Covid-19 : l’aide de l’Assurance Maladie aux professions libérales de santé

Via leur compte amelipro, les professions libérales de santé touchées par les effets économiques du Covid-19 peuvent demander à bénéficier de l’aide mise en place par l’Assurance Maladie.

Dans le cadre de l’épidémie de Covid-19, de nombreux professionnels de santé ont connus une baisse importante de leur activité. Le Gouvernement a mis en place un dispositif d’accompagnement exceptionnel à destination des professionnels de santé libéraux.

1 – Le principe général de l’aide Covid de l’Assurance Maladie pour les professions libérales de santé

L’Ordonnance n°2020-505 du 2 mai 2020 instituant une aide aux acteurs de santé conventionnés dont l’activité est particulièrement affectée par l’épidémie de covid-19 précise les conditions de cette aide.

Ce dispositif d’indemnisation s’adapte au caractère libéral des professions de santé. Il ne vise pas un objectif de garantie de revenu, à l’instar d’une logique propre aux salariés. Il doit permettre en revanche de garantir à chaque professionnel de santé la capacité à faire face à leurs charges fixes professionnelles, et ainsi leur permettre de reprendre leur activité, au terme de la crise.

2- Les professions libérales concernées par l’aide Covid de l’Assurance Maladie

L’Ordonnance précise :  » Peuvent bénéficier, sur leur demande, de cette aide les professionnels de santé, les centres de santé et les prestataires exerçant leur activité dans le cadre des conventions nationales prévues aux articles L. 162-5, L. 162-9, L. 162-12-2, L. 162-12-9, L. 162-14, L. 162-16-1, L. 162-32-1, L. 165-6 et L. 322-5-2 du code de la sécurité sociale et dont les revenus d’activité sont financés pour une part majoritaire par l’assurance maladie. Les dispositions de la présente ordonnance ne sont pas applicables aux professions mentionnées à l’alinéa précédent ayant conclu avec l’assurance maladie un accord ayant des effets équivalents à ceux de l’aide prévue au premier alinéa. »

Il s’agit donc des professions suivantes :
– médecins,
– infirmiers,
– masseurs-kinésithérapeutes,
– sages-femmes,
– orthoptistes,
– orthophonistes,
– dentistes,
– pharmaciens

Par ailleurs, sont exclus de cette aide, les pédicures-podologues, les opticiens et les audioprothésistes dans la mesure où ils sont financés à moins de 50 % par l’Assurance Maladie.

3- Calcul de l’aide

L’aide tient compte du niveau moyen des charges fixes de la profession, en fonction, le cas échéant, de la spécialité médicale et des conditions d’exercice et du niveau de la baisse des revenus d’activité du demandeur financés par l’assurance maladie.

Il est également tenu compte :
– des indemnités journalières versées au demandeur par les régimes de sécurité sociale depuis le 12 mars 2020 ;
– des allocations d’activité partielle perçues depuis la même date pour ses salariés en application des dispositions de l’article L. 5122-1 du code du travail ;
– des aides versées par le fonds de solidarité prévu par l’ordonnance du 25 mars 2020 susvisée.

L’aide est versée sous forme d’acomptes. La Caisse nationale de l’assurance maladie arrête le montant définitif de l’aide au vu de la baisse des revenus d’activité effectivement subie par le demandeur et procède, s’il y a lieu, au versement du solde ou à la récupération du trop-perçu selon la procédure prévue à l’article L. 133-4 du code de la sécurité sociale au plus tard le 1er juillet 2021.

4- Demande de l’aide

À compter du 30 avril 2020, les professionnels de santé ont accès à un télé-service dédié à cette démarche via leur compte amelipro.

Ce service permet à la fois d’effectuer une simulation du montant théorique de l’aide à laquelle ils peuvent bénéficier et demander un acompte sur la base de l’estimation réalisée.

Il est possible de demander un acompte pouvant aller jusqu’à 80 % maximum de l’aide.

La Caisse nationale de l’assurance maladie arrêtera le montant définitif de l’aide au vu de la baisse des revenus d’activité effectivement subie par le demandeur et procède, s’il y a lieu, au versement du solde ou à la récupération du trop-perçu.

Lire le communiqué de presse de l’Assurance Maladie (s’ouvre dans un nouvel onglet) »>> Lire le communiqué de presse de l’Assurance Maladie

> Toutes les actualités Covid-19 ici

Image par Darko Stojanovic de Pixabay

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