the agreed rate.
As with other medical imaging services, you must perform the MRI as part of a coordinated care pathway to claim the 70% reimbursement. If you do not have a prescription from your general practitioner, the MRI is covered by Social Security for 30% of its cost.
What reimbursement by the mutual?
Subscribing to mutual insurance reduces the remaining cost of an MRI. The coverage depends on the guarantees taken out in your mutual insurance contract.
In the majority of cases, mutuals cover the co-payment (ie the 30% not covered by Health Insurance). Some mutuals cover excess fees.
Does complementary health insurance reimburse me for the operation to remove laser tattoos?
A tattoo can be removed by laser sessions. These operations are called “cosmetic”, that is to say, that they are not done to improve the state of health of the person concerned. Health Insurance does not cover this type of operation.
Some health insurance can cover the operation to remove the tattoos. You will need to take out a specific guarantee for aesthetic operations. These options of mutual insurance contracts are generally expensive.
