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Les étudiants bénéficient de la réduction ou suppression de la participation dans les conditions prévues aux articles L. 160-13 et L. 160-14, sans qu'ils aient à justifier d'une interruption d'études.

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" } }, "LEGIARTI000006749544": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "R381-25", "ETAT": "TRANSFERE", "TYPE": "AUTONOME", "DATE_FIN": "2016-01-01", "DATE_DEBUT": "1985-12-21" } }, "META_COMMUN": { "ID": "LEGIARTI000006749544", "URL": "article/LEGI/ARTI/00/00/06/74/95/LEGIARTI000006749544.xml", "NATURE": "Article", "ORIGINE": "LEGI", "ANCIEN_ID": "SSAXXXXXXXX2X381R025XXAA" } }, "LIENS": { "LIEN": [ { "@id": "LEGIARTI000006767972", "@num": "5", "#text": "Décret n°48-2006 du 31 décembre 1948 - art. 5 (Ab)", "@sens": "source", "@cidtexte": "JORFTEXT000000496223", "@numtexte": "48-2006", "@typelien": "CONCORDANCE", "@naturetexte": "DECRET", "@datesignatexte": "1948-12-31" }, { "@id": "LEGIARTI000006767972", "@num": "5", "#text": "Décret n°48-2006 du 31 décembre 1948 - art. 5 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000000496223", "@numtexte": "48-2006", "@typelien": "CONCORDE", "@naturetexte": "DECRET", "@datesignatexte": "1948-12-31" }, { "@id": "JORFTEXT000000866621", "#text": "Décret 85-1353 1985-12-17 art. 1 JORF 21 décembre 1985", "@sens": "source", "@cidtexte": "JORFTEXT000000866621", "@numtexte": "85-1353", "@typelien": "CREATION", "@naturetexte": "DECRET", "@datesignatexte": "1985-12-17" }, { "@id": "JORFTEXT000000866621", "#text": "Décret n° 85-1353 du 17 décembre 1985", "@sens": "source", "@cidtexte": "JORFTEXT000000866621", "@numtexte": "85-1353", "@typelien": "CODIFICATION", "@naturetexte": "DECRET", "@datesignatexte": "1985-12-17" }, { "@id": "LEGIARTI000031795312", "@num": "6", "#text": "Décret n°2015-1865 du 30 décembre 2015 - art. 6", "@sens": "cible", "@cidtexte": "JORFTEXT000031740633", "@nortexte": "AFSS1528689D", "@numtexte": "2015-1865", "@typelien": "TRANSFERE", "@naturetexte": "DECRET", "@datesignatexte": "2015-12-30" }, { "@id": "LEGIARTI000006742479", "@num": "L322-2", "#text": "Code de la sécurité sociale. - art. L322-2", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006742482", "@num": "L322-3", "#text": "Code de la sécurité sociale. - art. L322-3", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000031828182", "@num": "R381-20", "#text": "Code de la sécurité sociale. - art. R381-20 (Ab)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CONCORDE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" } ] }, "CONTEXTE": { "TEXTE": { "TM": { "TM": { "TM": { "TM": { "TM": { "TITRE_TM": [ { "@id": "LEGISCTA000006173414", "@fin": "2019-01-01", "#text": "Section 3 : Etudiants.", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006156631", "@fin": "2999-01-01", "#text": "Chapitre 1er : Personnes rattachées au régime général pour certains risques ou charges", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006141871", "@fin": "2999-01-01", "#text": "Titre VIII : Dispositions relatives à diverses catégories de personnes rattachées au régime général - Dispositions d'application du livre 3", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006126956", "@fin": "2999-01-01", "#text": "Livre III : Dispositions relatives aux assurances sociales et à diverses catégories de personnes rattachées au régime général", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006106085", "@fin": "2999-01-01", "#text": "Partie réglementaire - Décrets en Conseil d'Etat", "@debut": "1961-01-12" } ] }, "@cid": "LEGITEXT000006073189", "@nature": "CODE", "TITRE_TXT": [ { "@fin": "2999-01-01", "#text": "Code de la sécurité sociale", "@debut": "1958-10-16", "@id_txt": "LEGITEXT000006073189", "@c_titre_court": "Code de la sécurité sociale." } ], "@date_publi": "2999-01-01", "@date_signature": "2999-01-01" } }, "VERSIONS": { "VERSION": [ { "@etat": "TRANSFERE", "LIEN_ART": { "@id": "LEGIARTI000006749544", "@fin": "2016-01-01", "@num": "R381-25", "@etat": "TRANSFERE", "@debut": "1985-12-21", "@origine": "LEGI" } } ] }, "BLOC_TEXTUEL": { "CONTENU": "
Les étudiants bénéficient de la réduction ou suppression de la participation dans les conditions prévues aux articles L. 322-2 et L. 322-3, sans qu'ils aient à justifier d'une interruption d'études.
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art. 1 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000044592184", "@nortexte": "SSAH2138157A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2021-12-27" }, { "@id": "LEGIARTI000045077175", "@num": "3", "#text": "Arrêté du 26 janvier 2022 - art. 3", "@sens": "cible", "@cidtexte": "JORFTEXT000045076515", "@nortexte": "SSAZ2202902A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2022-01-26" }, { "@id": "LEGIARTI000045759239", "@num": "1", "#text": "Arrêté du 5 mai 2022 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000045757677", "@nortexte": "SSAZ2213513A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2022-05-05" }, { "@id": "LEGIARTI000046037659", "@num": "1", "#text": "Arrêté du 11 juillet 2022 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000046037044", "@nortexte": "SPRZ2220484A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2022-07-11" }, { "@id": "LEGIARTI000047046510", "@num": "1", "#text": "Décret n°2022-1554 du 9 décembre 2022 - 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I.-La participation de l'assuré aux tarifs servant de base au calcul des prestations prévues aux 1°, 2° et 3° de l'article L. 160-8 peut être proportionnelle auxdits tarifs ou être fixée à une somme forfaitaire. Elle peut varier selon les catégories de prestations, les conditions dans lesquelles sont dispensés les soins, les conditions d'hébergement, la nature de l'établissement où les soins sont donnés. La participation de l'assuré peut être réduite en fonction de l'âge ou de la situation de famille du bénéficiaire des prestations.

La participation est fixée dans des limites et des conditions fixées par décret en Conseil d'Etat, par décision de l'Union nationale des caisses d'assurance maladie, après avis de l'Union nationale des organismes d'assurance maladie complémentaire. Le ministre chargé de la santé peut s'opposer à cette décision pour des motifs de santé publique. La décision du ministre est motivée. Le décret en Conseil d'Etat précise notamment le délai dont dispose l'Union nationale des caisses d'assurance maladie pour se prononcer et les conditions dans lesquelles le ministre chargé de la sécurité sociale se substitue à l'Union nationale des caisses d'assurance maladie en cas d'absence de décision de celle-ci, une fois ce délai expiré.

L'application aux spécialités pharmaceutiques mentionnées à l'article L. 162-17 des taux de participation mentionnés à l'alinéa précédent est déterminée par décision de l'Union nationale des caisses d'assurance maladie.

II.-L'assuré acquitte une participation forfaitaire pour chaque acte ou pour chaque consultation pris en charge par l'assurance maladie et réalisé par un médecin, en ville, dans un établissement ou un centre de santé, à l'exclusion des actes ou consultations réalisés au cours d'une hospitalisation. L'assuré acquitte également cette participation pour tout acte de biologie médicale. Cette participation se cumule avec celle mentionnée au I. Son montant est fixé, dans des limites et conditions prévues par décret en Conseil d'Etat, par l'Union nationale des caisses d'assurance maladie conformément à la procédure fixée au I.

Un décret fixe le nombre maximum de participations forfaitaires supportées par chaque bénéficiaire au titre d'une année civile.

Lorsque plusieurs actes ou consultations sont effectués par un même professionnel de santé au cours d'une même journée, le nombre de participations forfaitaires supportées par le bénéficiaire ne peut être supérieur à un maximum fixé par décret.

Un décret fixe les conditions dans lesquelles, lorsque l'assuré bénéficie de la dispense d'avance des frais, la participation forfaitaire peut être versée directement par l'assuré à la caisse d'assurance maladie ou être récupérée par elle auprès de l'assuré sur les prestations à venir. Il peut être dérogé aux dispositions de l'article L. 133-3.

III.-En sus de la participation mentionnée au premier alinéa du I, une franchise annuelle est laissée à la charge de l'assuré pour les frais relatifs à chaque prestation et produit de santé suivants, pris en charge par l'assurance maladie : 1° Médicaments mentionnés aux articles L. 5111-2, L. 5121-1 et L. 5126-4 du code de la santé publique, à l'exception de ceux délivrés au cours d'une hospitalisation ;

2° Actes effectués par un auxiliaire médical soit en ville, soit dans un établissement ou un centre de santé, à l'exclusion des actes pratiqués au cours d'une hospitalisation ;

3° Transports mentionnés au 2° de l'article L. 160-8 du présent code effectués en véhicule sanitaire terrestre ou en taxi, à l'exception des transports d'urgence.

Le montant de la franchise est forfaitaire. Il peut être distinct selon les produits ou prestations de santé mentionnés aux 1°, 2° et 3° du présent III. La franchise est due dans la limite globale d'un plafond annuel.

Lorsque plusieurs actes mentionnés au 2° sont effectués au cours d'une même journée sur le même patient, le montant total de la franchise supportée par l'intéressé ne peut être supérieur à un maximum. Il en est de même pour les transports mentionnés au 3°.

Lorsque le bénéficiaire des prestations et produits de santé mentionnés aux 1°, 2° et 3° bénéficie de la dispense d'avance de frais, les sommes dues au titre de la franchise peuvent être versées directement par l'assuré à l'organisme d'assurance maladie dont il relève ou peuvent être récupérées par ce dernier auprès de l'assuré sur les prestations de toute nature à venir. Il peut être dérogé à l'article L. 133-3.

Le Gouvernement présente chaque année au Parlement un rapport précisant les conditions dans lesquelles les montants correspondant à la franchise instituée par le présent III ont été utilisés.

Un décret fixe les modalités de mise en oeuvre du présent III.

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La participation de l'assuré mentionnée au premier alinéa de l'article L. 160-13 peut être limitée ou supprimée dans des conditions fixées par décret en Conseil d'Etat, pris après avis de l'Union nationale des caisses d'assurance maladie et de l'Union nationale des organismes d'assurance maladie complémentaire, dans les cas suivants :

1° Lorsque, à l'occasion d'une hospitalisation ou au cours d'une période de temps déterminée, la dépense demeurant à la charge de l'intéressé dépasse un certain montant ;

2° Lorsque l'état du bénéficiaire justifie la fourniture d'un appareil appartenant à une catégorie déterminée par ledit décret, pour les frais d'acquisition de l'appareil ;

3° Lorsque le bénéficiaire a été reconnu atteint d'une des affections, comportant un traitement prolongé et une thérapeutique particulièrement coûteuse, inscrites sur une liste établie par décret après avis de la Haute Autorité mentionnée à l'article L. 161-37 ;

4° Lorsque les deux conditions suivantes sont cumulativement remplies :

a) Le bénéficiaire est reconnu atteint par le service du contrôle médical soit d'une affection grave caractérisée ne figurant pas sur la liste mentionnée ci-dessus, soit de plusieurs affections entraînant un état pathologique invalidant ;

b) Cette ou ces affections nécessitent un traitement prolongé et une thérapeutique particulièrement coûteuse ;

5° Lorsque l'assuré est titulaire de l'allocation de solidarité aux personnes âgées au titre d'un avantage vieillesse ;

6° Lorsque le bénéficiaire est un enfant ou adolescent handicapé pour les frais couverts au titre du 2° de l'article L. 160-8 ;

7° Lorsque l'assuré est hébergé dans un établissement mentionné à l'article 3 de la loi n° 75-535 du 30 juin 1975 ou lorsqu'il bénéficie de soins dispensés par un centre mentionné à l'article L. 355-1-1 du code de la santé publique ;

8° Lorsque l'assuré est hébergé dans une unité ou un centre de long séjour mentionné à l'article L. 174-5 ou à l'article 52-1 de la loi n° 70-1318 du 31 décembre 1970 ;

9° Lorsque l'assuré bénéficie de soins paramédicaux dispensés dans le cadre d'une action médico-sociale de maintien à domicile par les institutions mentionnées au 1° de l'article 1er de la loi n° 75-535 du 30 juin 1975 ;

10° Lorsque l'assuré ne relève plus du 3° mais se trouve dans une situation clinique déterminée sur la base de recommandations de la Haute Autorité de santé et justifiant des actes et examens médicaux ou biologiques de suivi de son état, pour ces actes et examens, dans des conditions et pour une durée définies par décret pris après avis de la Haute Autorité de santé ;

11° Pour l'hospitalisation des nouveau-nés lorsqu'elle se produit pendant une période fixée par décret en Conseil d'Etat, ainsi que pour tous les soins qui leur sont dispensés en établissement de santé, jusqu'à un âge fixé par décret en Conseil d'Etat ;

12° Pour les investigations nécessaires au diagnostic de la stérilité et pour le traitement de celle-ci, y compris au moyen de l'insémination artificielle ;

13° Pour les titulaires d'une pension d'invalidité et les bénéficiaires des articles L. 341-15, L. 341-16 et L. 371-1 en ce qui concerne les frais engagés pour eux-mêmes ;

14° Pour les personnes mentionnées à l'article L. 161-1 rattachées aux bénéficiaires des dispositions de l'article L. 371-1 ;

15° Pour les soins consécutifs aux sévices subis par les mineurs victimes d'actes prévus et réprimés par les articles 222-23 à 222-32 et 227-22 à 227-27 du code pénal ;

16° Dans le cadre des programmes mentionnés au 5° de l'article L. 160-8, pour les frais d'examens de dépistage et les frais liés aux consultations de prévention destinées aux mineurs et à une unique consultation de prévention pour les personnes de plus de soixante-dix ans ;

17° Pour les frais relatifs à l'examen de prévention bucco-dentaire mentionné au 6° de l'article L. 160-8 ;

18° Pour les donneurs mentionnés à l'article L. 1211-2 du code de la santé publique, en ce qui concerne l'ensemble des frais engagés au titre du prélèvement d'éléments du corps humain et de la collecte de ces produits ;

19° Pour les frais de transport liés aux soins ou traitements dans les centres mentionnés au 3° du I de l'article L. 312-1 du code de l'action sociale et des familles et les centres médico-psycho pédagogiques autorisés dans des conditions fixées par voie réglementaire, après accord préalable de l'organisme qui sert les prestations, dans les conditions prévues au 2° de l'article L. 160-8 et à l'article L. 322-5 du présent code ;

20° Pour les frais liés à une interruption volontaire de grossesse mentionnée au 4° de l'article L. 160-8 ;

21° Pour l'assurée mineure d'au moins quinze ans, pour les frais d'acquisition de certains contraceptifs et pour les frais relatifs aux actes et consultations entrant dans le champ des articles L. 162-4-5 et L. 162-8-1 ;

22° Pour certains frais dus au titre des honoraires de dispensation des pharmaciens mentionnés au 7° de l'article L. 162-16-1 ;

23° Lorsque l'assuré ne relève ni du 3° ni du 10° mais se trouve dans une situation clinique nécessitant un dépistage spécifique du cancer du sein, fixée par décret en Conseil d'Etat, pour les frais d'examens de dépistage, dans des conditions fixées par ce même décret.

La liste mentionnée au 3° du présent article comporte également en annexe les critères médicaux utilisés pour la définition de l'affection et ouvrant droit à la limitation ou à la suppression de la participation de l'assuré.

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A modifié les dispositions suivantes :

- Code de la sécurité sociale.
\n Art. R381-32, Art. R381-21
\n

\n
\n
A abrogé les dispositions suivantes :

- Code de la sécurité sociale.
\n Art. R381-8, Art. R381-9, Art. R381-10, Art. R381-11, Art. R381-23, Art. R381-24, Art. R381-26, Art. R381-27, Art. R381-29, Art. R381-30, Art. R381-31\n
\n

\n
\n
A modifié les dispositions suivantes :

- Code de la sécurité sociale.
\n Art. R381-15, Art. R381-16, Art. R381-17, Art. R381-18\n
\n

\n
\n
A modifié les dispositions suivantes :

- Code de la sécurité sociale.
\n Art. R381-21, Art. R381-19\n
\n

\n
\n
A modifié les dispositions suivantes :

- Code de la sécurité sociale.
\n Art. R381-25, Art. R381-20, Art. R381-33, Art. R381-22, Art. R381-81, Art. R381-85, Art. R381-86, Art. R381-91, Art. R381-92, Art. R381-95-4, Art. R381-95-8, Art. R381-96\n
\n

\n
" } }, "LEGIARTI000031928827": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L160-13", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "2019-12-28", "DATE_DEBUT": "2016-01-28" } }, "META_COMMUN": { "ID": "LEGIARTI000031928827", "URL": "article/LEGI/ARTI/00/00/31/92/88/LEGIARTI000031928827.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "LIENS": { "LIEN": [ { "@id": "LEGIARTI000031687510", "@num": "9-1", "#text": "Loi n°89-1009 du 31 décembre 1989 - art. 9-1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000709057", "@nortexte": "SPSX8900080L", "@numtexte": "89-1009", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "1989-12-31" }, { "@id": "LEGIARTI000034405848", "@num": "69", "#text": "Décret n°90-1215 du 20 décembre 1990 - art. 69 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000717193", "@nortexte": "SPSS9001980D", "@numtexte": "90-1215", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "1990-12-20" }, { "@id": "LEGIARTI000044374888", "@num": "2", "#text": "Loi n° 91-1389 du 31 décembre 1991 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000355917", "@nortexte": "SPSX9100077L", "@numtexte": "91-1389", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "1991-12-31" }, { "@id": "LEGIARTI000048726086", "@num": "20-1", "#text": "Ordonnance n°96-1122 du 20 décembre 1996 - art. 20-1 (VD)", "@sens": "cible", "@cidtexte": "JORFTEXT000000368749", "@nortexte": "DOMX9600135R", "@numtexte": "96-1122", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "1996-12-20" }, { "@id": "LEGIARTI000043138095", "@num": "Annexe", "#text": "Arrêté du 20 octobre 2010 - art. 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Un décret fixe le nombre maximum de participations forfaitaires supportées par chaque bénéficiaire au titre d'une année civile.

Un décret fixe les conditions dans lesquelles, lorsque l'assuré bénéficie de la dispense d'avance des frais, la participation forfaitaire peut être payée directement par l'assuré à l'organisme d'assurance maladie, prélevée sur le compte bancaire de l'assuré après autorisation de ce dernier ou encore récupérée par l'organisme d'assurance maladie sur les prestations de toute nature à venir. Ce décret fixe également les modalités de recueil de l'autorisation de l'assuré de prélèvement sur son compte bancaire et de renoncement à cette autorisation. Il peut être dérogé aux dispositions de l'article L. 133-3.

1° Médicaments mentionnés aux articles L. 5111-2, L. 5121-1 et L. 5126-4 du code de la santé publique, à l'exception de ceux délivrés au cours d'une hospitalisation ;

2° Actes effectués par un auxiliaire médical soit en ville, soit dans un établissement ou un centre de santé, à l'exclusion des actes pratiqués au cours d'une hospitalisation ;

3° Transports mentionnés au 2° de l'article L. 160-8 du présent code effectués en véhicule sanitaire terrestre ou en taxi, à l'exception des transports d'urgence.

Lorsque le bénéficiaire des prestations et produits de santé mentionnés aux 1°, 2° et 3° bénéficie de la dispense d'avance de frais, les sommes dues au titre de la franchise peuvent être payées, prélevées ou récupérées selon les modalités prévues au dernier alinéa du II. Il peut être dérogé à l'article L. 133-3.

Un décret fixe les modalités de mise en œuvre du présent III.

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Article R381-20 AUTONOME ABROGE, en vigueur du 01/01/2016 au 01/01/2019 (Code de la sécurité sociale)