All workers generally subscribe to compulsory health insurance, also known as social security. However, its coverage can be insufficient, as it generally reimburses only 70% of medical expenses; what’s more, some treatments can be quite expensive while others can result in fee overruns, causing unexpected heavy financial burdens. Faced with such a precarious situation, it has become essential for everyone to take out a health insurance policy.
Unlike health insurance, the subscription of a mutual health insurance is optional. As such, its contributions are fixed, while those of social security depend mainly on the employee’s income. Social security only covers risks related to illness, maternity and personal and professional accidents. Other care is not covered by this insurance, so it is up to the mutual health insurance company to cover them: dental prostheses, optical and ophthalmologic care, etc. This is why it is also called complementary health insurance.
For every worker in a company, there is the mutual health insurance for salaried employees subscribed on a collective basis for all employees. It is generally obligatory even if some derogations may allow the employee to be exempted from it. However, this does not prevent you, as an employee, from opting for an individual supplementary health insurance, i.e. a mutual insurance company other than the one subscribed to by your company.
Concerning the reimbursement terms and conditions, if your health establishment accepts the third-party payer, your insurance company can immediately proceed with the payment; otherwise, you will have to advance the costs and be reimbursed afterwards.
There are two dilemmas when it comes to choosing a health insurance company: which formula should you choose and which insurance company should you choose? On the one hand, choosing a mutual health insurance company means clearly outlining your needs. To do so, explicitly define your profile, specifying your age, gender, family situation, health history, etc. This will allow you to make a point of honour of the guarantees you need: coverage for dependents, reimbursement of excess fees, specific care based on a hereditary disease, hospitalization coverage, etc. In addition, your budget must be taken into account, as it is the amount you can pay per month as a monthly contribution that will determine your level of protection and the rate of reimbursement.
To find the insurance company with the plan that best suits your needs, it’s a good idea to talk to an insurance broker or consult an insurance comparator. This will help you to better identify the offers in the various contracts and the possible scams they may conceal.
Freedom of choice is one of the main advantages of individual supplementary health insurance. Indeed, you have a great deal of leeway in terms of options and the scope of coverage. By combining the guarantees of the health insurance with those of the complementary health insurance, it is entirely possible for you to be fully covered from a health point of view.
As for the company supplementary health insurance, the employee is exempted from part of the monthly contribution because he shares this burden with his employee. In other words, if you are an employee with a group supplementary health insurance plan, you can make huge savings on health coverage. In short, subscribing to an individual or group mutual health insurance plan is a long-term investment that allows any insured person to benefit from the best care when they need it.