Is osteopathy reimbursed by social security and/or mutual funds?
Do you need a prescription to consult an osteopath and be reimbursed?
Osteopathy procedures are not covered by health insurance. Osteopathy is not a practice that is referenced in the Public Health Code. An agreement with Social Security allowing patients to be reimbursed for the price of osteopathy consultations (sessions) , even partially, cannot therefore be established. The referencing of osteopathy in the Public Health Code, which would make it possible to establish an agreement with the Health Insurance, requires the adoption of a law.
Osteopathy is an ” alternative medicine ” whose practice is not conventional. Patients who consult an osteopath cannot be entitled to reimbursement. Unlike, in particular, doctors and physiotherapists. The acts of the latter must be the subject of a medical prescription to allow their patients to be reimbursed on the basis of tariffs established by social security.
Cost of a consultation and reimbursement
How to be reimbursed for a consultation with the osteopath?
Most supplementary health insurance companies, mutuals, provident institutes and insurers cover part of the cost of consultations. This increasingly common practice actually responds to a growing and constant demand for reimbursement of osteopathy consultations by their policyholders.
Complementary Health uses platforms in charge of setting up and managing networks of partner health professionals in order to reduce the price of consultations.
The objective being both to satisfy their policyholders and to limit the cost of expenses. Conventions have thus been offered to exclusive osteopaths as is the case for opticians and dentists.
These professionals are referenced and their patients benefit from the absence of third-party payment advances. A significant source of new patients for the plethora of osteopaths, many of whom are struggling to build up a patient base.
This type of contract has also been badly received by the profession in general, supported by associations and unions of osteopaths, which they consider respectively as unfair competition and financially dependent. The same is true for online calendars with large audiences.
Currently, social security does not offer reimbursement for osteopathy consultations (sessions) . Only complementary health insurance covers this alternative medicine. The number of reimbursable consultations remains very limited and varies according to the level of contract offered by the complementary health insurance. A fixed price is established with an average basis of three consultations per year.
Are osteopaths under agreement and all housed in the same boat?
All osteopaths who have acquired the right to use the title after initial training in private schools or university for doctors, are required to establish a bill of fees specifying the nature of the act and its price on which must appear their registration number provided by a new register of osteopaths, the RPPS (Shared Directory of Health Professionals) ex ADELI directory, designed to bring together all titled osteopaths regardless of their initial profession.
In reality, some osteopaths among health professionals approved by social security, doctors but especially physiotherapists, issue care sheets with excess fees to allow their patients to benefit from better care by health insurance. . This illegal practice denounced by the National Health Insurance Fund (CNAM) seems, according to its fraud control service, difficult to verify.
Exclusive osteopathic practitioners who have chosen to favor osteopathy over their initial health profession and non-health professional osteopaths cannot therefore offer their patients the same conditions of access to care.
About prices: what is the price of a consultation with an osteopath?
The price of osteopathy consultations varies according to the mode of practice which may require more time, the geographical area, the reputation of the osteopath. It oscillates between 50 € and 120 € and the duration of the consultation between 20 minutes and one hour.
Which health insurance companies reimburse osteopathy consultations?
The list of mutuals that take part of the costs of osteopathic consultations is growing regularly, but coverage remains timid.
They are unfortunately based on the results of insufficient studies which have been carried out from practices that do not comply with all the fundamental principles of osteopathy.
The loss ratio of osteopathy consultations (sessions)
The loss experience is low, unlike the alerts issued. Osteopathic legal experts are relatively little called by the Judges.
But when a complaint leads to the conviction of the osteopath, the act performed is structural, an act unfortunately presented as essential in certain approved schools but, in any case, insufficient to be able to apply osteopathy in a manner consistent with its Fundamental principles.
Is osteopathy covered by Complémentaire santé solidaire (ex-CMU-C)?
Accessibility to osteopathic care is a real problem as more than three out of five French people have consulted an osteopath with more than 20 million acts performed each year, with 14.5 million patients.
Its financial accessibility is reserved for patients who can afford mutual insurance with costly guarantees or who are lucky enough to benefit from financial assistance from their company.
These situations are far from being the case for people who have to apply for complementary health insurance, which replaces the ex-CMU complementary universal health cover, when they are certainly those who most need osteopathic care.