I have been registered with CPAM for more than a year now and haven't used the doctor much, but when I have I'm very confused about how much I can expect to be reimbursed or how I can even know.
Most resources I see, for example, claim that most doctor visits are covered "about" 70%. But for my last consultation I paid 25€ up front, and was reimbursed 14€ (less than 60%). I also saw a specialist for some imaging and paid 72€ out of pocket. I was then reimbursed 38.69€ which is only 54%.
Update: So I found my account statement on the ameli.fr site, and for the imaging it broke things down like:
Montant payé: €72.00 Base de remboursement: €56.70 Taux: 70% Participation forfaitaire: (€1.00)
So they reimbursed me 70% of 56.70, and also deducted a 1 euro "participation forfaitaire". How would I know what the "base de remboursement" is as opposed to the amount I actually paid up front? What's the "participation forfaitaire"?
I ask in particular because I'm shopping around for mutuelle, but I don't even understand my existing coverage.