Refund Health insurance

Conditions of Care by Health Insurance 

In France, in order to receive reimbursement from de Assurance Maladie, you must fulfill certain conditions. Here are the main requirements :

     1. Registration : You must be registered under a French health insurance program, such as the Régime Général or another specialized program (e.g., the Régime des Travailleurs Indépendants or the Régime Agricole). Registration is usually automatic for employees and independent workers, but there may be specific requirements in some instances.

     2. Taxes : You must have paid your social security taxes, which are deducted from your salary or business income. Contributions are used to finance the health insurance system and other social benefits.

     3. Living in France : Health insurance coverage is usually available only for permanent residents of France. If you are a foreign resident, you must verify the conditions applicable to you situation.

     4. Medical procedures and treatments : To be eligible for reimbursement, all medical procedures and treatments must be considered medically necessary and relevant. Some treatments may require an advance medical prescription.

     5. Prices and reimbursements : Assurance Maladie defines reimbursement tariffs for various medical procedures and treatments. Reimbursements rates vary according to the nature to the procedure and conformity with the conventional tariffs. In some cases, you may be required to pay a contribution towards the remaining costs, known as a ticket modérateur.

Please note that this general information may be subject to conditions and regulations specific to certain medical situations, to people in precarious situations, or to people with special entitlements (e.g. people suffering from certain long-term conditions - ALD)

Vaginal and anorectal probes, and electrostimulation equipment must appear on the list of devices reimbursed by the Assurance Maladie.

This system is only valid in France.

A prescription from your doctor is required to claim the reimbursement of your equipment.

Refund

In France, perineal stimulators and vaginal/anorectal probes are reimbursed under certain conditions. Please find below some general information on how reimbursement works :

     1. Medical prescription : In order to be reimbursed by the Assurance Maladie, you must first obtain a medical prescription from your doctor. The prescription must specify the need for the perineal stimulator or rehabilitation probe as part of your medical treatment.

     2. LPPR classification : Perineal stimulators and probes are listed on the Liste des Produits et Prestations Remboursables (LPPR). They are classified in the "Aides à la rééducation périnéale" category and are subject to specific codification.

     3. Standard reimbursement : Reimbursement by the French Assurance Maladie for perineal stimulators and probes is generally 60% of the standard rate set by the LPPR. The exact amount reimbursed depends on the base tariff specific to the model prescribed.

     4. Complementary healthcare : In addition to the reimbursement provided by the French Assurance Maladie, you may be eligible for additional reimbursement from your mutuelle or "complementary" health insurance company. The amount of this reimbursement depends on the coverage and conditions of your contract.

The purchase of a perineal stimulator is reimbursed on the basis of:

  • 60% by CPAM, with a ceiling of €304.90
  • 40% by your Mutuelle

The purchase of a vaginal or anorectal probe (excluding pressure probes) is reimbursed on the basis of:

  • 60% by the CPAM, with a ceiling of 25.92€
  • 40% by your Mutuelle

How do I get my care sheet?

Sugar International is approved by the Health Insurance and is authorized to establish the necessary care sheets for the refund of eligible products on sale on our site.

When you order, you must check the box " I wish to receive a sheet of care " This box is directly on the product page.

If it is not included, it is that the product is not eligible for reimbursement.

NB/ Please scan your prescription admin@sugar-international.com

Before you check this box, make sure you are in possession of an order prescribing the product.

Without a prescription by the health professional, your purchase will not be refunded by Social Security. 

WARNING: WARNING TO REMEMEMORIES OF THE PERSON RECEIVED IN THE FACTURATION ADDRESSES OF YOUR COMMANDE.

After shipping the package, invoices are no longer editable.

We will include your invoice in your package.

What documents should I send to Social Security?

To collect your refund, you will need to send the following documents to your Health Insurance Fund by mail:

  • Your care sheet (CERFA)
    Attention: consider completing missing information (registration number = Social Security number + birth date + signature) before shipment
  • Your original prescription 

↳ Article : Care sheet : filling it in and sending it off

NB/ You can send the original of your invoice to your complementary health, if it supports the difference.

⇾⇾ For more information on Perineal Rehabilitation and health insurance, an online article is available by clicking here ⇽⇽

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