Health Insurance puts its skills at the service of many projects to protect the health of more than 60 million insured people.
For more than 70 years, Health Insurance has played a major role in promoting national solidarity. The key to the sustainability of the health system is a collective responsibility and lies in the strong involvement of each of its stakeholders.
Within this system, Health Insurance has a triple mission:
- guarantee universal access to rights and allow access to health care,
- to support everyone in the preservation of their health,
- improve the efficiency of the system.
All its missions, Health Insurance carries them out with the aim of ensuring the best quality of service. To achieve this, it relies on a local network covering the entire country and the commitment of 85,000 employees who work day after day at the departmental, regional and national levels.
The Caisse Primaire d’Assurance Maladie (CPAM) is a body attached to the Social Security system, but which is governed by private law and has a public service mission. In addition, a CPAM is positioned as an intermediary between the insured and the Health Insurance. In other words, a CPAM ensures close relations with Health Insurance policyholders. Also, any insured wishing to consult his reimbursement statements, download administrative documents, choose his attending doctor can go to the CPAM website (ameli.fr).
The CPAMs are responsible for:
- Affiliate social security contributors to Health Insurance
- Manage their right to this health insurance
- Process the care sheets of social security contributors but also the remote transmission of reimbursement statements to mutual insurance companies and supplementary health insurance companies.
- Provide services including: reimbursement of medical expenses according to the percentage of reimbursements granted, payment of daily allowances, advance payment of medical expenses for those benefiting from CMUC
- Implement an action plan each year in terms of risk management with health professionals
- Improve prevention and health promotion policies (cancer screening, etc.) in order to reduce health expenditure and thus safeguard the health insurance budget
Offer individual aid to insured persons and collective aid to associations as part of a health and social policy
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