{"id":776,"date":"2013-11-04T13:33:39","date_gmt":"2013-11-04T12:33:39","guid":{"rendered":"http:\/\/smartbe.be\/?page_id=776"},"modified":"2014-05-05T09:33:30","modified_gmt":"2014-05-05T08:33:30","slug":"comment-etre-rembourse","status":"publish","type":"page","link":"https:\/\/smartbe.be\/fr\/assurance\/comment-etre-rembourse\/","title":{"rendered":"Comment \u00eatre rembours\u00e9?"},"content":{"rendered":"<div>Les trois syst\u00e8mes<\/div>\n<div>Il existe trois syst\u00e8mes de remboursement\u00a0: le ticket mod\u00e9rateur, le tiers payant et le maximum \u00e0 facturer.<\/div>\n<p><strong>Le ticket mod\u00e9rateur<\/strong><br \/>\nC\u2019est le syst\u00e8me le plus usuel. Le patient <strong>paie le prix plein<\/strong>, par exemple de la consultation, et, avec l\u2019attestation remise par le prestataire de soins, il se rend \u00e0 sa mutualit\u00e9 pour se faire <strong>rembourser<\/strong> la part due par la S\u00e9curit\u00e9 sociale. La part qu\u2019il a pay\u00e9e est le <strong>ticket mod\u00e9rateur<\/strong>.<\/p>\n<p><strong>Le tiers payant<\/strong><br \/>\nLe patient ne paie au prestataire de soins que le <strong>ticket mod\u00e9rateur<\/strong>\u00a0: la partie qu\u2019il doit dans tous les cas payer. Le prestataire agit comme tiers payant et se fait rembourser par l\u2019INAMI la diff\u00e9rence.<br \/>\nC\u2019est le syst\u00e8me utilis\u00e9, notamment, par les <strong>pharmaciens<\/strong> et les <strong>h\u00f4pitaux<\/strong>.<\/p>\n<p><strong>Le maximum \u00e0 facturer<\/strong><br \/>\nCe syst\u00e8me s\u2019ajoute aux deux pr\u00e9c\u00e9dents. Il permet de limiter les d\u00e9penses du patient et de son m\u00e9nage. D\u00e8s que les <strong>tickets mod\u00e9rateurs<\/strong> cumul\u00e9s atteignent un <strong>plafond annuel<\/strong> (450\u20ac ou 650\u20ac selon les revenus), certains soins de sant\u00e9 des membres du m\u00e9nage sont <strong>enti\u00e8rement rembours\u00e9s<\/strong>.<\/p>\n<p><i> <strong>Attention<\/strong> <\/i>, certaines d\u00e9penses ne seront pas rembours\u00e9es enti\u00e8rement. Les <strong>suppl\u00e9ments tarifaires<\/strong> des m\u00e9decins non conventionn\u00e9s ne seront par exemple pas rembours\u00e9s.<\/p>","protected":false},"excerpt":{"rendered":"<p>Les trois syst\u00e8mes Il existe trois syst\u00e8mes de remboursement\u00a0: le ticket mod\u00e9rateur, le tiers payant et le maximum \u00e0 facturer. Le ticket mod\u00e9rateur C\u2019est le syst\u00e8me le plus usuel. Le patient paie le prix plein, par exemple de la consultation, &hellip;<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":144,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"tags":[],"class_list":["post-776","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.9 - aioseo.com -->\n\t<meta name=\"description\" content=\"Les trois syst\u00e8mes Il existe trois syst\u00e8mes de remboursement : le ticket mod\u00e9rateur, le tiers payant et le maximum \u00e0 facturer. Le ticket mod\u00e9rateur C\u2019est le syst\u00e8me le plus usuel. 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