Health: ambulances will soon be less well reimbursed by Social Security

Health insurance will reduce its coverage of non-emergency medical transport, from 65% currently to around 50%, according to a decree published during the weekend, despite the opposition of complementary health insurance which will have to compensate for this partial reimbursement.

The text, published on Saturday in the Official Journal, provides that “the participation of the insured in the costs relating to medical transport”, today included in a range of “30 to 40%”, will soon increase to a rate of “45 to 55% “which will be fixed by the Health Insurance.

This decision will apply to so-called scheduled transport, for patients who do not already benefit from an exemption (chronically ill, pregnant women, invalids, etc.). The measure aims to “neutralize” the free “urgent medical transport”: the private ambulances sent at the request of the Samu have indeed been covered at 100% since January 1, for a cost estimated at 70 million euros per year, according to the impact study of the 2023 Social Security budget.

This sum will therefore be passed on to some 12 million scheduled trips, the rest of which at average expense will increase from 20 to 25 euros, according to government calculations. An increase that will be painless for most policyholders, the vast majority of whom are covered by mutual insurance companies and provident institutions. Organizations supposed to also find their account there, since they previously paid for part of the urgent transport. But the National Union of Complementary Health (Unocam) opposed it in March, giving an “unfavorable opinion” because of “doubts about the financial neutrality of the operation”.

Partly founded fear, because in the meantime the Health Insurance and the ambulance unions concluded an agreement in April, with an envelope of 340 million euros by 2025 including in particular price increases.