2023-04-21 14:53:17
«A significant deterioration in access to state medical aid (AME) through an accumulation of administrative obstacles and a lack of information making it very difficult to access the branches of the Primary Health Insurance Fund. » This is what several associations denounce, including Cimade, Secours Catholique and Médecins du Monde, in conclusion of a survey published Thursday, April 20, conducted via a questionnaire with 258 people, a telephone test and a collection of information in line. This deterioration would be linked in particular to the 2019 AME reform.
Since this reform, applicants must prove that they have been present in an irregular situation for a minimum of three months on the territory and go physically to one of the centers approved for the AME to file their file providing the documents related to their identity and administrative status.
According to the Premiers Pas survey carried out by the Institute for Research and Documentation in Health Economics (Irdes) in 2019, only 51% of people eligible for AME actually benefit from this device, even when they declare that they suffer from diseases requiring care. The survey carried out by the associations thus shows step by step how the application process is strewn with pitfalls.
Hard-to-find agencies
The associations express their concern about a “screaming lack of information” on the agencies responsible for receiving AME applications. For example, they deplore the frequent changes of information on the places where applications can be submitted, as well as the closure of certain counters in a context of the dematerialization of public services.
“The first difficulty for an AME applicant is knowing where to file their application. The addresses of the counters are not necessarily available on the Internet, and the incessant reorganization of the reception of applicants and the differences between departments make it difficult to obtain information, the information can quickly prove to be obsolete., explains Céline Gabarro, sociologist specializing in access to care for people in precarious situations.
Concretely, to be directed to the right counter, the applicant must therefore first go to a Health Insurance counter, or else be accompanied by an association.
Too long delays in filing your application
Of the eight CPAM (Primary Health Insurance Fund) in Île-de-France, five require an appointment to be made in order to file an AME application, by Internet or by telephone. Gold, «it is common to wait between twenty and forty-five minutes depending on the department for a call to be picked up”, find the associations. For the CPAMs of Seine-Saint-Denis and Val-de-Marne, more than one in three calls were unsuccessful during the testing carried out for the survey. Also, some applicants cannot read and speak French, or do not have access to the Internet, and may therefore be helpless in the face of this process.
The deadlines for obtaining appointments are also too long for the associations: on average between ten and twenty-four days, according to their tests. ” A person concerned by the AME must not only make an appointment, but also suffer waiting times to simply submit their file”, they regret.
More than half of applications refused
Out of 60 file submission requests, less than half were successful (45%). Two reasons justify these refusals: firstly an incomplete file, often linked to the difficulty of obtaining precise information. But also, almost one in five people were refused entry to the agency by a security guard, because delays of more than ten minutes are not allowed.
Finally, having submitted your file does not guarantee that you will be able to recover your AME card, «the main reason being the lack of mention of the obligation to make an appointment on the mail announcing that the card was ready”.
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