Vocabulary of health insurance to be known

Definition of convention tariff

This is the rate set by the Social Security to calculate the reimbursement of the fees and care provided by practitioners and medical auxiliaries subject to a national convention.

For example, consultation with a general practitioner who complies with the convention rate (sector 1) costs 22 €.Social Security pays 70% of this tariff, ie 14.40 €.

Definition of authority tariff

Some doctors have not signed an agreement with the Social Security (sector 3) and practice a free fee. The Social Security calculates its reimbursement on the basis of a very symbolic tariff: it is the tariff of authority .

For example, for a consultation with a general practitioner (sector 3) in Paris, the tariff of authority is 0.61 €.

Definition of user fee

The co-payment represents the difference between 100% of the convention rate and the rate applied by the Social Security on this tariff . This amount may be refunded in full or in part by your health insurance.

For example, consultation with a general practitioner who complies with the convention rate (sector 1) costs 22 €.Social Security pays 70% of this tariff, ie 14.40 €. The user fee is therefore € 7,60.

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