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Health cover



Appendix III

Glossary of technical terms

[1] Personal Insurance Health Insurance offered by the Social Security for people that do not have automatic access to its benefits.
[2] Complementary Health Insurance or Mutual Health Insurance Insurance which reimburses all or most of the fees paid by the assured party.
[3] Optional Insurance Health Insurance policy drawn up with a private insurance company.
[4] "attestation de prise en charge" Document certifying that you are covered by an health insurance.
[5] Beneficiaries Those who can be covered by your health insurance without paying any supplements (your spouse, children in your charge)
[6] Caisse Primaire d'Assurance Maladie (CPAM) The body which administers all health and accident reimbursements.
[7] Social Security Card Card which proves your affiliation with a certain regime of health cover and contains your insurance number.
[8] Mutual Centres Health Care centres accessible to all insured parties of a particular mutual where all the practitioners are approved by the Department of Health.
[9] Approved Doctor Doctor approved by the Department of Health and uses the Social Security Convention Tariff.
[10] Doctors Approved by the Department of Health who fixes his own rates These doctors charge fees superior to that of the Social Security Convention Tariff, but the fees are partially reimbursed to the limit of the convention.
[11] Private Doctors These doctors' fees are not very well reimbursed by the Social Security.
[12] Waiting Period This is the initial period of your policy during which any medical costs incurred are not reimbursed.
[13] Excessive Fees This is the amount of the fees for an Approved Doctor who fixes his own rates which goes beyond the Social Security Convention Tariff.
[14] Real Expenses This is the totality of the expenses for medical benefit.
[15] Civil Liability The liability you have to reimburse for any damages caused to another by accident.
[16] Civil Liability Guarantee Insurance that covers you for payment of damages to another if your civil liability is put into question.
[17] Social Security The organisation that administers all the different regimes of social cover in France.
[18] Authority Tariff The amount (very little) reimbursed for private doctors.
[19] Convention Tariff Tariff upon which the reimbursement of medical costs is based, used in particular with approved doctors.
[20] Deterrent Fee The part of the medical fees which is not reimbursed by the Caisse Primaire d'Assurance Maladie (CPAM) and therefore which remains for you to pay. It can be paid by a complementary health insurance.
[21] Third Party A system which exempts you in advance from the fees reimbursed by the "Caisse Primaire d'Assurance Maladie", or by your mutual insurance company.



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Since its creation in 1993, the Foundation has enjoyed continuous financial support from the Alsatian local authorities. The Foundation gratefully acknowledges their essential contributions. The durable financial support that was part of the triennial 2000/2002 contract between the government and the Region allowed the foundation to truly take off.


 
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