All about Getting Mutual Health Insurance
Since reimbursements from Social Security are not always sufficient to cover the health expenses incurred, subscribing to mutual health insurance is essential to benefit from better coverage of medical expenses.
But how to take out health insurance adapted to your profile, your needs and your budget? Here are all our tips for choosing the right complementary health insurance!
Subscribing to mutual health insurance: the criteria to take into account to choose the best contract
The operation of insurance can often seem complex, especially in terms of complementary health.
This is why any subscription assumes a good understanding of the proposed contract.
Read also: Can we do without Mutual Health Insurance?
A mutual health contract is indeed composed of several important elements, which it is imperative to know and compare before making your choice:
The levels of reimbursement for each guarantee and in particular the reimbursement of excess fees;
The waiting period, ie the period during which the insured cannot benefit from certain guarantees of the contract. Some contracts also provide for temporary limitations of guarantees;
the insured then benefits from the guarantee but the level of reimbursement is lower than the level subscribed for a certain period.
These waiting or limitation periods begin when the guarantees take effect, and last between 1 and 3 months depending on the contract.
But some offers offer contracts with no waiting period and no limitations.
Guarantee exclusions , which are therefore situations and treatments not covered by complementary health insurance.
To take out the best health insurance possible, you must also take into account your profile and, depending on it, the different levels of reimbursement to be targeted.
A good mutual is often an à la carte contract : it is only effective if it is personalized!
So take the time to take stock of your needs regarding:
Medical consultations: do you often go to your doctor? Do you consult specialist physicians with significant fee overruns?
Optical care: do you wear glasses or contact lenses, do you need to have your lenses changed regularly?
Dental care: do you wear braces, or do you need special care?
Hospitalization: do you have an illness or pathology requiring you to be hospitalized regularly? Are you planning surgery soon?
But also, depending on your age and your health habits, hearing aids or even natural medicine and prevention…
The answers to these questions will allow you to define the priority health posts , for which you need high coverage, and those for which a minimum reimbursement will be sufficient.
To do this, rely on the advice of a mutual health professional (broker or other intermediary).
Buying health insurance online : a good idea?
Yes ! More and more insurers offer the possibility of subscribing to a mutual health insurance contract entirely online , without having to travel or print a file. An ease that should not lead to rush.
Any subscription must be the subject of an in-depth analysis of the guarantees and the price offered, and the health insurance contract must be carefully compared to other offers.
If you regret your choice, know that you most often have a withdrawal period of 14 days from the date of signature of your contract (this point must be indicated to you when subscribing).
Beyond that, you will have to wait until the end of its 1st year to be able to benefit from the possibilities of termination in terms of mutual health insurance.
Is mutual health insurance compulsory?
Legally, mutual health insurance is only compulsory for employees in the private sector . Indeed, since 2016, the latter must imperatively adhere to the collective contract offered by their employer.
However, some situations are exceptions, and exempt you from subscribing to your company’s mutual insurance:
You are already covered by your spouse’s health insurance on a compulsory basis;
You are a beneficiary of Complementary Health Solidarity;
You have a very part-time contract (15 hours per week maximum);
You are on fixed-term contract or in apprenticeship.
If you are in one of these cases, then you can refuse to join your company’s mutual insurance company, especially if you feel that it does not meet your needs.
And as for the self-employed, civil servants, students, the unemployed or retirees, taking out complementary health insurance is not an obligation.
But beware: doing without mutual health insurance exposes you to having to bear the cost of health costs not covered by Social Security or poorly reimbursed!
Indeed, Social Security reimbursements very rarely cover all health costs, and excess fees are never covered by the latter.
Subscribing to mutual health insurance is therefore essential to be well reimbursed.
And to benefit from the “zero remaining charge” system, particularly in terms of optics, dental or hearing aids, having complementary health insurance is also essential.
Can we subscribe to several mutual health insurance?
Does your company’s health insurance only offer you a minimum care basket, which is not suited to your needs? Know that it is possible to take out several health insurances!
If you have joined your company’s collective contract, you can also take out individual health insurance with more advantageous guarantees.
This second mutual insurance contract will then supplement the reimbursements of your collective contract, within the limit of the health costs incurred.
Read also: Tax Credit and Common Health Insurance Terms
If you are not a private sector employee and have already subscribed to individual mutual insurance, you can also subscribe to what is called additional health insurance;
and benefit from reimbursements in addition to those of your first mutual insurance company.
Be careful, however, to take stock of your needs, because the supplementary health insurance has a cost;
and only intervenes after the reimbursement of the Social Security and the support of your first mutual insurance company.
If your health insurance company reimburses you for all of the rest, your supplementary health insurance will not intervene and will then be totally superfluous.