Emergency patient package: amount, reimbursement, for whom?

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Emergency patient package amount reimbursement for whom

Since January 1, 2022, the organization of emergency care costs has changed. A single flat rate is set up for care not followed by hospitalization. This “emergency patient package” (FPU) is provided for by the Social Security financing law (LFSS). What is the amount ? Who is concerned ? Exempt? How to get reimbursed?

Definition: What is the emergency patient package?

The emergency patient package (FPU) is the single invoice, what must be paid by each person who goes to the emergency room for unscheduled care and without being hospitalized since January 1, 2022. It corresponds to the patient’s contribution to the costs associated with his visit to the emergency room. The FPU is set at € 19.61 regardless of the care received. It replaces the old costs which were reimbursed up to 80% by Social Security (the remaining 20%, the “co-payment”, were paid by the complementary health or paid for by the patient). The FPU simplifies billing, caps the cost of going to the emergency room and makes the amount payable on entry to the hospital legible.

Where can I find the decree?

The emergency patient package (FPU) depends on thedecree of September 17, 2021 to be found in article L.160-13 of the Social Security code on legifrance.gouv.fr.

Since January 1, 2022, each time you go to the emergency room without hospitalization and regardless of the treatment provided, the person must pay an emergency patient package in the amount of 19.61 euros. Patients are informed of the cost of their passage as soon as they leave the emergency room and the sum is payable upon receipt of the invoice. If the health facility allows it, it is possible to pay the amount of the FPU directly when going to the emergency room.

Who is concerned ? Is not concerned?

The FPU concerns patients who go to the emergency room for unscheduled care and who are not hospitalized. For some people, the FPU is reduced and its amount increases to € 8.49. The patients concerned are:

  • People with long-term illness (ALD)
  • Beneficiaries of benefits following a work accident or illness; professional with a disability of less than two-thirds.

In some cases, patients are exempt from FPU regulations :

  • women pregnant beneficiaries of maternity insurance;
  • beneficiaries of a disability pension ;
  • beneficiaries of benefits following an industrial accident or occupational disease ;
  • having a inability at least equal to two thirds;
  • insured minors victims of sexual violence ;
  • newborns less than a month;
  • donors organ;
  • holders of a military invalidity pension ;
  • victims ofacts of terrorism ;
  • beneficiaries ofstate medical aid (SOUL);
  • people imprisoned.

The emergency patient package is fully refunded by mutual health insurance, complementary health insurance or state medical aid. “For people who do not benefit from a supplement – i.e. around 4% of the population – the introduction of the emergency patient package de facto protects them from out-of-pocket expenses exceeding € 19.61, which could be the case. with the old calculation method“, according to the press release from the Ministry of Health.

Sources:

“Going to the emergency room: all you need to know about the new package to be paid for”, ameli.fr, January 6, 2022.

“Emergency patient package: a single, more readable and fairer rate from January 1, 2022”, Ministry of Health, December 31, 2021.

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