General information, not an individual diagnosis. Ask a healthcare professional if you are unsure about your situation.
Ameli’s health directory indicates, among other things, whether a doctor charges freely set fees or controlled extra fees through Optam. Find the label for the professional you selected.
A doctor practising in secteur 1 uses fees set by the Assurance Maladie agreement. Extra fees remain possible for certain specific patient requests, for example concerning appointment times.
A doctor practising in secteur 2 may set fees freely, with restraint and moderation. Assurance Maladie does not reimburse the extra-fee amount.
Optam means the doctor commits to moderating and stabilising fees. Assurance Maladie then uses the reimbursement basis applicable to secteur 1.
Your complementary insurer’s coverage depends on your contract. Ask about its extra-fee benefits; the Optam label alone cannot tell you what your coverage will be.
You have a right to information about fees. Before the consultation, ask the practice what applies to the intended appointment, then ask your complementary insurer about the corresponding benefits.
Sources
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