What is a Complementary Health Insurance? : Types & Health Benefits

What is a Complementary Health Insurance? : Types & Health Benefits

Complementary health insurance is insurance that supplements social security benefits. This contract makes it possible to lighten your remaining dependents.

Complementary Health Insurance: We Explain Everything to You

Complementary health insurance, often called mutual health insurance, is a supplement to the health insurance reimbursement system. Health insurance allows you to have better medical coverage. The main advantage of this type of contract is that it will enable you to reduce your remaining costs for all your medical expenses.

What is mandatory health coverage?

All people who are affiliated with the general health insurance scheme, benefit from partial reimbursement of their medical expenses. The coverage of the insured corresponds to a rate of the conventional tariff.

The insured must therefore pay the remaining sums. This is the “moderator ticket”. And for certain medical care or for certain services, such as optical care, dental care, or even excess fees, the bill can quickly climb.

Why do I need to take complementary health insurance?

Also called health insurance or mutual health insurance, complementary health supplements are the basic guarantees of compulsory health coverage. In this sense, complementary health insurance offers much more complete coverage, it allows you to be truly protected against the unexpected. It is possible to take out the health insurance contract with an insurance company, a mutual insurance company, or a provident institution.

Is it mandatory?

An individual subscription is not an obligation, but it is nevertheless strongly recommended if you do not wish to spend all your budget on healthcare costs.

However, if you are employed, your boss will be obliged to offer you complementary collective health insurance. Know that your children and your spouse can also benefit from this membership.

What are the differences between mutual and complementary health insurance?

The mutuals are governed by the Mutuality Code. These are non-profit private law legal persons. Their operation is based on a system of solidarity financing carried out thanks to the contributions of the members. A mutual is managed by a volunteer administrator who has been elected by the members.

Conversely, complementary health insurance is an insurance contract that is offered by several types of organizations such as insurers for example.

What are the guarantees of complementary health?

It should be understood that not all complementary health contracts offer the same guarantees or the same levels of reimbursement.

The level of support can be very different from one formula to another or from one company to another.

For a basic contract, coverage will concern:
• medical consultations;
• medicines to be obtained from pharmacies on presentation of a prescription;
• hospitalization costs;
• dental care;
• optical care.

The most extensive covers make it possible to obtain a better level of coverage and additional guarantees such as the reimbursement of excess fees, for example.

What is the price of complementary health insurance?

As an insured, you must pay a premium, the amount of which will depend on your level of coverage. Different factors can influence the prices of your complementary health insurance.

For income, age, and professional situation, we advise you to compare the different offers available in order to select the contract that offers you the best guarantees at the best price. Remember that your contract should meet your needs.

What should I know about refunds?

In the event that the healthcare professional accepts third-party payment in his office, you will not have to advance any money. Social Security and your complementary health insurance will make the reimbursement directly.

If the doctor does not accept third-party payment, you will have to advance the medical expenses. Via the Vitale card, Social Security and your mutual health insurance will be informed of the payment and the organizations will reimburse you within 5 days.

What is complementary health insurance?

Complementary health care (CMU) is financial assistance that allows you to pay your medical expenses if you have very little or no income. Depending on your resources, complementary health insurance will cost you nothing or it will cost you less than 1 euro per day and per person. This solidarity health insurance can cover all the members of your household.

Lena Sunderland

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