Are chronic long-term illnesses (ALD) subject to the annual ceiling?

No, treatments and medications for recognized long-term chronic conditions (ALD) are covered at 100% and completely exempt from the annual cap.

What is the standard refund percentage for doctor visits?

CNAM reimburses 80% of the statutory conventional medical fee for general practitioner and specialist doctor consultations.

TunisiaUpdated for 2026Health

Tunisia CNAM Healthcare Reimbursement & Ceiling Calculator 2026

Calculate annual family medical reimbursement ceiling and out-of-pocket health refunds from CNAM in Tunisia.

Health & Wellness Medical & Clinical Social Security & Pension

Calculated Result

Actual CNAM Refund Due

487.5TND

Calculator Inputs

Spouse Covered under Insured

Number of Dependent Children

Quick select:

Total Medical Invoices Filed

TND

Quick select:

Actual CNAM Refund Due

487.5TND

Total Annual Family Ceiling

550 TND

Out-of-Pocket Expense

162.5 TND

Reimbursement Distribution

Reimbursed by CNAM

487.5 TND(75%)

Uncovered Balance

162.5 TND(25%)

Reimbursements and annual financial ceilings are governed by Tunisian Law 2004-71 and regulatory conventions with the CNAM health fund.

This calculator is a mathematical model for fitness and nutrition estimation for general awareness only. Estimated results do not constitute medical diagnosis or a substitute for professional healthcare. Always consult a physician or certified nutritionist before starting any new diet or training regimen.

Official Statute: القانون التونسي عدد 71 لسنة 2004 المتعلق بنظام التأمين على المرض وقرارات الصندوق الوطني للتأمين على المرض (CNAM)Last Verified: 2026-09-06

Calculation Methodology

Annual Ceiling = 300 TND (Insured) + 100 TND (Spouse) + 75 TND per dependent child. Consultations reimbursed at 80% of convention rates.

Frequently Asked Questions

The annual ceiling is 300 TND for the primary insured member, plus 100 TND for a covered spouse, and 75 TND for each dependent child.

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Tunisia

Tunisia CNAM Healthcare Reimbursement & Ceiling Calculator 2026

Calculator Inputs

Reimbursement Distribution

Calculation Methodology

Frequently Asked Questions

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