1. What are sectors 1, 2, 3?
In France, a medical convention links social security and doctors.
The objectives of this agreement:
- Setting the prices for medical services
- Define reimbursement level
The sector 1 approved doctor is a healthcare professional who has chosen to apply the rates set by the medical agreement. Indeed, the sector agreement 1 requires that fees not be exceeded.
The approved sector 2 doctor is not obliged to set his rates according to the basis for reimbursement by Social Security. We then speak of free fees. It will apply a rate that may be covered by your complementary health insurance, in whole or in part, if you have taken out mutual health insurance reimbursing excess fees.
Among the sector 2 doctors, some are OPTAM members, i.e. members of the controlled tariff practice option. In other words, if you consult a sector 2 approved doctor who is an OPTAM member, the latter undertakes to practice moderate overruns, and the basis for reimbursement by Social Security is therefore higher.
The sector 3 doctor is a non-contracted doctor. They practice totally free rates, with excess fees. Social Security reimbursement for their consultations is minimal.
