“You have a free choice”: general practitioner or specialist, how can you change your treating physician ?

Comment changer de médecin traitant ?

Il peut être généraliste ou spécialiste… dans tous les cas, "vous avez le libre choix de votre médecin traitant", emphasizes Health Insurance. Which means that you can change it. How to do it ?

The treating physician system was established by law in 2004, as part of what is called the coordinated care pathway. It therefore consists of choosing a doctor who will thus be "entrusted with the coordination of care for your medical follow-up", explains Health Insurance. On the form, "the appointment of a treating physician is not mandatory. It results from a voluntary approach by the insured person who must request the formal agreement of the practitioner he has chosen to designate to the Health Insurance as such“, recalls the Court of Auditors.

Penalties…

However, if you do not follow this care pathway, you will be reimbursed less well. Illustration on the ameli.fr website: "for a consultation with a general practitioner approved by sector 1, at a rate of 26.50 euros: if you do not have a registered treating physician, health insurance will only reimburse you 30% of the consultation fee, less 2 euros as a flat-rate contribution, i.e. a reimbursement of 5.95 euros (compared to 16.55 euros otherwise)".

How to declare ?

In practice, the declaration of choice of treating physician can be made during a consultation at the office and upon presentation of your Vitale card. The doctor thus makes the declaration online, before sending it to your primary health insurance fund (CPAM).

Changing without justifying yourself

The law of course provides for the possibility of changing treating physician. And this, very easily moreover, without needing to justify yourself. Concretely, you can thus do it directly in the office, with your new treating physician. Or after the latter's agreement of course, by sending a new declaration to your CPAM in order to proceed with the change. This is precisely the form S3704 Declaration of choice of treating physician.

Finally, note that if your treating physician works in a group practice, in the absence of the healthcare professional, you can consult another physician in the practice in question, "without penalty on the amount of your reimbursements", specifies the Health Insurance. "Colleagues have the possibility of billing as a replacement, indicating ‘treated physician replaced’ on the care sheet“, she completes.