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Les 10°, 11° et 12° de l'article L. 160-14 s'appliquent, sauf dispositions plus favorables, aux personnes qui relèvent du régime institué par le présent chapitre.

" } }, "LEGIARTI000031676036": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L160-14", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "2018-01-01", "DATE_DEBUT": "2016-01-01" } }, "META_COMMUN": { "ID": "LEGIARTI000031676036", "URL": "article/LEGI/ARTI/00/00/31/67/60/LEGIARTI000031676036.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "LIENS": { "LIEN": [ { "@id": "JORFTEXT000000699217", "#text": "Loi n° 75-535 du 30 juin 1975 (V)", "@sens": "source", "@cidtexte": "JORFTEXT000000699217", "@numtexte": "75-535", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "1975-06-30" }, { "@id": "LEGIARTI000031687551", "@num": "9-5", "#text": "Ordonnance n°77-1102 du 26 septembre 1977 - art. 9-5 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000699946", "@numtexte": "77-1102", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "1977-09-26" }, { "@id": "LEGIARTI000037950482", "@num": "20-2", "#text": "Ordonnance n° 96-1122 du 20 décembre 1996 - art. 20-2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000368749", "@nortexte": "DOMX9600135R", "@numtexte": "96-1122", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "1996-12-20" }, { "@id": "LEGIARTI000044404972", "@num": "20-7", "#text": "Ordonnance n° 96-1122 du 20 décembre 1996 - art. 20-7 (VD)", "@sens": "cible", "@cidtexte": "JORFTEXT000000368749", "@nortexte": "DOMX9600135R", "@numtexte": "96-1122", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "1996-12-20" }, { "@id": "LEGIARTI000048874948", "@num": "14", "#text": "Décret n°2004-942 du 3 septembre 2004 - art. 14 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000253592", "@nortexte": "SANS0422327D", "@numtexte": "2004-942", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2004-09-03" }, { "@id": "LEGIARTI000047012877", "@num": "19", "#text": "Décret n°2004-942 du 3 septembre 2004 - art. 19 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000253592", "@nortexte": "SANS0422327D", "@numtexte": "2004-942", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2004-09-03" }, { "@id": "LEGIARTI000047012832", "@num": "29-3", "#text": "Décret n°2004-942 du 3 septembre 2004 - art. 29-3 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000253592", "@nortexte": "SANS0422327D", "@numtexte": "2004-942", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2004-09-03" }, { "@id": "LEGIARTI000046914409", "@num": "29-4", "#text": "Décret n°2004-942 du 3 septembre 2004 - art. 29-4 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000253592", "@nortexte": "SANS0422327D", "@numtexte": "2004-942", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2004-09-03" }, { "@id": "LEGIARTI000031666218", "@num": "59", "#text": "LOI n°2015-1702 du 21 décembre 2015 - art. 59", "@sens": "cible", "@cidtexte": "JORFTEXT000031663208", "@nortexte": "FCPX1523191L", "@numtexte": "2015-1702", "@typelien": "CREE", "@naturetexte": "LOI", "@datesignatexte": "2015-12-21" }, { "@id": "LEGIARTI000031666024", "@num": "64", "#text": "LOI n°2015-1702 du 21 décembre 2015 - art. 64", "@sens": "cible", "@cidtexte": "JORFTEXT000031663208", "@nortexte": "FCPX1523191L", "@numtexte": "2015-1702", "@typelien": "MODIFIE", "@naturetexte": "LOI", "@datesignatexte": "2015-12-21" }, { "@id": "LEGIARTI000031666058", "@num": "65", "#text": "LOI n°2015-1702 du 21 décembre 2015 - art. 65", "@sens": "cible", "@cidtexte": "JORFTEXT000031663208", "@nortexte": "FCPX1523191L", "@numtexte": "2015-1702", "@typelien": "MODIFIE", "@naturetexte": "LOI", "@datesignatexte": "2015-12-21" }, { "@id": "LEGIARTI000031916248", "@num": "83", "#text": "LOI n°2016-41 du 26 janvier 2016 - art. 83", "@sens": "cible", "@cidtexte": "JORFTEXT000031912641", "@nortexte": "AFSX1418355L", "@numtexte": "2016-41", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2016-01-26" }, { "@id": "LEGIARTI000034366232", "@num": "2", "#text": "Décret n°2017-472 du 3 avril 2017 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000034365680", "@nortexte": "AFSS1637751D", "@numtexte": "2017-472", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2017-04-03" }, { "@id": "LEGIARTI000034366234", "@num": "3", "#text": "Décret n°2017-472 du 3 avril 2017 - art. 3 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000034365680", "@nortexte": "AFSS1637751D", "@numtexte": "2017-472", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2017-04-03" }, { "@id": "LEGIARTI000037341750", "@num": "16", "#text": "Arrêté du 20 août 2018 - art. 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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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Article L713-4 AUTONOME ABROGE, en vigueur du 15/07/2018 au 01/09/2023 (Code de la sécurité sociale)