Health insurance supports chronic pathologies


People with asthma or diabetes can benefit from the free program called sophia. An effective follow-up that helps them on a daily basis.

More than 3.5 million French people are affected by diabetes and more than 4 million suffer from asthma. These two pathologies are constantly increasing. To help people insured with these chronic illnesses to take care of their health, Health Insurance has set up sophia, a free remote support service. Offered in 2008 to people with diabetes in mainland France and overseas, it was extended in 2018 to asthmatics.

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1) Its role

Sophia is a personalized support and advice information service. He intervenes in relay of the consultations of the attending physician to help you put his recommendations into practice and adapt your lifestyle (physical activity, smoking, diet, etc.) in order to reduce the risk of complications. It allows patients to better understand their disease and their therapy. Sophia promotes compliance with treatments and reminds you of your follow-up examinations, such as fundus examination, lipid and renal assessment or electrocardiogram. It particularly contributes to maintaining the long-term motivation of diabetic patients.

To know

Of all the existing chronic diseases, Sophia focuses on diabetes and asthma due to the high number of patients in France. And above all, because a good follow-up of the course of care and its control are crucial to avoid sometimes severe complications.

2) Eligibility

Sophia is intended for adults with type 1 or 2 diabetes, followed by a general practitioner and covered 100% by the general health insurance scheme under a long-term condition (ALD) . To be eligible, you must have at least three prescriptions per year for diabetes medication. These conditions are cumulative. For asthma, you must be between 18 and 44 years old, be followed by a attending physician, benefit from at least two reimbursements for asthma medications in the year and one reimbursement the previous year, and be attached to the plan. general.

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It is, in principle, the Health Insurance which directly contacts, by mail, the persons concerned to invite them to register. In practice, registration can be done online – possible again, since April 2022, after a temporary interruption – or by post by returning the completed form in the attached stamped envelope. Registration is free and without obligation. Each member is free to leave the sophia system at any time, on simple request.

To know

Registration for the sophia service has no impact on the level of reimbursement for your care. Sophia is covered by medical secrecy. Your data is confidential and is not transmitted to any organization.

3) Monitoring

The sophia service offers remote support: dispatch of newspapers, brochures, newsletters, telephone support, etc. Diabetic members thus receive four Sophia newsletters each year containing health information (recommended examinations, advice on taking care of their feet or teeth…), testimonials, recommendations on physical activities and nutrition, etc. They also receive “benchmark booklets” on a theme (prevention of cardiovascular diseases, glycated hemoglobin, fats in the diet, kidney complications of diabetes, etc.). Asthmatic members receive three information brochures, for example on the different types of asthma, breath measurement, etc. and eight newsletters containing health information, testimonials and news.

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On the other hand, after an initial call from a health nurse-advisor to discuss your illness with you, you may be offered regular telephone follow-up, in particular to help you implement your doctor’s recommendations. You can also contact sophia’s nurses directly to discuss the issues that concern you. They can be contacted Monday to Friday from 9 a.m. to 7 p.m., and on Saturday morning until 1 p.m. on 0 809 400 040 (free service + call charge). Teams are at your disposal on 0 809 109 974 (free service + call price) if you live in Réunion, and on 0 809 100 097 (free service + call price) if you live in Guadeloupe, Martinique or Guyana.

To know

To strengthen the patient’s motivation between two consultations, the attending physician can ask the sophia service to call his patient member on a specific topic: smoking cessation, medication compliance, follow-up of examinations, physical activity, etc.

4) An online space

This summer, the sophia service will open a new member area, accessible 24 hours a day, 7 days a week. This personal and secure account will consist of a kind of online coaching, adapted to your needs to help you change your habits (monitor treatment, diet, physical activity, quitting smoking). It is also a real logbook. You can enter and follow your health data (medical tests, blood pressure, weight, etc.), but also request notifications to remind you of your medical appointments. An integrated message system allows you to question nurse advisers in writing.

To know

According to a satisfaction survey carried out by the A+A Institute for Health Insurance, most members feel more at ease talking to their general practitioner since they have benefited from sophia. The same goes for general practitioners who believe that the understanding of their advice has improved and that their patients, members of sophia, are more comfortable asking them questions related to their diabetes or talking difficulties encountered.

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