Third Party Paid

Verified 26 April 2024 - Directorate for Legal and Administrative Information (Prime Minister)

What is the third party paying? The paying third party consists of pay directly the health professional. Thus, you do not advance a fee on the part of the care reimbursed by the Health Insurance. Accident at work It applies in particular if you are receiving the health supplement (CSS) or the medical aid of the State (AME), if you are a victim of a withdrawal or suffering from a long-term illness (ALD). We present you with the information you need to know.

There are 2 types of paying third parties: total and partial.

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Total third party fee

You don't have to pay any fees. You do not have to pay the healthcare professional immediately.

However, the flat-rate contribution and medical allowances remain at your charge.

For example, Health Insurance:

  • Recover amounts due on your subsequent payments
  • Or will ask you for a direct payment.

Please note

Some people are exempt from flat-rate contributions and medical allowances : minors, pregnant women, persons with complementary health solidarity or thestate medical aid, minors for the contraception and the emergency contraception without parental consent, care related to an act of terrorism...

Partial Paid Third Party

You pay the part of the costs not covered by the Health Insurance.

FYI  

Excess fees are not covered by the Health Insurance. Your mutual may do so. Find out from her.

Automatic third party

Third Party Paid applies when you are in any of the following :

  • You have the complementary health solidarity (CSS). The paying third party then also applies on the part of the care reimbursed by the complementary health
  • You benefit from theMEA: titleContent
  • You are undergoing preventive measures as part of organized screening (e.g. mammography during organized breast cancer screening, cervical cancer screening, M'T Teeth examination)
  • You benefit from maternity insurance the fact that you're pregnant

Warning  

A pharmacist may not practice third-party payment if you refuse the use of generic medicines.

Third party paid at the initiative of the healthcare professional

You can benefit from the third party paying in particular in the following situations:

  • Pharmacist's dispensing of drugs reimbursed by Medicare
  • Examinations, care, provided by radiology or medical analysis firms 
  • Consultation with your treating doctor, for example if you are facing financial difficulties
  • Community-based healthcare provider initiative. The latter can offer you the paying third party on the mandatory share, whatever your situationBut it's not an obligation.

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General case

If you are eligible for the fee-based third party, you must present your vital card up to date.

This update can be done at the following locations:

  • Most pharmacies
  • Multi-service kiosks available at the reception points of the Health Insurance
  • Some health facilities.

If you can't move, contact your health insurance provider by phone or mail.

Who shall I contact

The update must be performed:

  • In case of change of situation personal (example: you are in ALD and have received a certificate exempting you from user fees) or professional (example: change of organization ensuring the payment of your health expenses)
  • And to the less once a year.

FYI  

Exceptionally, it is possible to presentpaper certificate justifying the opening of your rights.

Beneficiary of the solidarity health supplement

To benefit from the paying third party, you must present your up-to-date Vitale card (otherwise, exceptionally, it is possible to present thepaper certificate justifying the opening of your rights).

The update of the Vitale card can be done in the following places:

  • Most pharmacies
  • Multi-service kiosks available at the reception points of the Health Insurance
  • Some health facilities.

This update must be done:

  • In the event of a change of personal or professional situation
  • And at least once a year.

If you can't move, contact your health insurance provider by phone or mail.

Who shall I contact

Recipient of State medical aid

In order to benefit from the fee-paying third party, you must present your AME card.

Who can help me?

Find who can answer your questions in your region

  • Primary health insurance fund (CPAM)

  • Health Info Rights

    A telephone line created by a collective of user associations to provide legal or social information related to health

    By telephone

    01 53 62 40 30

    Price of a local call

    Open Service:

    • mondays, wednesdays and fridays from 2pm to 6pm
    • tuesdays and thursdays from 2pm to 8pm

    By Form

    You can also ask your question by completing the contact form ;

    From this form, you can request to be called back.

FAQ