Complementary health insurance: how does it work?

Complementary health insurance makes it possible to compensate for health expenses and medical costs not covered by Social Security, such as hospitalization costs, consultations with specialist doctors, excess fees, or even medical expenses. optical or dental. To be well protected in the event of illness, it is essential to subscribe to a good complementary mutual insurance company.

The guarantees offered

To begin with, you should know that the guarantees offered by complementary health insurance are not all the same. However, the operation of a supplementary health insurance remains the same. Health insurance covers health costs according to an agreed rate fixed for each medical procedure. It is important to compare the different formulas offered and to subscribe to the complementary one that best meets the needs of the family.

For example, the hospitalization formula covers all the costs associated with a stay in hospital, such as the cost of a single room, the hospital package or telephone and television costs. Complementary health insurance can also reimburse part of the expenses incurred for dental appliances, contact lenses or glasses. The repayment rate will also have to be taken into account. If it is 100% for a given service, this means that the co-payment is covered by the complementary. As a reminder, it is not supported by Social Security. As a result, the complementary health insurance reimburses the full agreement rate. Nevertheless, it is not uncommon to see companies offering reimbursement rates of 150%, 200% or even 300%. In this case, the excess fees that some health professionals may practice are covered.

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The fastest and most practical solution to know precisely the amount of your future repayments is to carry out an online simulation. Some health supplements like Apreva, for example, allow you to do this. It’s a real plus!

Medical expenses covered

By presenting your affiliation card to a complementary health insurance, certain medical expenses can be paid directly without having to be advanced. This is the case during hospitalization, the purchase of medication, examinations in a radiology office or laboratory analyses. It may happen that professionals refuse to take the mutual insurance card. In this case, the costs must be paid in advance. Reimbursement is then made by bank transfer.

An individual or collective subscription

A supplementary contract can be taken out individually or collectively, via the company. In this case, the contracts offered are often much more interesting than the contracts taken out individually. The reimbursements of employees who require health costs are quickly amortized by the contributions of employees who do not have health problems. Therefore, at an equivalent rate, the guarantees are often more attractive with a collective contract than an individual contract. In addition, the employer participates, generally up to 50%, in the payment of contributions. It should be noted that since January 1, 2016, the employer is obliged to offer employees who do not benefit from it a minimum collective coverage of health costs.

How much does it cost ?

The price of a complementary health is not the same for everyone. It depends on several criteria: the personal situation of the subscriber, his age, his place of residence… Someone who lives in town will be more likely to consult practitioners who practice fee overruns. Age is also a very important factor. The older the insured, the more the amount of his complementary increases. The reason is simple: an older person will have greater health needs than a younger person.

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Complementary health insurance is absolutely not compulsory. But a health problem can happen at any time and lead to high expenses. This is why it is wise to take out mutual insurance.

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