Question 6960 — maternity health insurance

Summary

Mr. Guillaume Florquin draws the attention of the Minister of Labor, Health, Solidarity and Families to the restrictive conditions for reimbursement of occupational therapy sessions, particularly outside the institutional framework. Occupational therapy plays a fundamental role in the autonomy of people with disabilities, chronic illnesses or age-related loss of autonomy. However, to date, social security does not reimburse 100% occupational therapy sessions only when prescribed by a doctor and carried out in medical or medico-social structures such as a hospital, a rehabilitation center or an EHPAD. Sessions carried out in a private practice, although essential for many patients, are not covered, except for exceptional one-off assistance on file. This limitation creates inequality of access to care, particularly for people who cannot benefit from an institutional pathway: children with neurodevelopmental disorders, elderly people living at home, or patients with serious pathologies requiring regular and personalized monitoring. The average cost of a session, around 50 euros, represents a real financial obstacle and mutual insurance companies, which sometimes cover these costs, do so very unevenly. He would therefore like to know if the Government plans to revise the reimbursement criteria for occupational therapy, in particular by extending social security coverage to sessions carried out in private practice, when they are prescribed and medically justified, in order to guarantee better access to this essential care for the autonomy and quality of life of many French people.

Machine translation from French. The official text remains authoritative.

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