Ticket modérateur et participation forfaitaire : le patient de nouveau mis à contribution

Dans le cadre du plan de redressement des comptes de la Sécurité sociale, annoncé début juillet 2007, deux mesures relatives à la participation de l’assuré aux dépenses maladie viennent d’être prises par des décrets n° 2007-1166 du 1er août 2007 et n° 2007-1170 du 2 août 2007 :

  • la majoration de la participation de l’assuré hors parcours de soins est relevée de 10 points, passant ainsi à une fourchette de 17,5% – 22,5% du tarif de sécurité sociale (au lieu d’une fourchette comprise entre 7,5% et 12,5%; art. R. 322-1-1 CSS modifié) ((Le taux de cette majoration doit être fixé par décision de l’UNCAM. Cette majoration s’applique, pour rappel, lorsque l’assuré n’a pas fait le choix d’un médecin traitant ou consulte un autre médecin sans prescription de son médecin traitant (sauf exceptions admises).)) ;
  • le relèvement du plafonnement de la participation forfaitaire de l’assuré, qui passe de 1€ à 4€, lorsqu’un professionnel de santé effectue, au cours d’une même journée et pour un même patient, plusieurs actes ou consultations (art. D. 322-4 CSS).

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