Caisse Primaire d’Assurance Maladie, the Health Support Mission goes out to meet people who have given up on healthcare

the essential
With the Health Support Mission, Health Insurance offers personalized support to enable you to access your rights and your care, and to guide you through the health journey.

D ince the implementation in the Tarn of the Health Support Mission in 2017, 5,302 waivers of treatment have been declared by the insured. Currently, 304 people are supported in the context of difficulties in accessing rights, renunciation, difficulties in accessing care or fragility in the face of digital technology. Emilio Quesada, acting director of the Caisse Primaire d’Assurance Maladie (CPAM) of the Tarn, specifies the profile of these people who have given up care: “25% are people who do not have complementary health insurance, the exCMU, i.e. who do not benefit from any mutual insurance or additional assistance. They therefore have a financial difficulty in accessing healthcare. 47% are people who live alone. Among them, many retirees, but also 24% of people who have children, and 3% of these children are not treated, while the care of the child is total until the age of 16”. Various reasons explain this renunciation of care. Some do not know the steps to take and do not know who to contact, others do not dare to call on a public institution, still others find it difficult to obtain an appointment with a professional. health. To this must be added those who have difficulty with transportation or access to online procedures. “Most often this renunciation relates to dental care, but also orthopedic, and to acts of specialists” indicates Emilio Quesada.

Find the solutions:

As part of the CPAM du Tarn Health Support Mission, advisers speak directly to policyholders so that they become actors in their health journey. They call them directly, then, once contacted, find the solutions to enable them to get real treatment. “We have a process of approaching these people, with dedicated staff, also relying on the territorial network of reception in the department as well as the Espaces France Services. But we also have agreements with relay partners which allow us to detect these people and set up a health course, in consultation with the insured and as quickly as possible”. The Health Support Mission has signed agreements with the UDAF, Emmaüs, the Association of the Paralyzed of France (APF), the Restos du Cœur which meets people in difficult social and personal situations.

Prevention and health checks:

It also directs policyholders towards preventive actions, health check-ups (in the centers of Albi and Castres) and offers a complete check-up on the state of health of the policyholder (concerning in particular teeth and eyes). The Health Support Mission offers a 100% dematerialized offer, but also a “100% attentive” offer. The “proximity offer” advisors travel to the insured’s home to sort out, for example, files that pose problems. “This is the illustration of our approach: “going towards”, concludes Emilio Quesada. The advisers of the Health Support Mission find the solution, by establishing a relationship of trust with the insured”.

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