Signing up to our agreements

Adherence to our Agreements is a personal and voluntary process for the health professional who practices a medical or paramedical activity as a liberal profession. Only those based in Monaco or in the Alpes-Maritimes region can become contracted to our Agreements.

How to contract

The formalities are simple. Send the membership form to our fund, completed and signed and accompanied by the following items:

  • A photocopy of your qualification or professional card
  • If you work in the Principality, a photocopy of the certified copy of the Ministerial Decree of Authorisation
  • If you work in France, a copy of the pre-identified French treatment form
  • An original bank statement (+if the bank account is not in your own name, attach the Kbis extract [company registration document] bearing your surname and forename(s))

Select the form that corresponds to your situation
or the Agreement to which you wish to contract:
(Midwife or medical auxiliary => Ordre des Médecins de Monaco/Order of the Doctors of Monaco)

If you change your address or your business, you must inform the Health Professionals Relations Department.

What are the commitments made under the Agreement?

For reimbursing health expenses, the fund agrees to use a standard tariff as a calculation base.  This is generally three times higher than the tariff applied when treatment is performed by a non-contracted practitioner or medical auxiliary.

Health professionals agree to comply with:

  • the general principle of using the most cost-effective treatment,
  • the standard tariff provisions.
What fees can you charge?

In order to understand the tariff provisions of our Agreements, it is important to point out that our insureds are classified into three categories depending on their income and the composition of the family (application of a family quotient). The category and "form colour" code appears on the registration card issued to our active insureds annually or when they become affiliated as pensioners. For the accurate application of the tariff provisions, you must find out this colour category by asking our insureds to present their registration card.

All health professionals must use the colour indicated by the category on this registration card.

Maximum tariffs for the fees of Doctors, Dentists, Midwives and paramedical professions covered by the Agreement with the Ordre des Médecins:

  • Green category:
    • Dentists: the fees correspond to the standard tariff,
    • Doctors and paramedical professions under the same Agreement:
      • for treatment listed on the NGAP: the fees correspond to the standard tariff,
      • for treatment listed on the CCAM: a maximum co-efficient of 191% can be applied to the conventional French price (except OPTAM*).
    • Midwives:
      • for treatment listed on the NGAP: the fees correspond to the standard tariff,
      • for treatment listed on the CCAM: a maximum co-efficient of 151% can be applied to the conventional French price (except OPTAM*).
  •  Pink category:
    • Dentists: the standard tariff can be increased by a maximum of 20%,
    • Doctors and paramedical professions under the same Agreement:
      • for treatment listed on the NGAP: the standard tariff can be increased by a maximum of 20%,
      • for treatment listed on the CCAM: a maximum co-efficient of 236% can be applied to the conventional French price (except OPTAM*).
    • Midwives:
      • for treatment listed on the NGAP: the standard tariff can be increased by a maximum of 20%,
      • for treatment listed on the CCAM: a maximum co-efficient of 181% can be applied to the conventional French price (except OPTAM*).

(*) The conventional French reference rate through CCAM is that applicable by doctors in sectors 2 or 1 DP apart from OPTAM contracts in your specialty.

Maximum tariffs for the fees of Nurses, Physiotherapists and Speech Therapists:

  • Green category: the fees correspond to the standard tariff,
  • Pink category: the maximum fee tariffs are set at 110% of the basic standard tariff
  • Buff category: the maximum fee tariffs are set at 130% of the basic standard tariff.
How to dissolve the contractual relationship

Since membership of our Agreements is a voluntary process, the health professional can terminate it at any time.

In the event of a breach in their obligations, the health professional can be temporarily or permanently removed from the Agreement by a Commission, the composition of which is set out by each of the Agreements.