Personal Insurance

Complementary Health Insurance

Health Insurance benefits

The purpose of the Health Insurance is to reduce the expenses of health benefits of the French by reimbursing all or part. What may remain at your expense is thus covered by complementary health insurance.

What Health Insurance covers:

Health Insurance covers part of the health service expenses of its policyholders, on the basis of a reference rate that it defines.

The reimbursed portion of this reference rate depends on the type of expense and compliance with certain rules (following the coordinated care pathway, having a prescription, using your Vitale card, etc.).

For example, medicines with a blue sticker are reimbursed at 30% and medical consultations at 70% of the conventional rate.

What Health Insurance does not cover

Certain health service costs are not covered by Health Insurance.

It is :

  • Certain so-called comfort services: private room, accompanying costs, pedicures, etc.;
  • Certain services relating to unrecognized medical practices and in particular what is commonly called alternative medicine: osteopathy, chiropractic, etc.

A certain number of deductibles or limits are also applied to reimbursements:

  • The medical deductible:
    • it is an amount of € 0.50 to € 2 deducted from reimbursements made by the Health Insurance for drugs, paramedical acts and medical transport;
  • User fees:
    • it is the part of the expenses (on medical expenses and reimbursable care) which remain at your expense after reimbursement of the Health Insurance;
  • Fee overruns:
    • they are authorized for doctors working in sector 2, justified by the technical nature of the act, the time spent, the service provided to the patient but also the reputation of the practitioner and the patient's income;
  • The flat-rate contribution of 1 euro:
    • it applies to consultations and medical acts performed by a doctor, to radiological examinations and to biological analyzes, for any insured person over 18 years of age;
  • The hospital package:
    • it is your financial contribution to accommodation costs for a stay of more than 24 hours in a hospital;
  • The 18 euros package:
    • it replaces the co-payment for acts whose price is greater than or equal to € 120, or having a coefficient greater than or equal to 60. se substitue au ticket 

How to choose your mutual?

What is supplementary health insurance used for?

How to choose the right formula?

We help you see clearly and choose the level of health benefits that meet your needs.

Complementary health insurance, what for?

Have you paid for a doctor's visit, hospitalization, medication? You have surely noticed that Social Security does not reimburse you for 100% of your health expenses.

In the event of hospitalization, for example, the compulsory plan covers 80% of the costs, but the remaining 20% to be paid can represent a significant sum. Optical and dental care, which is often very expensive, is hardly reimbursed. Certain treatments such as acupuncture and osteopathy are not covered by Social Security.

In the end, these supplements can be very heavy on your budget.

Your complementary health insurance supplements the reimbursement of Social Security. Depending on the formula chosen, it also helps you pay for unsupported services, such as excess fees, vaccines, alternative medicine, etc.


How to choose your complementary health insurance?

Assess your needs:

they vary according to your age, your family composition, your compulsory diet, your budget ...

Refine your expectations,

depending on your personal situation: do I need glasses or dental care? Do I have a lot of pharmacy expenses? Am I at risk of being hospitalized?

List the additional services required:

Is third-party payment important?

Do I need health information and advice?

In the event of hospitalization, will I need home help?

All you have to do is choose the guarantee that suits your needs.

Feel free to contact us if any further information is needed

How and when to cancel your mutual health insurance?

Before subscribing to a new complementary health insurance, it is important to terminate your previous contract.

Find out how and when to terminate your mutual health insurance.

How to terminate your mutual health insurance?

A request must be sent to the insurer in accordance with 2 conditions. This termination request must be:

  • Sent by registered mail, with acknowledgment of receipt
  • Done within the deadlines indicated in the general conditions of the contract: notice of 2 months before the fixed expiry date, in most cases, on December 31, otherwise it will be the anniversary date of the contract.

We can take care of all your formalities with your former complementary health insurance to facilitate your membership.


When can you cancel your mutual health insurance?

It is possible to terminate your complementary health insurance contract:

  • At the end of the contract, even if you have allowed the 2 months notice to pass, under the Châtel law
  • Following a subscription to the mandatory contract offered by his company
  • Remember to check your contract before proceeding.

Termination of mutual insurance: what does the Châtel law allow?

Insurers and mutuals are required to inform their members about the possibility of not renewing their tacitly renewable health contract.

This information, included in the due date notice, must be sent sufficiently early: at least 15 days before the termination date.

If you are informed late, you have a further 20 days from the date of receipt of the letter to terminate the renewal of your mutual insurance contract.

If you have not received anything by the contract expiry date, it can be terminated at any time without penalty.

Only "non-life" individual insurance contracts with tacit renewal, insuring individuals outside their professional activity, are affected by this law.

Many reasons can lead you to change mutual: seeking better health coverage, new health needs, a price better suited to your budget, etc.

Feel free to contact us if any further information is needed

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